As a global public health concern, parasitic diseases have been a great threat to human health for a long period of time. Following decades of integrated control efforts, the incidence of soil-transmitted and food-borne parasitic diseases has been remarkable reduced in most endemic foci of China, and is now low across the country. However, there are still multiple factors affecting the transmission of soil-transmitted and food-borne parasitic diseases, which pose multiple challenges to parasitic diseases surveillance in the new era. This article analyzed the current status and challenges of soil-transmitted and food-borne parasitic diseases surveillance in Jiangsu Province, a low-endemicity area, and proposed countermeasures to tackle the challenges, so as to provide insights into key parasitic diseases surveillance in the new era.

Objective To explore the protective mechanism of baicalin regulating NOD like receptor thermal protein domain associated protein 3(NLRP3)inflammasomes against acne.Methods Compound acne models were prepared by intradermal injection of Propionibacterium acnes into the auricle.Rats were randomly divided into control group(normal rats were given physiological saline by gavage),model group(acne model rats were given physiological saline by gavage),experimental-L,-M,-H groups(acne model rats were given 25,50,and 100 mg·kg-1 of baicalin by gavage),and positive control group(acne model rats were given 3.125 mg·kg-1 of isotretinoin by gavage),with 10 rats in each group.Observe the morphology of rat auricles;enzyme linked immunosorbent assay(ELISA)was used to detect the level of inflammation in serum;hematoxylin-eosin staining was used to detect pathological changes in rat auricle tissue;Western blotting was used to detect the protein expression level in the auricle tissue.Results After drug treatment,the auricular thickness of rats in the control,model,experimental-H and positive control groups were(0.42±0.05),(0.75±0.10),(0.49±0.05)and(0.50±0.05)mm;the serum levels of tumor necrosis factor-α were(20.46±2.13),(62.32±5.47),(23.27±2.26)and(25.41±2.28)pg·mL-1;interleukin-1 β levels were(11.38±1.26),(31.62±2.58),(15.61±1.35)and(16.72±1.38)pg·mL-1;interleukin-6 levels were(10.62±1.02),(25.43±2.51),(13.27±1.15)and(14.01±1.17)pg·mL-1;NLRP3 protein expression levels in auricular tissues were 0.23±0.03,0.81±0.08,0.30±0.04 and 0.32±0.04;and Caspase-1 protein expression levels were 0.31±0.04,0.76±0.08,0.39±0.04 and 0.41±0.04;matrix metalloproteinase-2 protein expression levels were 0.35±0.04,0.86±0.10,0.40±0.05 and 0.42±0.05.Compared with the model group,the above indexes in the experimental-H group were statistically significant(all P＜0.05).Conclusion Baicalin can inhibit the inflammatory response in acne rats,and its mechanism of action may be related to the inhibition of the NLRP3 inflammasome signaling pathway.

Adaptive immunity is a critical component of the human immune system, playing an essential role in identifying antigens and orchestrating a tailored immune response. This review delves into the significant strides made in the development of epitope prediction tools, their integration into vaccine design, and their pivotal role in enhancing immunotherapy strategies. The review emphasizes the transformative potential of these tools in refining our understanding and application of immune responses. Adaptive immunity distinguishes itself from innate immunity by its ability to recognize specific antigens and remember past infections, leading to quicker and more effective responses upon subsequent exposures. This facet of immunity involves complex interactions between various cell types, primarily B cells and T cells, which recognize distinct epitopes presented by antigens. Epitopes are small sequences or configurations on antigens that are recognized by the immune receptors on B cells and T cells, acting as the focal points of immune recognition and response. Epitopes can be broadly classified into two types: linear (or sequential) epitopes and conformational (or discontinuous) epitopes. Linear epitopes consist of a sequence of amino acids in a protein that are recognized by B cells and T cells in their primary structure form. Conformational epitopes, on the other hand, are formed by spatially distinct amino acids that come together in the tertiary structure of the protein, often recognized by the immune system only when the protein folds into its native conformation. The role of epitopes in the immune response is critical as they are the primary triggers for the activation of B cells and T cells. When an epitope is recognized, it can stimulate B cells to produce antibodies, mobilize helper T cells to secrete cytokines, or prompt cytotoxic T cells to kill infected cells. These actions form the basis of the adaptive immune response, tailored to eliminate specific pathogens or infected cells effectively. The prediction of B cell and T cell epitopes has evolved with advances in computational biology, leading to the development of several sophisticated tools that utilize a variety of algorithms to predict the likelihood of epitope regions on antigens. Tools employing machine learning methods, such as support vector machines (SVMs), XGBoost, random forest, analyze large datasets of known epitopes to classify new sequences as potential epitopes based on their similarity to known data. Moreover, deep learning has emerged as a powerful method in epitope prediction, leveraging neural networks capable of learning high-dimensional data from vast amounts of immunological inputs to identify patterns that may not be evident to other predictive models. Deep learning models, such as convolutional neural networks (CNNs), recurrent neural networks (RNNs) and ESM protein language model have demonstrated superior accuracy in mapping the nonlinear relationships inherent in protein structures and epitope interactions. The application of epitope prediction tools in vaccine design is transformative, enabling the development of epitope-based vaccines that can elicit targeted immune responses against specific parts of the pathogen. These vaccines, by focusing the immune response on highly specific regions of the pathogen, can offer high efficacy and reduced side effects. Similarly, in cancer immunotherapy, epitope prediction tools help identify tumor-specific antigens that can be targeted to develop personalized immunotherapeutic strategies, thereby enhancing the precision of cancer treatments. The future of epitope prediction technology appears promising, with ongoing advancements anticipated to enhance the precision and efficiency of these tools further. The integration of broader immunological data, such as patient-specific immune profiles and pathogen variability, along with advances in AI and machine learning, will likely drive the development of more adaptive, robust, and clinically relevant prediction models. This will not only improve the effectiveness of vaccines and immunotherapies but also contribute to our broader understanding of immune mechanisms, potentially leading to breakthroughs in the treatment and prevention of multiple diseases. In conclusion, the development and refinement of epitope prediction tools stand as a cornerstone in the advancement of immunological research and therapeutic design, highlighting a path toward more precise and personalized medicine. The ongoing integration of computational models with experimental immunology holds the promise of revolutionizing our approach to combating infectious diseases and cancer.

Objective To investigate the prevalence of Enterobius vermicularis infections among children in China from 2016 to 2021, so as to provide insights into enterobiasis control and formulation of the enterobiasis control strategy among children. Methods Publications pertaining to the prevalence of E. vermicularis infections among children were retrieved from Wanfang Data, CNKI, VIP and PubMed databases published from January 2016 to June 2023. Eligible publications were screened according to inclusion and exclusion criteria, and the publication bias was evaluated using the assessment tool for prevalence studies proposed by the Joanna Briggs Institute Evidence-Based Practice Resources in Australia. The study period, study areas, study subjects, sample size and number of infections were extracted from publications, and a pooled analysis was performed using a meta-analysis. A meta-regression analysis was performed with the prevalence of E. vermicularis infections as an independent variable, and sample size, source of samples, study area, study method, geographical area and province as dependent variables to identify the source of the study heterogeneity. Results A total of 66 studies were included, covering 23 provinces (municipalities, autonomous regions) in China, and with the investigations conducted between 2016 and 2021. Meta-analysis showed that the pooled prevalence of E. vermicularis infections was 4.5% [95% confidence interval (CI): (3.1%, 6.0%)] among children in China from 2016 to 2021, and the annual prevalence was 4.1% [95% CI: (2.2%, 6.5%)], 4.2% [95% CI: (2.4%, 6.6%)], 4.2% [95% CI: (2.2%, 6.8%)], 3.2% [95% CI: (1.5%, 5.4%)], 2.3% [95% CI: (0.9%, 4.3%)] and 1.1% [95% CI: (0.4%, 2.1%)] from 2016 to 2021. The pooled prevalence of E. vermicularis infections was 4.9% [95% CI: (3.4%, 6.8%)] in studies with a sample size of < 5 000 cases, which was higher than that in studies with a sample size of 5 000 cases and higher [2.1%, 95% CI: (0.2%, 3.6%)], and the pooled prevalence of E. vermicularis infections was 5.2% [95% CI: (2.9%, 8.2%)] among subjects from schools, which was higher than that among subjects from communities [4.2%, 95% CI: (2.7%, 6.0%)]. The pooled prevalence of E. vermicularis infections was 4.4% [95% CI: (2.8%, 6.2%)] among children included in comprehensive surveillance, which was higher than that among children included in specific surveillance [4.8%, 95% CI: (2.6%, 7.7%)], and the pooled prevalence of E. vermicularis infections was 5.7% [95% CI: (3.8%, 7.8%)] among children included in county-level surveys, which was higher than that among children included in city-[4.8%, 95% CI: (2.3%, 8.0%)] and province-level surveys [1.8%, 95% CI: (0.3%, 4.7%)]. In addition, the pooled prevalence of E. vermicularis infections was higher among children in southern China [11.3%, 95% CI: (7.5%, 15.7%)] than that in central China [5.2%, 95% CI: (2.8%, 8.2%)], eastern China [5.2%, 95% CI: (2.8%, 8.2%)] and southwestern China [2.6%, 95% CI: (1.4%, 4.1%)]. Meta-regression analysis identified geographical area and survey province as factors affecting the study heterogeneity. Conclusions Currently, the overall prevalence of E. vermicularis infections is moderate among children in China, and the prevalence varies greatly in regions, with a high prevalence rate in southern China and presence of small-scale clusters. Enterobiasis surveillance and health education pertaining to enterobiasis control are required with adaptations to local circumstance to reduce the prevalence of E. vermicularis infections among children.

ObjectiveTo observe the effect of Yangyin Xifeng Tongluo Formula （养阴熄风通络方） and its core herbs combination on prevention of ventricular precontraction （PVC）. MethodsExperiment 1： Forty SD rats were randomly divided into model group， formula group， core herb-pairs medium-dose group and amiodarone group， with 10 rats in each group. Rats in the model group were given 10 ml/（kg·d） of pure water by gavage， rats in the formula group were given 1.125 g/（kg·d） of Yangyin Xifeng Tongluo Granules （养阴熄风通络方颗粒） by gavage， rats in the core herb-pairs medium-dose group were given 0.585 g/（kg·d） of granules of core herb-pairs by gavage， and rats in the amiodarone group were given 18 mg/（kg·d） of amiodarone hydrochloride tablets by gavage. The rats in each group were gavaged once a day for 14 consecutive days， and then a PVC model was established using rat tail vein injection of aconitine 25 μg/kg to compare the mortality and incidence of PVC， ventricular tachycardia （VT） and ventricular fibrillation （VF）， the time of the appearance of PVC， and the duration of PVC in the rats in each group. Experiment 2： Sixty SD rats were randomly divided into model group， the amiodarone group， and the core herb-pairs of low， medium and high dose groups， 12 rats in each group. Rats in the model group were gavaged with 10 ml/（kg·d） of purified water， rats in the low， medium， and high dose groups were gavaged with 0.2925， 0.585， and 1.17 g/（kg·d） of the core herb-pairs granules respectively， and rats in the amiodarone group were gavaged with 18 mg/（kg·d） of amiodarone hydrochloride tablets. All of them were gavaged once a day. After 14 days， rats in each group were injected intravenously into the tail vein with aconitine 25 μg/kg， and then the rats in each group were observed to show the mortality and incidence of PVC， VT and VF， and the time of appearance and duration of PVC. ResultsExperiment 1： Compared with the model group， The difference in the incidence of PVC in rats of all groups was not statistically signi-ficant （P＞0.05）， and the mortality and incidence of VT and VF in rats in the formula group， the core herb-pairs medium-dose group， and the amiodarone group significantly reduced， with delayed time of the occurrence of PVC and shorter duration of the PVC （P＜0.05 or P＜0.01） as compared with the model group， whereas the difference between each group with medication intervention was not statistically significant （P＞0.05）. Experiment 2： There was no statistically significant difference in the incidence of PVC in all groups （P＞0.05）， and the mortality and incidence of VT and VF reduced in the core herb-pairs of low-， medium-， and high-dose groups and in the amiodarone group， and the appearance of PVC delayed and its duration shortened （P＜0.05 or P＜0.01） as compared with the control group， whereas the differences were not statistically significant in the comparison among groups with medication （P＞0.05）. ConclusionBoth Yangyin Xifeng Tongluo Formula and its core herb-pairs could delay the time of occurrence and shorten the duration of PVC.

ObjectiveTo retrospectively analyze the clinical efficacy of Xibining Ⅱ prescription in the treatment of knee osteoarthritis with cold-dampness blockage syndrome by oral medication and to explore the influencing factors of endpoint events. MethodA real-world retrospective cohort design was adopted， and medical records of knee osteoarthritis patients with cold-dampness blockage syndrome treated with oral medication from the orthopedics outpatient department of Jiangsu Province Hospital of Chinese Medicine were collected. All patients received conventional Western medicine treatment and were divided into non-exposure group （573 cases） and exposure group （427 cases） according to whether or not they received treatment with Xibining Ⅱ prescription. Descriptive analysis of the baseline data of the 1 000 screened cases was performed using IBM SPSS 27.0. According to the baseline data， 334 pairs were matched using the propensity score matching method， resulting in a total of 668 cases in both groups. The changes in visual analogous scale （VAS）， Western Ontario and McMaster Universities Osteoarthritis Index （WOMAC） total score， Japanese Knee Osteoarthritis Measure （JKOM） score， and traditional Chinese medicine （TCM） syndrome score before treatment and at 2， 6， 12 weeks after treatment， as well as the incidence of adverse reactions， were compared between the two groups. A multivariate logistic regression analysis was conducted to analyze the influencing factors of endpoint events， with clinical cure judged based on the improvement rate of WOMAC total score before and after treatment. ResultAfter 12 weeks of treatment， compared to the results before treatment， the VAS， WOMAC total score， JKOM score， and TCM syndrome score of patients in both groups significantly decreased （P<0.01）. Compared to the non-exposure group， the exposure group showed a more significant reduction in VAS， WOMAC total score， JKOM score， and TCM syndrome score （P<0.01）. After 12 weeks of treatment， the clinical cure rate and significant efficiency were higher in the exposure group than in the non-exposure group （P<0.05）. Compared to the results before treatment within each group， VAS， WOMAC pain， stiffness， function scores， JKOM score， and TCM syndrome score significantly decreased at 2， 6， 12 weeks after treatment in both groups （P<0.01）. Compared to the non-exposure group at the same time points， the exposure group showed a reduction in VAS at 2， 12 weeks， WOMAC pain at 6， 12 weeks， and function scores at 12 weeks （P<0.05， P<0.01）. The JKOM score decreased at 6， 12 weeks， and the TCM syndrome score significantly decreased at 2， 6， 12 weeks in the exposure group （P<0.05， P<0.01）. Multivariate logistic regression analysis at 12 weeks showed that factors affecting clinical cure included the course of disease， history of alcohol consumption， hypertension， coronary heart disease， and the use of Xibining Ⅱ prescription （P<0.05， P<0.01）. Compared to the non-exposure group at the same time points， the incidence of epigastric discomfort in the exposure group was lower at 2， 12 weeks （P<0.01）， the incidence of diarrhea and vomiting was slightly higher than that in the non-exposure group， but the difference was not statistically significant. ConclusionThe clinical application of Xibining Ⅱ prescription combined with conventional Western medicine treatment in the treatment of knee osteoarthritis with cold-dampness blockage syndrome is more effective than conventional Western medicine treatment alone. It can significantly reduce VAS， WOMAC total score， JKOM score， and TCM syndrome score， with more pronounced long-term effects and a low incidence of adverse reactions.

Objective To establish the method of fingerprint and content determination of multi-component for Xiangsha Yangwei pill by gas chromatography(GC).Methods The GC fingerprint of Xiangsha Yangwei pill was found,and the peak attribution was carried out.The contents of limonene,eucalyptol,camphor,borneol,bornyl acetate,patchouli alcohol,pogostone,and α-cyperone were determined.Results The fingerprint similarity of 56 batches of Xiangsha Yangwei pill were 0.33-0.99,28 common peaks were confirmed,and 14 known components were identified.Limonene,eucalyptol,camphor,borneol,bornyl acetate,patchouli alcohol,pogostone and α-cyperone showed good linearity within the determined ranges(14.30-286.08,24.52-490.44,16.14-322.88,9.40-187.95,15.39-307.83,25.78-515.60,19.95-398.90,and 24.87-497.30 μg·mL-1).The average recoveries were 101.20％,97.90％,93.97％,94.23％,102.94％,100.54％,99.16％,and 98.31％;with the RSDs were 2.41％,1.48％,1.65％,2.00％,1.93％,2.30％,2.07％,and 2.38％,respectively.The concentrations of eight components were 0.2-959.1,0.3-420.4,1.0-542.6,0.0-64.5,0.0-364.2,0.0-339.6,0.0-130.7,0.0-82.0 μg·g-1,respectively.Conclusion The fingerprint and multi-component determination method can be used for the quality control and evaluation of Xiangsha Yangwei pill.

OBJECTIVE To study the effect of fluoropezil on embryo-fetal developmental toxicity and toxicokinetics in rabbits,and provide reference for clinical medication.METHODS According to the sequence of pregnancy,pregnant rabbits were divided into five groups:vehicle control group(1%hydroxy-propyl methylcellulose+1.5%polyethylene glycol 400 aqueous solution),positive control group(cyclo-phosphamide 18 mg·kg-1),and fluoropezil(3.6,9.0 and 22.5 mg·kg-1)groups.The vehicle control group and the fluoropezil groups were ig administrated on the 6th to 18th day of gestation(GD6-18)while the positive control group was ig given cyclophosphamide on GD6-20.The pregnant rabbits were sacri-ficed on GD28,and the embryo-fetal development was detected.Sex hormone levels of pregnant rabbits on GD5,GD18 and GD28 were detected by ELISA method.Blood samples with toxokinetics were collected for concomitant toxic generation at the first and last administration,and drug concentrations in fetal,placenta and amniotic fluid were detected with liquid chromatography tandem mass spectrometry(LC-MS/MS).RESULTS Fluoropezil 3.6,9.0 and 22.5 mg·kg-1 had no significant effect on body mass,mass gain,food consumption,pregnancy outcomes,fetal appearance,viscera,skeletal and physical growth and development of pregnant rabbits.Only on GD18 or GD28,the levels of follicle stimulating hormone,estra-diol and progesterone in each dose group fluctuated to some extent.The combined toxokinetics results indicated that fluoropezil could cross the placental barrier of the rabbits,but did not accumulate in preg-nant rabbits or fetuses.Fetal mass,crown-rump length and uterus mass in the cyclophosphamide group were lower than those in the vehicle control group.The appearance and bone of the cyclophos-phamide group were positive.CONCLUSION The no observed adverse effect level(NOAEL)of fluoro-pezil toxicity on rabbit embryo-fetal development is 22.5 mg·kg-1,which is 125 times of the effective dose.At the dosage level of 22.5 mg·kg-1,Cmax is 1093 μg·L-1,and AUC(0-24 h)6650 μg·h·L-1 on GD18.

Objective:To report the results of national surveillance on the distribution and antimicrobial resistance profile of clinical Gram-negative bacteria isolates from bloodstream infections in China in 2022.Methods:The clinical isolates of Gram-negative bacteria from blood cultures in member hospitals of national bloodstream infection Bacterial Resistant Investigation Collaborative System（BRICS）were collected during January 2022 to December 2022. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute（CLSI）. WHONET 5.6 and SPSS 25.0 software were used to analyze the data.Results:During the study period，9 035 strains of Gram-negative bacteria were collected from 51 hospitals，of which 7 895（87.4%）were Enterobacteriaceae and 1 140（12.6%）were non-fermenting bacteria. The top 5 bacterial species were Escherichia coli（ n=4 510，49.9%）， Klebsiella pneumoniae（ n=2 340，25.9%）， Pseudomonas aeruginosa（ n=534，5.9%）， Acinetobacter baumannii complex（ n=405，4.5%）and Enterobacter cloacae（ n=327，3.6%）. The ESBLs-producing rates in Escherichia coli， Klebsiella pneumoniae and Proteus spp. were 47.1%（2 095/4 452），21.0%（427/2 033）and 41.1%（58/141），respectively. The prevalence of carbapenem-resistant Escherichia coli（CREC）and carbapenem-resistant Klebsiella pneumoniae（CRKP）were 1.3%（58/4 510）and 13.1%（307/2 340）；62.1%（36/58）and 9.8%（30/307）of CREC and CRKP were resistant to ceftazidime/avibactam combination，respectively. The prevalence of carbapenem-resistant Acinetobacter baumannii（CRAB）complex was 59.5%（241/405），while less than 5% of Acinetobacter baumannii complex was resistant to tigecycline and polymyxin B. The prevalence of carbapenem-resistant Pseudomonas aeruginosa（CRPA）was 18.4%（98/534）. There were differences in the composition ratio of Gram-negative bacteria in bloodstream infections and the prevalence of main Gram-negative bacteria resistance among different regions，with statistically significant differences in the prevalence of CRKP and CRPA（ χ2=20.489 and 20.252， P<0.001）. The prevalence of CREC，CRKP，CRPA，CRAB，ESBLs-producing Escherichia coli and Klebsiella pneumoniae were higher in provinicial hospitals than those in municipal hospitals（ χ2=11.953，81.183，10.404，5.915，12.415 and 6.459， P<0.01 or <0.05），while the prevalence of CRPA was higher in economically developed regions（per capita GDP ≥ 92 059 Yuan）than that in economically less-developed regions（per capita GDP <92 059 Yuan）（ χ2=6.240， P=0.012）. Conclusions:The proportion of Gram-negative bacteria in bloodstream infections shows an increasing trend，and Escherichia coli is ranked in the top，while the trend of CRKP decreases continuously with time. Decreasing trends are noted in ESBLs-producing Escherichia coli and Klebsiella pneumoniae. Low prevalence of carbapenem resistance in Escherichia coli and high prevalence in CRAB complex have been observed. The composition ratio and antibacterial spectrum of bloodstream infections in different regions of China are slightly different，and the proportion of main drug resistant bacteria in provincial hospitals is higher than those in municipal hospitals.

ObjectiveTo explore the syndrome elements and evolving patterns of patients with hepatitis B virus-related acute on chronic liver failure （HBV-ACLF） at different stages. MethodsClinical information of 1,058 hospitalized HBV-ACLF patients， including 618 in the early stage， 355 in the middle stage， and 85 in the late stage， were collected from 18 clinical centers across 12 regions nationwide from January 1， 2012 to February 28， 2015. The “Hepatitis B-related Chronic and Acute Liver Failure Chinese Medicine Clinical Questionnaire” were designed to investigate the basic information of the patients， like the four diagnostic information （including symptoms， tongue， pulse） of traditional Chinese medicine （TCM）， and to count the frequency of the appearance of the four diagnostic information. Factor analysis and cluster analysis were employed to determine and statistically analyze the syndrome elements and patterns of HBV-ACLF patients at different stages. ResultsThere were 76 four diagnostic information from 1058 HBV-ACLF patients， and 53 four diagnostic information with a frequency of occurrence ≥ 5% were used as factor analysis entries， including 36 symptom information， 12 tongue information， and 5 pulse information. Four types of TCM patterns were identified in HBV-ACLF， which were liver-gallbladder damp-heat pattern， qi deficiency and blood stasis pattern， liver-kidney yin deficiency pattern， and spleen-kidney yang-deficiency pattern. In the early stage， heat （39.4%， 359/912） and dampness （27.5%， 251/912） were most common， and the pattern of the disease was dominated by liver-gallbladder damp-heat pattern （74.6%， 461/618）； in the middle stage， dampness （30.2%， 187/619） and blood stasis （20.7%， 128/619） were most common， and the patterns of the disease were dominated by liver-gallbladder damp-heat pattern （53.2%， 189/355）， and qi deficiency and blood stasis pattern （27.6%， 98/355）； and in the late stage， the pattern of the disease was dominated by qi deficiency （26.3%， 40/152） and yin deficiency （20.4%， 31/152）， and the patterns were dominated by qi deficiency and blood stasis pattern （36.5%， 31/85）， and liver-gallbladder damp-heat pattern （25.9%， 22/85）. ConclusionThere are significant differences in the distribution of syndrome elements and patterns at different stages of HBV-ACLF， presenting an overall trend of evolving patterns as "from excess to deficiency， transforming from excess to deficiency"， which is damp-heat → blood stasis → qi-blood yin-yang deficiency.