Objective:To analyze the epidemic characteristics and trends of visceral leishmaniasis (VL) in Shaanxi Province, and provide a basis for formulating control strategies.Methods:The information on VL cases in Shaanxi Province from January 2012 to December 2024 were obtained from the Shaanxi Provincial Infectious Disease Reporting Management System, and demographic data were collected from the Shaanxi Statistical Yearbook. Descriptive epidemiological method was used to analyze the prevalence and the distribution by the three dimensions (time, region, and population). Joinpoint 4.9.1.0 software and Geoda 1.6 software were used for regression analysis and spatial clustering analysis, respectively. SuperMap 8C software was used for visualization.Results:From January 2012 to December 2024, a total of 304 cases of VL were reported in Shaanxi Province, with an annual incidence rate of 0.06/100 000. VL cases occurred in all months of the year in Shaanxi Province with no significant seasonality, yet the onset was predominantly concentrated from April to August(52.30%, 159/304). The majority of cases were male (61.51%, 187/304), aged 5 months to 4 years (17.11%, 52/304), and farmers (67.11%, 204/304). A total of 54 districts (counties, cities) of 10 cities in the province had reported cases, mainly concentrated in Weinan City (49.34%, 150/304). Joinpoint regression analysis revealed a significant overall upward trend in the VL incidence rate in Shaanxi Province from 2012 to 2024 [average annual percent change (AAPC) = 12.60%, 95% confidence interval ( CI): 6.01% - 19.62%, t = 3.95, P < 0.001]. The year 2020 was identified as a turning point in the trend. The incidence rate showed a rapid upward trend from 2012 to 2020 [annual percent change (APC) = 23.75%, 95% CI: 13.33% - 35.12%, t = 5.62, P < 0.001]. Global spatial autocorrelation analysis indicated significant positive spatial autocorrelation in VL incidence in 2012, 2014, 2015, 2018, and 2022 (Moran's I > 0, Z > 1.96, P < 0.05). Local spatial autocorrelation analysis identified 12 "high-high" clustering areas from 2012 to 2024, mainly located in Shangluo City in southern Shaanxi Province, and Weinan City and Yan'an City in northern Shaanxi Province. Conclusions:From 2012 to 2024, VL cases in Shaanxi Province are predominantly male farmers. The incidence of VL shows an overall upward trend, with significant spatial clustering. The prevention and control situation is severe. It is imperative to strengthen control measures, including vector disinfection and health education, to effectively control the spread and transmission of VL.

Objective:To evaluate the efficacy of peroral super minimally invasive incision for esophageal diverticulum.Methods:The clinical data of patients with esophageal diverticulum who underwent super minimally invasive surgery (SMIS) at the First Medical Center of the PLA General Hospital from April 2022 to September 2024 were retrospectively analyzed. These data include clinical baseline data, endoscopic surgical parameters, preoperative and postoperative Eckardt scores, surgical costs, and the duration of hospitalization.Results:Thirteen patients successfully completed submucosal tunneling endoscopic septum division (STESD) surgery without any postoperative adverse events. The duration of operation was (37.00 ± 5.82) min, the application time of proton pump inhibitors (PPI) was 4 (4, 4) d, the application time of antibiotics was 3 (2, 4) d, the surgical cost was 22 580 (27 044, 34 255) yuan, and the hospital stay was 12 (10, 22) d. The Eckardt scores before and after the operation were 3 (2, 4) scores and 1 (0, 1) score respectively, the Eckardt score after the operation decreased significantly compared with that before the operation.Conclusions:STESD is a safety and efficient operation for the treatment of esophageal diverticulitis. It has the advantages of short term curative effect and obvious improvement of the patient′s symptoms.

Objective:To analyze the epidemic characteristics and trends of visceral leishmaniasis (VL) in Shaanxi Province, and provide a basis for formulating control strategies.Methods:The information on VL cases in Shaanxi Province from January 2012 to December 2024 were obtained from the Shaanxi Provincial Infectious Disease Reporting Management System, and demographic data were collected from the Shaanxi Statistical Yearbook. Descriptive epidemiological method was used to analyze the prevalence and the distribution by the three dimensions (time, region, and population). Joinpoint 4.9.1.0 software and Geoda 1.6 software were used for regression analysis and spatial clustering analysis, respectively. SuperMap 8C software was used for visualization.Results:From January 2012 to December 2024, a total of 304 cases of VL were reported in Shaanxi Province, with an annual incidence rate of 0.06/100 000. VL cases occurred in all months of the year in Shaanxi Province with no significant seasonality, yet the onset was predominantly concentrated from April to August(52.30%, 159/304). The majority of cases were male (61.51%, 187/304), aged 5 months to 4 years (17.11%, 52/304), and farmers (67.11%, 204/304). A total of 54 districts (counties, cities) of 10 cities in the province had reported cases, mainly concentrated in Weinan City (49.34%, 150/304). Joinpoint regression analysis revealed a significant overall upward trend in the VL incidence rate in Shaanxi Province from 2012 to 2024 [average annual percent change (AAPC) = 12.60%, 95% confidence interval ( CI): 6.01% - 19.62%, t = 3.95, P < 0.001]. The year 2020 was identified as a turning point in the trend. The incidence rate showed a rapid upward trend from 2012 to 2020 [annual percent change (APC) = 23.75%, 95% CI: 13.33% - 35.12%, t = 5.62, P < 0.001]. Global spatial autocorrelation analysis indicated significant positive spatial autocorrelation in VL incidence in 2012, 2014, 2015, 2018, and 2022 (Moran's I > 0, Z > 1.96, P < 0.05). Local spatial autocorrelation analysis identified 12 "high-high" clustering areas from 2012 to 2024, mainly located in Shangluo City in southern Shaanxi Province, and Weinan City and Yan'an City in northern Shaanxi Province. Conclusions:From 2012 to 2024, VL cases in Shaanxi Province are predominantly male farmers. The incidence of VL shows an overall upward trend, with significant spatial clustering. The prevention and control situation is severe. It is imperative to strengthen control measures, including vector disinfection and health education, to effectively control the spread and transmission of VL.

Objective:To evaluate the efficacy of peroral super minimally invasive incision for esophageal diverticulum.Methods:The clinical data of patients with esophageal diverticulum who underwent super minimally invasive surgery (SMIS) at the First Medical Center of the PLA General Hospital from April 2022 to September 2024 were retrospectively analyzed. These data include clinical baseline data, endoscopic surgical parameters, preoperative and postoperative Eckardt scores, surgical costs, and the duration of hospitalization.Results:Thirteen patients successfully completed submucosal tunneling endoscopic septum division (STESD) surgery without any postoperative adverse events. The duration of operation was (37.00 ± 5.82) min, the application time of proton pump inhibitors (PPI) was 4 (4, 4) d, the application time of antibiotics was 3 (2, 4) d, the surgical cost was 22 580 (27 044, 34 255) yuan, and the hospital stay was 12 (10, 22) d. The Eckardt scores before and after the operation were 3 (2, 4) scores and 1 (0, 1) score respectively, the Eckardt score after the operation decreased significantly compared with that before the operation.Conclusions:STESD is a safety and efficient operation for the treatment of esophageal diverticulitis. It has the advantages of short term curative effect and obvious improvement of the patient′s symptoms.

ObjectiveTo investigate the therapeutic effect of Qinggongtang in regulating Glu/GABA metabolic balance and the mechanism of its anxiolytic effect on rat models of anxiety. MethodFifty-four rats were randomly divided into normal， model， diazepam （0.225 mg·kg^-1）， and low-dose， medium-dose， and high-dose groups of Qinggongtang （5.085， 10.17， 20.34 g·kg^-1）， with nine rats in each group. Except for the normal group， the other groups were subjected to indeterminate vacutainer stress and chronic restraint stress for 12 days to prepare the anxiety model. On the 3^rd day of the stress， 10 days of corresponding drug intervention was started. At the end of the drug treatment， the anxiety level of rats in each group was evaluated by the elevated cross maze experiment （EPM） and the light and dark box experiment （LDB）， and the effect of Qinggongtang on the anxiety behavior of rats was preliminarily analyzed. The levels of Glu and GABA in the amygdala tissue of the rats were detected by enzyme linked immunosorbent assay （ELISA）， and the changes in the synaptic ultrastructure of the amygdala of the rats in each group were observed by electron microscopy. The mRNA expression of glutamic acid decarboxylase （GAD65 and GAD67）， glutamine synthetase （GS）， and glutamate transporter-1 （GLT-1） in the amygdala were detected by Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）， and their protein expression was detected by Western blot. ResultCompared with those in the normal group， rats in the model group showed an obvious anxiety state and dull yellow and lusterless fur. They were irritable， easy to anger， and preferred to curl up in the corner. The number of times the EPM entered the open arm and the residence time in the open arm were significantly reduced （P<0.01）， and the residence time in the open box and the number of times the LDB went through the box were significantly reduced （P<0.01）. The content of Glu in the amygdala was increased （P<0.01）， and the content of GABA was reduced （P<0.01）. The value of Glu/GAB was elevated （P<0.01）， and the number of synaptic and pre-synaptic membrane vesicles in the amygdala was decreased. Sparse dense material in the post-synaptic membrane， increased synaptic gap， slightly disrupted internal structure， and decreased mRNA and protein expressions of GAD65， GAD67， GS， and GLT-1 in the amygdala were observed （P<0.01）. Compared with those in the model group， rats in the medium-dose and high-dose groups of Qinggongtang and the diazepam group had bright fur， sensitive reactions， and more active behavior. The number of times EPM entered the open arm and the residence time in the open arm increased significantly （P<0.01）， and the residence time in the open box and the number of times the LDB went through the box increased significantly （P<0.01）. The content of Glu in all-dose groups of Qinggongtang and the diazepam group decreased （P<0.05， P<0.01）， while GABA content increased （P<0.05， P<0.01）. The value of Glu/GABA decreased （P<0.01）， and the internal and external synaptic structure of each groups of Qinggongtang and the diazepam group was more complete. Synapses and vesicles were numerous， and the synaptic gap was more clearly defined. The efficacy of the high-dose group of Qinggongtang and the diazepam group was the best， and the mRNA and protein expressions of GAD65， GAD67， GS， and GLT-1 in the amygdala were increased in the high-dose group of Qinggongtang and diazepam group （P<0.05， P<0.01）. ConclusionQinggongtang can improve synaptic plasticity and affect the expression of GAD65， GAD67， GS， and GLT-1 in the amygdala of rats to regulate Glu/GABA metabolic balance and thus exert anxiolytic effects.

Humans ; Paraproteinemias ; Polycythemia

The choice of treatment in locally advanced cervical carcinoma is a hot topic in the controversy of treatment for gynecology tumor.The three primary therapies for locally advanced cervical carcinoma are concurrent chemotherapy and radiotherapy,direct radical hysterectomy and operation after radiotherapy.This article mainly discusses several types of treatment and advises personalized treatment for locally advanced cervical carcinoma.

Clinical data indicated that the fallopiantube may be related to high-level serous ovarian cancer.Current studies show that prophylactic bilateral sal-pingectomy can reduce the risk of ovarian cancer inpremenopausal women and it has been used as a pri-mary prevention of ovarian cancer.In recent years,much more attention has been paid to the value ofprophylactic bilateral salpingectomy in preventingovarian cancer.We will discuss the value of prophy-lactic bilateral salpingectomy and its effect on ovarianfunction.