This study was aimed at exploring the epidemic characteristics and spatio-temporal evolution patterns of severe fever with thrombocytopenia syndrome(SFTS)in Henan Province from 2011 to 2022,to provide a reference for prevention and control ef-forts.Data on SFTS in Henan Province from 2011 to 2022 were collected from the Information Management System for Infectious Dis-ease Reporting,and epidemiological characteristics and spatio-temporal evolution patterns were investigated through spatial autocorre-lation analysis,standard deviation ellipse analysis,and spatial-centered transfer curves,on a district-county basis.From 2011 to 2022,a total of 5 471 SFTS cases associated with 81 deaths were reported in Henan Province.The incidence rate showed an increasing trend(χ2trend=23.24,P<0.001),and the average annual incidence was 0.4 677/100 000.The case-fatality rate showed a decreasing trend from 2011 to 2019(χ2trend=8.86,P=0.003),but an increasing trend from 2020 to 2022(χ2trend=12.93,P<0.001).The average an-nual case-fatality rate was 1.48%.The peak incidence period was from May to July;this period accounted for 58.75%of the total cases.Females(59.39%),individuals 60-80 years old(55.40%),and farmers(96.64%)were the high prevalence groups.The disease was distributed primarily in Xinyang City,and Shangcheng County had the highest incidence rate(27.411 8/100 000).Spatial aggregation was observed in the southeastern region(Moran's I>0,P<0.001),and the disease centers were all located in Guangshan County,Xin-yang City,and showed southeast-northwest-southeast-northwest-southeast-northeast-southwest movement during the 12-year pe-riod.In conclusion,from 2011 to 2022,SFTS in Henan Province had a high incidence in May to July,and females,older people,and farmers were the high-risk groups.Spatial aggregation was observed in the southeastern region,along with spread to surrounding areas.Xinyang City is therefore a key area for the prevention and control of SFTS.

This paper reported a case of fetal congenital chloride diarrhea (CCD) indicated by prenatal ultrasound and confirmed by whole-exome sequencing. At 26 weeks and two days of gestation, a routine prenatal ultrasound revealed fetal bowel dilation and numerous floating echogenic particles in the amniotic fluid, suggesting the possibility of CCD. Multiple follow-up ultrasounds in late pregnancy showed persistent bowel dilation, polyhydramnios with numerous floating echogenic particles, and fetal development larger than the gestational age. Whole-exome sequencing and Sanger validation revealed two compound heterozygous mutations in the fetal SLC26A3 gene: c.2006C>A (p.S669*) inherited from the mother and c.1355T>A (p.L452Q) inherited from the father, leading to a diagnosis of CCD. Postnatally, the infant exhibited persistent watery diarrhea. Based on prenatal ultrasound and diagnostic results, the infant was immediately given intravenous and oral electrolyte supplementation after birth, preventing severe electrolyte imbalance. As of June 2024, the infant was five months old, with follow-up showing good growth and development.

This paper reported a case of fetal congenital chloride diarrhea (CCD) indicated by prenatal ultrasound and confirmed by whole-exome sequencing. At 26 weeks and two days of gestation, a routine prenatal ultrasound revealed fetal bowel dilation and numerous floating echogenic particles in the amniotic fluid, suggesting the possibility of CCD. Multiple follow-up ultrasounds in late pregnancy showed persistent bowel dilation, polyhydramnios with numerous floating echogenic particles, and fetal development larger than the gestational age. Whole-exome sequencing and Sanger validation revealed two compound heterozygous mutations in the fetal SLC26A3 gene: c.2006C>A (p.S669*) inherited from the mother and c.1355T>A (p.L452Q) inherited from the father, leading to a diagnosis of CCD. Postnatally, the infant exhibited persistent watery diarrhea. Based on prenatal ultrasound and diagnostic results, the infant was immediately given intravenous and oral electrolyte supplementation after birth, preventing severe electrolyte imbalance. As of June 2024, the infant was five months old, with follow-up showing good growth and development.

This study was aimed at exploring the epidemic characteristics and spatio-temporal evolution patterns of severe fever with thrombocytopenia syndrome(SFTS)in Henan Province from 2011 to 2022,to provide a reference for prevention and control ef-forts.Data on SFTS in Henan Province from 2011 to 2022 were collected from the Information Management System for Infectious Dis-ease Reporting,and epidemiological characteristics and spatio-temporal evolution patterns were investigated through spatial autocorre-lation analysis,standard deviation ellipse analysis,and spatial-centered transfer curves,on a district-county basis.From 2011 to 2022,a total of 5 471 SFTS cases associated with 81 deaths were reported in Henan Province.The incidence rate showed an increasing trend(χ2trend=23.24,P<0.001),and the average annual incidence was 0.4 677/100 000.The case-fatality rate showed a decreasing trend from 2011 to 2019(χ2trend=8.86,P=0.003),but an increasing trend from 2020 to 2022(χ2trend=12.93,P<0.001).The average an-nual case-fatality rate was 1.48%.The peak incidence period was from May to July;this period accounted for 58.75%of the total cases.Females(59.39%),individuals 60-80 years old(55.40%),and farmers(96.64%)were the high prevalence groups.The disease was distributed primarily in Xinyang City,and Shangcheng County had the highest incidence rate(27.411 8/100 000).Spatial aggregation was observed in the southeastern region(Moran's I>0,P<0.001),and the disease centers were all located in Guangshan County,Xin-yang City,and showed southeast-northwest-southeast-northwest-southeast-northeast-southwest movement during the 12-year pe-riod.In conclusion,from 2011 to 2022,SFTS in Henan Province had a high incidence in May to July,and females,older people,and farmers were the high-risk groups.Spatial aggregation was observed in the southeastern region,along with spread to surrounding areas.Xinyang City is therefore a key area for the prevention and control of SFTS.

Objective:To understand the epidemiological characteristics and spatial distribution of hemorrhagic fever with renal syndrome (HFRS) in Henan Province, and to provide a basis for the development of prevention and control measures.Methods:Data of reported cases with HFRS in Henan Province from January 2012 to December 2022 were obtained from the Chinese disease control and prevention information system subsystem infectious disease monitoring system. Descriptive epidemiological methods were used to analyze the temporal, regional, population distributions, and the type of clinical diagnoses of HFRS. The spatial clustering analyses were carried out at county level. Correlation analysis between different clinical diagnostic types and mortality rate was conducted using Pearson method.Results:A total of 2 843 HFRS cases were reported, with an average annual incidence rate of 0.26/100 000, and 49 cases died with a case-fatality rate of 1.72%. There were two peaks of incidence each year, which were fall and winter (from October to the next January) and late spring and summer peak (from May to July). Among the patients, 2 174(76.47%) were male and 2 294(80.69%) were farmers. The average ages of reported cases from 2012 to 2022 were 43.70 years, 45.44 years, 45.91 years, 48.33 years, 45.41 years, 48.53 years, 48.93 years, 48.87 years, 45.90 years, 51.27 years, and 50.89 years, respectively. There was a strong negative correlation between laboratory-confirmed cases and case fatality ( r=-0.652, P<0.001) , and a strong positive correlation between suspected cases, clinical-diagnosed cases and case fatality ( r=0.304, P=0.035 and r=0.623, P<0.001, respectively). A higher rate of case-fatality was found in areas with a lower number of reported cases. Case-fatality rate ranking among the top five counties were Weidong District (five cases of disease with two deaths), Muye District (three cases of disease with one death), Xinhua District (three cases of disease with one death), Shunhe Hui District (six cases of disease with one death), and Anyang County (53 cases of disease with six (11.32%) death). Global spatial autocorrelation analysis from 2012 to 2022 showed that the Moran′s I coefficients ranged from 0.138 to 0.326, and all of them had a correlation (all P<0.01). The high-high aggregation area was mainly concentrated in the confluence of Zhumadian City and Xinyang City in the south of Henan Province. Conclusions:In Henan Province, the reported cases of HFRS have been distributed throughout the province, with obvious spatio-temporal aggregation in some areas. The average age of reported cases shows a fluctuating upward trend. The rate of laboratory-confirmed diagnosis should be further improved in the high incidence areas.

Objective:To understand the epidemiological characteristics and spatial distribution of hemorrhagic fever with renal syndrome (HFRS) in Henan Province, and to provide a basis for the development of prevention and control measures.Methods:Data of reported cases with HFRS in Henan Province from January 2012 to December 2022 were obtained from the Chinese disease control and prevention information system subsystem infectious disease monitoring system. Descriptive epidemiological methods were used to analyze the temporal, regional, population distributions, and the type of clinical diagnoses of HFRS. The spatial clustering analyses were carried out at county level. Correlation analysis between different clinical diagnostic types and mortality rate was conducted using Pearson method.Results:A total of 2 843 HFRS cases were reported, with an average annual incidence rate of 0.26/100 000, and 49 cases died with a case-fatality rate of 1.72%. There were two peaks of incidence each year, which were fall and winter (from October to the next January) and late spring and summer peak (from May to July). Among the patients, 2 174(76.47%) were male and 2 294(80.69%) were farmers. The average ages of reported cases from 2012 to 2022 were 43.70 years, 45.44 years, 45.91 years, 48.33 years, 45.41 years, 48.53 years, 48.93 years, 48.87 years, 45.90 years, 51.27 years, and 50.89 years, respectively. There was a strong negative correlation between laboratory-confirmed cases and case fatality ( r=-0.652, P<0.001) , and a strong positive correlation between suspected cases, clinical-diagnosed cases and case fatality ( r=0.304, P=0.035 and r=0.623, P<0.001, respectively). A higher rate of case-fatality was found in areas with a lower number of reported cases. Case-fatality rate ranking among the top five counties were Weidong District (five cases of disease with two deaths), Muye District (three cases of disease with one death), Xinhua District (three cases of disease with one death), Shunhe Hui District (six cases of disease with one death), and Anyang County (53 cases of disease with six (11.32%) death). Global spatial autocorrelation analysis from 2012 to 2022 showed that the Moran′s I coefficients ranged from 0.138 to 0.326, and all of them had a correlation (all P<0.01). The high-high aggregation area was mainly concentrated in the confluence of Zhumadian City and Xinyang City in the south of Henan Province. Conclusions:In Henan Province, the reported cases of HFRS have been distributed throughout the province, with obvious spatio-temporal aggregation in some areas. The average age of reported cases shows a fluctuating upward trend. The rate of laboratory-confirmed diagnosis should be further improved in the high incidence areas.

Objective:To observe the influence of wogonin on colitis mice induced by dextran sulfate sodium (DSS) and explore the related mechanism.Methods:Eighteen C57BL/6 mice were randomly and equally divided into the control group, the model group and the treatment group. The water was given normally to mice in control group, and the 2.5% DSS drinking water was given to mice of other two groups for 7 days. Wogonin via intraperitoneal injection was administrated in the mice of treatment group on the second and the fourth day. The mice were sacrificed on the eighth day and specimens were collected. The pathological damage and inflammation degree of mice colon were evaluated by measuring the length of colon and using HE staining. Immunofluorescence was used to detect the infiltration of neutrophils in mice colon tissue. Wogonin of 25, 50, 100 μmol/L was applied to handle neutrophils from mice marrow tissue in vitro, and there was no treatment in the negative control group. The flow cytometry was used to detect the apoptosis of neutrophil. Western blot was used to detect the expressions of anti-apoptotic protein myeloid cell leukelia-1 (Mcl-1) and extracellular signal-regulated kinase (ERK) . Results:Compared with the model group, the mice colon length in the treatment group was significantly longer [ (7.80 ± 0.21) cm vs. (6.43 ± 0.10) cm, P<0.01], the pathological damage score of the colon tissue was significantly lower [ (6.83 ± 0.98) points vs. (14.33 ± 1.03) points, P<0.01], the number of infiltrative neutrophils in the colon of mice was significantly lower [ (8.52 ± 0.15) neutrophils per low power field vs. (29.43 ± 0.43) neutrophils per low power field, P<0.01]. The apoptosis rate of neutrophils were 6.41% ± 0.51%, 14.01% ± 0.81%, 20.89% ± 0.82%, 24.23% ± 0.29% in negative control group and 25, 50, 100 μmol/L wogonin groups. The apotosis rate of neutrophils increased constantly with the concentration of wogonin increasing gradually and there were significant differences among any two groups ( P<0.01) . Compared with the negative control group, the phosphorylated ERK expressions of neutrophils in 25, 50, 100 μmol/L wogonin groups were decreased obviously (all P<0.05) . The Mcl-1 expression of neutrophils declined constantly with the concentration of wogonin increasing gradually. Conclusion:Wogonin can induce the apoptosis of neutrophils in concentration-dependent manner, reduce the infiltration of neutrophils and relieve the intestinal damage in colon tissue of colitis mice, which may be regulated by the inhibition of ERK phosphorylation and decreased expression of Mcl-1 in concentration-dependent manner.

Objective:To observe the influence of wogonin on colitis mice induced by dextran sulfate sodium (DSS) and explore the related mechanism.Methods:Eighteen C57BL/6 mice were randomly and equally divided into the control group, the model group and the treatment group. The water was given normally to mice in control group, and the 2.5% DSS drinking water was given to mice of other two groups for 7 days. Wogonin via intraperitoneal injection was administrated in the mice of treatment group on the second and the fourth day. The mice were sacrificed on the eighth day and specimens were collected. The pathological damage and inflammation degree of mice colon were evaluated by measuring the length of colon and using HE staining. Immunofluorescence was used to detect the infiltration of neutrophils in mice colon tissue. Wogonin of 25, 50, 100 μmol/L was applied to handle neutrophils from mice marrow tissue in vitro, and there was no treatment in the negative control group. The flow cytometry was used to detect the apoptosis of neutrophil. Western blot was used to detect the expressions of anti-apoptotic protein myeloid cell leukelia-1 (Mcl-1) and extracellular signal-regulated kinase (ERK) . Results:Compared with the model group, the mice colon length in the treatment group was significantly longer [ (7.80 ± 0.21) cm vs. (6.43 ± 0.10) cm, P<0.01], the pathological damage score of the colon tissue was significantly lower [ (6.83 ± 0.98) points vs. (14.33 ± 1.03) points, P<0.01], the number of infiltrative neutrophils in the colon of mice was significantly lower [ (8.52 ± 0.15) neutrophils per low power field vs. (29.43 ± 0.43) neutrophils per low power field, P<0.01]. The apoptosis rate of neutrophils were 6.41% ± 0.51%, 14.01% ± 0.81%, 20.89% ± 0.82%, 24.23% ± 0.29% in negative control group and 25, 50, 100 μmol/L wogonin groups. The apotosis rate of neutrophils increased constantly with the concentration of wogonin increasing gradually and there were significant differences among any two groups ( P<0.01) . Compared with the negative control group, the phosphorylated ERK expressions of neutrophils in 25, 50, 100 μmol/L wogonin groups were decreased obviously (all P<0.05) . The Mcl-1 expression of neutrophils declined constantly with the concentration of wogonin increasing gradually. Conclusion:Wogonin can induce the apoptosis of neutrophils in concentration-dependent manner, reduce the infiltration of neutrophils and relieve the intestinal damage in colon tissue of colitis mice, which may be regulated by the inhibition of ERK phosphorylation and decreased expression of Mcl-1 in concentration-dependent manner.

Objective To study the platelet inhibition rate of foreign clopidogrel,domestic clopidogrel,combined domestic clopidogrel and tongxinluo and their effct on major adverse cardiovacular events (MACE) after PCI.Methods Two hundred and twenty patients after PCI were divided into foreign clopidogrel treatment group (n=77),domestic clopidogrel treatment group (n=80),combined domesticclopidogrel and tongxinluo treatment group (n =63).The high platelet reactivity (HPR) in 3 groups was detected by thrombelastography after PCI.The incidence of MACE in 3 groups was compared.Results The incidence of left anterior descending branch lesion was lower,the number of sacculi was smaller,and the incidence of HPR was higher in foreign clopidogrel treatment group than in domestic clopidogrel treatment group and combined domestic clopidogrel and tongxinluo treatment group after PCI (63.6％ vs 87.5％ vs 77.8％,P=0.002;2.3±1.1 vs 2.8±1.4 vs 2.7±1.5,P=0.026;24.7％ vs 21.3％ vs 11.1％,P=0.030).The incidence of HPR was significantly higher in foreign clopidogrel treatment group than in combined domestic clopidogrel and tongxinluo treatment group (24.7 ％ vs 11.1％,P =0.040).No significant difference was found in the incidence of MACE in 3 groups (P ＞ 0.05).Conclusion The incidences of MACE of domestic clopidogrel and foreign clopidogrel are similar.Combined clopidogrel and tongxinluo can improve the platelet inhibition rate after PCI.

Objective To evaluate the clinical characteristics of patients with adrenocorticotropin-independent macronodular adrenal hyperplasia (AIMAH).Methods A total of 10 AIMAH cases were enrolled in this retrospective study.The clinical and laboratory findings of all patients were collected and analyzed.Results All patients manifested some clinical features and biochemical evidence of Cushing's syndrome.The plasma adrenocorticotropic hormone (ACTH) level was undetectable in all the patients and their serum cortisol secretion rhythm was abnormal.Low and high-dose dexamethasone suppression tests failed to suppress the cortisol secretion.The bilateral macronodular adrenal enlargement was shown by CT/magnetic resonance imaging.The supine-upright posture test was positive in four patients.Three patients were performed bilateral adrenalectomy,five were unilateral adrenalectomy and the remaining two patients were taken propranolol.All the patients had followed up for 10 to 89 months.Contralateral adrenalectomy was performed in two patients with recurrent symptoms after unilateral adrenalectomy and two patients given propranolol were underwent bilateral adrenalectomy when their symptoms had not been improved or recurred.Conclusion AIMAH is a relatively rare subtype of Cushing's syndrome with unique clinical and laboratory findings.Propranolol is a good choice if the supine-upright posture test is positive.Unilateral adrenalectomy appears to be an effective and safe alternative treatment for AIMAH.Bilateral adrenalectomy could be performed if the symptoms have not been improved or recurred after unilateral adrenalectomy.