Objective:To analyze the epidemiological and clinical features of infectious diseases of the central nervous system (CNS).Methods:A cross-sectional study and analysis were conducted to summarize the epidemiological and clinical characteristics of 9 918 patients with CNS infectious diseases, who were diagnosed and treated at 29 hospitals across China from January 1, 2001 to December 31, 2020. Data collected included demographic data, clinical manifestations, health economic indicators, and prognostic outcomes.Results:Among the 9 918 collected cases of CNS infectious diseases, 5 559 were male (56.0%) and 4 359 were female (44.0%), with an onset age of 38 (25, 53) years. Education level: slightly more junior high school education (2 651 cases, 26.7%), and less elementary school education and below (2 181 cases, 22.0%) were found. Occupational distribution: farmers were found predominant (3 215 cases, 32.4%), followed by workers (1 826 cases, 18.4%) and students (1 633 cases, 16.5%). Clinical manifestations: headache (6 074 cases, 61.2%), fever (5 869 cases, 59.2%) and positive meningeal irritation signs (2 273 cases, 22.9%) were the 3 most common clinical manifestations, followed by nausea and (or) vomiting (2 095 cases, 21.1%), impaired consciousness (2 077 cases, 20.9%), psychiatric symptom (1 866 cases, 18.8%) and epilepsy (1 627 cases, 16.4%), etc., and cranial nerve involvement was found in 669 cases (6.7%). Major pathogens included viruses in 6 814 cases (68.7%), Mycobacterium tuberculosis in 1 677 cases (16.9%), common bacteria in 864 cases (8.7%), fungi in 254 cases (2.6%), spirochetes of syphilis in 183 cases (1.8%), parasites in 121 cases (1.2%), and rickettsiae in 5 cases (0.1%). Urban-rural distribution: slightly more cases were found in the countryside (5 418 cases, 54.6%) than in the towns (4 500 cases, 45.4%). Distribution of onset by season: 2 412 cases (24.3%) fell ill in spring, 2 835 cases (28.6%) in summer, 2 187 cases (22.1%) in fall, and 2 484 cases (25.0%) in winter. Health economics: the duration of hospitalization was 15 (8, 27) days, and the cost of hospitalization was 1.53 (0.91, 3.02)×10 000 yuan. Prognosis: 9 531 cases (96.1%) were cured or improved, and 92 cases (0.9%) died. Conclusions:The pathogens responsible for CNS infectious diseases are predominantly viruses. Although the incidence is slightly higher during the summer months, the overall seasonal pattern is not particularly pronounced. These infections are more commonly observed in young and middle-aged males and present with a diverse range of clinical manifestations, contributing to a significant disease burden.

Objective:To analyze the epidemiological and clinical features of infectious diseases of the central nervous system (CNS).Methods:A cross-sectional study and analysis were conducted to summarize the epidemiological and clinical characteristics of 9 918 patients with CNS infectious diseases, who were diagnosed and treated at 29 hospitals across China from January 1, 2001 to December 31, 2020. Data collected included demographic data, clinical manifestations, health economic indicators, and prognostic outcomes.Results:Among the 9 918 collected cases of CNS infectious diseases, 5 559 were male (56.0%) and 4 359 were female (44.0%), with an onset age of 38 (25, 53) years. Education level: slightly more junior high school education (2 651 cases, 26.7%), and less elementary school education and below (2 181 cases, 22.0%) were found. Occupational distribution: farmers were found predominant (3 215 cases, 32.4%), followed by workers (1 826 cases, 18.4%) and students (1 633 cases, 16.5%). Clinical manifestations: headache (6 074 cases, 61.2%), fever (5 869 cases, 59.2%) and positive meningeal irritation signs (2 273 cases, 22.9%) were the 3 most common clinical manifestations, followed by nausea and (or) vomiting (2 095 cases, 21.1%), impaired consciousness (2 077 cases, 20.9%), psychiatric symptom (1 866 cases, 18.8%) and epilepsy (1 627 cases, 16.4%), etc., and cranial nerve involvement was found in 669 cases (6.7%). Major pathogens included viruses in 6 814 cases (68.7%), Mycobacterium tuberculosis in 1 677 cases (16.9%), common bacteria in 864 cases (8.7%), fungi in 254 cases (2.6%), spirochetes of syphilis in 183 cases (1.8%), parasites in 121 cases (1.2%), and rickettsiae in 5 cases (0.1%). Urban-rural distribution: slightly more cases were found in the countryside (5 418 cases, 54.6%) than in the towns (4 500 cases, 45.4%). Distribution of onset by season: 2 412 cases (24.3%) fell ill in spring, 2 835 cases (28.6%) in summer, 2 187 cases (22.1%) in fall, and 2 484 cases (25.0%) in winter. Health economics: the duration of hospitalization was 15 (8, 27) days, and the cost of hospitalization was 1.53 (0.91, 3.02)×10 000 yuan. Prognosis: 9 531 cases (96.1%) were cured or improved, and 92 cases (0.9%) died. Conclusions:The pathogens responsible for CNS infectious diseases are predominantly viruses. Although the incidence is slightly higher during the summer months, the overall seasonal pattern is not particularly pronounced. These infections are more commonly observed in young and middle-aged males and present with a diverse range of clinical manifestations, contributing to a significant disease burden.

Objective To investigate the clinical and cytogenetic characteristics of acute myeloid leukemia(AML)patients with NRAS mutations.Methods Newly diagnosed AML patients in our hospital from January 2020 to August 2022 were selected,and their clinical data were retrospectively analyzed.According to NRAS mutations,the patients were divided into NRAS mutation group and NRAS wild group.The clinical characteristics and cytogenetic differences were compared between the two groups.Results A total of 162 newly diagnosed AML patients were included in this study.There were 28 in NRAS mutation group and 134 in NRAS wild group.The peripheral white blood cell count of NRAS mutation group was significantly higher than that of NRAS wild type group(53.10×109/L vs 24.78×109/L,P<0.05).There were no significant differences in the hemoglobin level,platelet count or bone marrow blast cell count between the two groups(P>0.05).The coexisting gene mutation occurred in 25 patients(89.3%,25/28)in NRAS mutation group.The most common coexisting gene mutation was KRAS,with a mutation rate of 28.6%.Compared with NRAS wild group,NRAS mutation group was more likely to obtain KRAS mutations(P<0.05).There was no significant difference in other coexisting mutated genes between the two groups(P>0.05).The proportion of poor prognosis karyotype in the NRAS mutation group was 23.1%,which was significantly higher than that in NRAS wild group(P<0.05).The proportions of favorable and intermediate prognosis karyotypes in NRAS mutation group were 7.7%and 69.2%,respectively,which were not significantly different from those in NRAS wild group(P>0.05).Conclusion The incidence of NRAS mutation is 17.3%in AML patients in this study.Patients with NRAS mutation are more likely to have KRAS mutation and have a higher proportion of poor prognosis karyotype.

Objective:To discuss how to make the surgical strategy for tibial tubercle fracture associated with bicondylar tibial plateau fracture.Methods:Data of thirty-five patients of tibial tubercle fractures associated with bicondylar tibial plateau fractures who were treated from October 2014 to May 2018 were retrospectively analyzed. There were 26 males and 9 females with an average age of 37.6 years (range, 21-68 years). According to Schatzker classification in tibial plateau fracture, 16 cases were type V and 19 cases were type VI. According to the integrity of tibial tubercle fracture and cortical bone of the proximal tibia in bicondylar tibial plateau fracture, they were divided into four types: type A, tibial tubercle fracture fragment and cortical bone of the proximal tibia are both complete; type B, tibial tubercle fracture fragment is complete but cortical bone of the proximal tibia is comminuted; type C, tibial tubercle fracture fragment is comminuted but cortical bone of the proximal tibia is complete; type D, both of them are comminuted. The surgical approaches and fixation methods of all the tibial tubercle fractures were according to the four different types. There were 22 cases with type A and B that were treated via an anterolateral and a medial incision, 13 cases with type C and D were treated via an anterior midline and a medial incision. There were 4 cases belonging to type A fixed with lag screws singly, 18 cases with type B fixed with 1/4 tubular plates, 7 cases with type C and 6 cases with type D fixed by 1/4 tubular plates combined with lag screws.Results:Thirty-five patients were followed up for 16.8 months (range, 12-24 months). All fractures healed with an average time of 4.7 months (range, 3-6 months). Loss of reduction didn’t occur in 34 cases except one. According to Rasmussen radiographic evaluation, the average score was 14.1 (range, 10-18) and clinical outcomes were rated with excellent in 11 cases, good in 19, fair in 5. The excellent and good rate was 85.7% (30/35) . The mean Hospital for Special Surgery (HSS) scores of all cases were 86.8 (range, 64-98) and the functional scores were excellent in 22 cases, good in 10 cases and fair in 3 cases with the excellent and good rate of 91.4% (32/35) . Surgical complications included fat liquefaction in 2 cases, superficial wound infection in 1, loosening of implant in 1and traumatic arthritis in 1.Conclusion:This kind of tibial tubercle fracture associated with bicondylar tibial plateau fracture is rare and special. Therefore, the preoperative plan should be made by considering the morphological features of the tibial tubercle fragments and the cortical bone of the proximal tibia. The middle longitude approach is the best way to expose tibial tubercle fragments which should be fixed with 1/4 tubularplate and/or lag screws.

Objective To compare the value of monoexponential and biexponential models in the preoperative evaluation of myometrial invasion in endometrial carcinoma.Methods 35 cases of endometrial carcinoma were examined by diffusion weighted imaging (DWI) with monoexponential model (b=0,800 s/mm2)and biexponential model (b=0,50,100,150,200,400,600,800,1 000,1 200,and 1 500 s/mm2),including 14 cases of deep myometrial invasion and 21 cases of non-deep myometrial invasion.The values of apparent diffusion coefficient (ADC),pure diffusion coefficient,perfusion related diffusion coefficient and the microvascular volume fraction were measured by the Matlab software.These parameters of two groups were compared and analyzed,respectively.Results The D value and the ADC value in the deep myometrial invasion group of endometrial carcinoma were lower than those in the non-deep myometrial invasion group,and the differences were statistically significant (both P<0.001).There was no significant difference between the two groups in the f value(P=0.600)and D?value(P=0.600).The AUC of ADC value and D value for the differential diagnosis of endometrial carcinoma with and without deep myometrial invasion were 0.9 1 3 and 0.9 6 9,respectively.Based on the Youden index and its corresponding optimal cut-point,the sensitivity of ADC value and D value were 90.48% and 100%,respectively,and the specificity of ADC value and D value were both 85.71% in differential diagnosis of endometrial carcinoma with and without deep myometrial invasion. Conclusion The ADC value in monoexponential model and the D value in biexponential model can be both used to evaluate deep myometrial invasion of endometrial carcinoma,among which D value is better.

OBJECTIVE:To observe clinical efficacy and safety of Xuebijing injection combined with octreotide and ulinastatin in the treatment of acute severe pancreatitis.METHODS:A total of 150 patients with acute severe pancreatitis admitted to emergency department of our hospital during Jan.2012-Jan.2016 were divided into control group,drug control group and observation group according to therapy method,with 50 cases in each group.All patients were treated with fasting,gastrointestinal decompression time,antibiotics,blood purification and other conventional treatment.Control group additionally received Cctreotide acetate injection 0.1 mg intravenously,tid,on the basis of conventional treatment.Drug control group additionally received Ulinastatin for injection 100 000 U added into 10％ Glucose injection 250 mL,ivgtt,bid,on the basis of control group.Observation group additionally received Xuebijing injection 100 mL added into 10％ Glucose injection 100 mL,ivgtt,bid,on the basis of drug control group.Three groups were treated for 10 days.The clinical indexes as fotal response rates,gastrointestinal decompression time,abdominal pain relief time,length of stay were observed in 3 groups.Related serum indexes (AMY,WBC,IL-6,CRP,TNF-α) before and after treatment and the occurrence of compliance during treatment were compared among 3 groups.RESULTS:The total response rate of observation group was 90.0％,which was significantly higher than 72.0％ of drug control group and 52.0％ of control group,with statistical significance (P＜0.05).The gastrointestinal decompression time,abdominal pain relief time and length of stay in observation group were significantly shorter than drug control group and control group,with statistical significance (P＜0.05).Before treatment,there was no statistical significance in the serum levels of AMY,WBC,IL-6,CRP or TNF-α among 3 groups (P＞0.05).After treatment,above serum indexes of 3 groups were decreased significantly,and observation group was significantly lower than the drug control group and control group,with statistical significance (P＜0.05).The incidence of ARDS,shock and acute renal failure in observation group were significantly lower than drug control group and control group,with statistical significance (P＜0.05).There was no statistical significance in the incidence of sepsis,abdominal abscess or MODS among 3 groups (P＞0.05).CONCLUSIONS:Xuebijing injection combined with octreotide and ulinastatin show significant therapeutic efficacy for acute severe pancreatitis,can effectively control inflammation progress,improve clinical symptoms and promote disease recovery with good safety.

Objective To study how to design the treatment plan to reduce the influence of respiratory movement and the dose of heart and lung as few as possible,to improve the dosage distribution in the target area after radical mastectomy of breast cancer.Methods Twelve patients with breast cancer after radical mastectomy were selected.A dose of 50 Gy with 2 Gy every day and 5 times per week was prescribed.Based on the treatment planning system (TPS),4-field intensity modulated radiotherapy (4FIMRT) and hybrid intensity modulated treatment planning 2-field conformal radiotherapy (2FCRT) + 4FIMRT were designed respectively.The two plans were compared from the aspects of target conformity index (CI),the homogeneity index (HI) and exposure dose volume delivered to organ at risk.Results According to the hybrid plan of 2FCRT + 4FIMRT,HI was 1.08±0.01,which was superior to that from 4FIMRT (1.11±0.01,t =9.587,P ＜ 0.05).While CI was 0.74±0.08,based on the plan of 2FCRT+4FIMRT,which was slightly lower than that from 4FIMRT (0.80±0.03,t =2.497,P ＜ 0.05).Considering the dose volumes on ipsilateral lung in two plans,the values of V5,V10,Dmean of 2FCRT+4FIMRT plan were significantly less than those of 4FIMRT plan.V5,V10,Dmean from the former plan were 13 ％,23 ％,7 ％ less than those from the latter plan (t =6.002,P ＜ 0.05;t =6.826,P ＜ 0.05;t =3.645,P ＜ 0.05).Meanwhile,Dmean of contralateral lung,Dmean of heart,Dmean and V5 of contralateral breast from the 2FCRT +4FIMRT plan were all lower than those of 4FIMRT plan.Those differences between two plans were statistically significant (P ＜ 0.05).Differences of V20 and V30 of ipsilateral lung,and V30 of heart between two plans did not make sense by the statistics analysis (P ＞ 0.05).Conclusion Hybrid radiotherapy theoretically reduces the influence of respiratory movement,improves the uniformity of target dose and lowers the risk of complications of radiation therapy on breast cancer.

Objective To explore the status and influencing factors of the rescue posttraumatic growth of Chinese people' s armed forces soldiers in order to provide a new point of view for psychological intervention.Methods 424 soldiers who had executed earthquake rescue task were assessed with Posttraumatic Growth Inventory (PTGI),and the growth status between different groups were compared.Results (1) The average score of PTGI 21 items ranged from 2.72-3.72,and the score of most items were above 3,which implied the growth degree was between middle change and more change.8 items with highest score were focused on three dimensions which were labeled interpersonal relationship,appreciation of life and personal strength.(2) There was no significant difference between the total score of different rank groups (F=0.885,P＞0.05),which score were 3.43±0.66,3.50±0.62,3.50±0.79,3.30±1.11 respectively.The was significant difference in 4 dimensions and total score of PTGI between the group which had executed rescue task for more than 14 days and the other which had executed rescue task for less than 14 days,and the scores of the group which had executed rescue task for more than 14 days were higher (P＜0.05 or 0.01).Conclusion Almost all rescue soldiers perceives mental growth,such as the changes of interpersonal relationship,attitude of life,and personal strength particularly.The duration of rescue task might be a influencing factor of posttraumatic growth.

OBJECTIVETo clone and sequence the cDNA of squalene epoxidase gene in Eleutherococcus senticosus.

METHODTotal RNA of E. senticosus was extracted by the improved isothiocyanate method and reverse transcripted into cDNA. The primers were designed depending on the reported SE cDNA sequences of Panax ginseng. The SE cDNAs in E. senticosus was amplified using RT-PCR strategy.

RESULTSequencing results showed two different cDNA fragments (SE1, SE2) with 1665, 1629 bp each ORF which encoded 554,542 amino acids, respectively. The identities of nucleotides and amino acids between SE1, SE2 were 91.49%, 92.55%. SE1, SE2 had the highest amino acids similarity to the SE1 of P. notoginseng, 93.45%, 94.87% respectively. SE1, SE2 both had a FAD binding domain. The deduced speculated amino acids of SE1, SE2 each had 2,4 membrane-spanning helices.

CONCLUSIONThe two SE sequences in E. senticosus were firstly separated and reported, which has made foundation for E. senticosus secondary metabolite engineering researches.

Amino Acid Sequence ; Cloning, Molecular ; DNA, Complementary ; chemistry ; genetics ; Eleutherococcus ; enzymology ; genetics ; Isoenzymes ; classification ; genetics ; Molecular Sequence Data ; Phylogeny ; Plant Proteins ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Sequence Analysis, DNA ; Sequence Homology, Amino Acid ; Squalene Monooxygenase ; classification ; genetics

OBJECTIVETo clone calmodulin (CaM) gene in Eleutherococcus senticosus, and study the effect of endophytic fungi on expression amount of CaM gene.

METHODThe CaM full length cDNA sequence was cloned by rapid amplification of cDNA ends (RACE). The gene was analyzed and corresponding structure and functions were predicted by the bioinformatics methods. The expression amount of CaM gene affected of endophytic fungus P116-1a, P116-1b, P1094 and P312-1 was detected by RT-PCR.

RESULTThe full length of CaM cDNA was 856 bp containing an ORF of 450 bp that encoded a protein of 149 amino acids. The homologous of predicted protein was almost 100% with plants like Panax ginseng and Daucus carota. RT-PCR results showed that endophytic fungus improved CaM expression amount significantly (P<0.05). The highest expression amount of CaM occurred 90 d after reinoculated with endophytic fungi P1094, up to 2.96 times of the control.

CONCLUSIONThe CaM gene of E. senticosus was successfully cloned for the first time. The results demonstrated that endophytic fungus of E. senticosus improved CaM expression amount significantly.

Calmodulin ; chemistry ; genetics ; metabolism ; Cloning, Molecular ; Eleutherococcus ; classification ; genetics ; metabolism ; microbiology ; Endophytes ; physiology ; Fungi ; physiology ; Gene Expression Regulation, Plant ; Molecular Sequence Data ; Phylogeny ; Plant Proteins ; chemistry ; genetics ; metabolism