Objective: To understand the epidemiological characteristics of a pertussis outbreak in Guangzhou, so as to provide references for outbreak response and prevention strategies. Methods: From April 5 to June 9, 2024, case screening was conducted among 246 preschool children, 35 staff members, and one full time school nurse in a kindergarten in Guangzhou based on case definition. Field epidemiological investigation methods were employed to collect relevant information, and screening samples were collected from individuals involved in the outbreak. The clinical manifestations, epidemiological characteristics, and risk factors for transmission of the outbreak were analyzed, with rate comparisons performed using the χ 2 test. Results: There were a total of 15 confirmed cases of pertussis in the kindergarten. The main clinical manifestations included intermittent cough in 14 cases ( 93.33 %), sputum production in 5 cases (33.33%), fever in 2 cases (13.33%), paroxysmal spasmodic cough in 1 case (6.67%), and vomiting in 1 case (6.67%). There was no statistically significant difference in the reporting rates of interrupted cough symptoms between pertussis cases (93.33%) and non pertussis cases (92.86%)( χ 2=3.74, P >0.05). The cases were aged 4-5 years, including 5 males and 10 females. The interval between symptom onset and diagnosis ranged from 2 to 25 days, with a median of 10 days. The outbreak involved two classes, with attack rates of 48.28% and 3.45%, respectively. Laboratory testing confirmed 14 close contacts positive for Bordetella pertussisnucleic acid. Among close contacts, only one received prophylactic medication as required. Conclusion The outbreak is a pertussis outbreak in a kindergarten caused by Bordetella pertussis infection, demonstrating distinct temporal and spatial clustering characteristics.

A 34-year-old male patient was diagnosed with adult-onset Still's disease.After treatment with methylprednisolone and tocilizumab,the levels of aminotransferase and bilirubin increased significantly,and decreased to normal levels after drug withdrawal and liver protective treatment.After the patient was treated with methylprednisolone again,the aminotransferase and bilirubin levels significantly increased.The treatment was changed from methylprednisolone to prednisolone,the levels of aminotransferase and bilirubin decreased significantly,the patient's condition improved and was discharged.Using the Naranjo Assessment Scale score of 9 points,the causal relationship between severe liver injury and methylprednisolone in this patient can be judged as"very likely".Clinical pharmacists conducted a comprehensive analysis of patients'medication usage and provided evidence-based recommendations for subsequent treatment regimens,thereby serving as a valuable reference for promoting rational drug use in clinical practice.

Objective:To observe the diuretic effects of Zhuling Decoction on mice with adriamycin nephropathy (ADRN); To explore its mechanism.Methods:Totally 32 SPF male C57BL/6 mice were divided into a blank group of 7 mice and a model group of 25 mice using a random number table method. ADRN model was prepared by single tail vein injection of 0.01 g/kg of amphotericin. Two weeks later, the successfully modeled mice were divided into a model group (7 mice), a furosemide group (8 mice), and a Zhuling Decoction group (8 mice). The blank group and model group mice were given equal volumes of injection water by gavage. The furosemide group was given 2.6 mg/kg of furosemide by gavage, and the Zhuling Decoction group was given 6.5 g/kg of Zhuling Decoction by gavage, once a day, for 8 consecutive weeks. Changes in body weight and urine output of mice were observed. A biochemical analyzer was used to detect 24-hour urinary protein quantification and blood potassium and SCr levels in mice. HE staining was used to observe pathological changes in mouse kidneys, and immunohistochemistry and Western blot were used to detect the homology of cyclin dependent kinase 18 (CDK18), STIP1, and the expressions of U-box protein 1 (STUB1) and aquaporin 2 (AQP2) in mouse kidney tissue cells.Results:Compared with the model group, both the furosemide and Zhuling Decoction groups exhibited increased 24-hour urine output ( P<0.05); compared with the model group and furosemide group, Zhuling Decoction group showed reduced average optical density values and protein expressions of CDK18 and AQP2 ( P<0.05) and increased STUB1 average optical density value and protein expression ( P<0.05). Conclusion:Zhuling Decoction can increase 24-hour urine output in ADRN mice, and the mechanism may be related to down-regulation of CDK18 and AQP2 protein expressions and up-regulation of STUB1 protein expression, thereby modulating the CDK18/STUB1/AQP2 pathway and reducing water reabsorption.

Objective:To examine the longitudinal relationships between perceived social support,life satis-faction and acceptance by others among relocated residents for poverty alleviation.Methods:A two-wave longitudi-nal survey was conducted with 383 relocated residents from 39 resettlement communities in Guizhou Province,with a six-month interval.Participants completed the Perceived Social Support Scale(PSSS),the Acceptance by Others Scale of the Acceptance of others Scale(AOS),and the Satisfaction With Life Scale(SWLS).Results:T1 PSSS scores positively predicted T2 acceptance by others scores(β=0.20,P＜0.001).T2 acceptance by others scores positively predicted T2 SMLS scores(β=0.45,P＜0.001).Perceived acceptance by others fully mediated the lon-gitudinal relationship between perceived social support and life satisfaction(effect=0.09,95％CI:0.03-0.18).Conclusion:Perceived social support predicts life satisfaction of relocated residents for poverty alleviation through perceived acceptance by others.

Objective:To evaluate the efficacy and safety of Luofuoshan-Baicao oil (LBO) and wind medicated oil for the treatment of Aedes albopictus bites. Methods:A paired self-controlled study was conducted. Thirty-six healthy volunteers were recruited from Guangdong Provincial Hospital of Traditional Chinese Medicine from February 2023 to March 2023. Each participant's forearms were subjected to Aedes albopictus bites, with 3 bites on each arm. For the first 18 participants, LBO was applied to the left arm, and wind medicated oil to the right arm; for the latter 18 participants, wind medicated oil was applied to the left arm, and LBO to the right arm. The observation period was 24 hours. Within the first 3 hours after the mosquito bites, the topical agents were applied once every other hour for a total of 3 sessions, with an applicator centered on the bite site at a dose of approximately 50 μl, covering a skin area of about 2 cm in diameter; after 3 hours, participants applied the topical agents themselves until symptoms subsided or the 24-hour observation period ended. All subjects were followed up at the occurrence of skin lesions after mosquito bites, 0 to 3 hours after the first treatment, as well as 24 hours after the first treatment. During the follow-up, the effects of both topical agents on pruritus, erythema, papules, or wheals were evaluated, differences in treatment frequency were analyzed, and treatment-related adverse events were recorded. The time to disappearance of pruritus after treatment was statistically analyzed using Kaplan-Meier survival analysis, and intergroup differences were analyzed using the log-rank (Mantel-Cox) test. Two independent samples t-test was used for comparisons of other measurement data, and Pearson's chi-square test or Fisher's exact test was used for comparisons of count data between groups. Results:Within 3 hours after the first treatment, the time to initial disappearance of pruritus was significantly shorter in the LBO group (20.71 ± 1.92 min) than in the wind medicated oil group (28.30 ± 2.20 min, P < 0.05). The cumulative pruritus rate (the proportion of participants with pruritus among all participants) over time showed an overall stable fluctuation, and the cumulative pruritus rates at all observation points were significantly lower in the LBO group than in the wind medicated oil group ( P<0.05). After 3 hours of treatment, the mean values of changes in erythema diameters were 25.83 mm in the LBO group and 26.24 mm in the wind medicated oil group, while the mean values of changes in papule or wheal diameters were 8.25 mm in the LBO group and 9.18 mm in the wind medicated oil group; within 24 hours after the first treatment, the average time to disappearance of papules or wheals was 71.85 minutes in the LBO group and 73.01 minutes in the wind medicated oil group, while the average time to disappearance of erythema was 82.27 minutes in the LBO group and 84.86 minutes in the wind medicated oil group; there were no significant differences in the above observational indices between the two groups (all P > 0.05). The number of pruritus episodes within 24 hours of treatment was 56 in both the LBO group and wind medicated oil group, and the treatment frequency was 107 in both two groups; there were also no significant differences in the frequencies of pruritus episodes or treatment (both P > 0.05). No adverse events or reactions occurred during the trial. Conclusion:LBO was more effective than wind medicated oil in reducing the time to disappearance of pruritus after Aedes albopictus bites, with a high safety profile.

Objective To explore the interaction between estrogen-related receptor β(ERRB)gene rs12437118 polymorphism and serum 25-hydroxyvitamin D[25(OH)D]level on tuberculosis multidrug resistance in patients with pulmonary tuberculosis.Methods A total of 104 multidrug resistant tuberculosis(MDR-TB)patients admitted to People's Hospital of Xinjiang Uygur Autonomous Re-gion from January 2018 to December 2023 were selected as the MDR-resistant group,and 102 non-MDR-resistant tuberculosis pa-tients treated of People's Hospital in Xinjiang Uygur Autonomous Region during the same period were selected as the control group.The gene frequency was compared between the two groups.Multivariate Logistic regression was used to analyze the influencing factors of MDR.Multiple linear regression was used to analyze the association of ERRB gene rs12437118 polymorphism with mul-tidrug resistance and 25(OH)D.The interaction between ERRB gene rs12437118 genotype and 25(OH)D on multidrug resistance was analyzed by unconditional Logistic regression model.Results The frequencies of GG(50.96%)and AA(13.46%)genes in MDR group were significantly higher than those in control group(37.25%,9.80%),and the difference was statistically significant(χ2=6.296,P<0.05).There was no significant difference in the frequencies of G and A alleles between the two groups(χ2=1.163,P>0.05).Mul-tivariate Logistic regression analysis showed that age,place of residence,treatment history,smoking history,empty number,regular medication,occupation,rs12437118 G allele and 25(OH)D were all independent influencing factors on multidrug resistance(Wald χ2=0.873～3.152,all P<0.05).Multiple linear regression analysis showed that rs12437118 was significantly associated with MDR risk in allele model,additive model,dominant model and recessive model(all P<0.05).The results of interaction analysis showed that the effects of rs12437118 genotype G allele and 25(OH)D on multidrug resistance were interactive in additive and multiplica-tive models.Conclusion The effects of rs12437118 genotype G allele of ERRB gene and 25(OH)D on multidrug resistance in pulmonary tuberculosis patients interacted in additive model and multiplicative model,and the risk of multidrug resistance is higher when both exist together.

Objective:To evaluate the efficacy and safety of Luofuoshan-Baicao oil (LBO) and wind medicated oil for the treatment of Aedes albopictus bites. Methods:A paired self-controlled study was conducted. Thirty-six healthy volunteers were recruited from Guangdong Provincial Hospital of Traditional Chinese Medicine from February 2023 to March 2023. Each participant's forearms were subjected to Aedes albopictus bites, with 3 bites on each arm. For the first 18 participants, LBO was applied to the left arm, and wind medicated oil to the right arm; for the latter 18 participants, wind medicated oil was applied to the left arm, and LBO to the right arm. The observation period was 24 hours. Within the first 3 hours after the mosquito bites, the topical agents were applied once every other hour for a total of 3 sessions, with an applicator centered on the bite site at a dose of approximately 50 μl, covering a skin area of about 2 cm in diameter; after 3 hours, participants applied the topical agents themselves until symptoms subsided or the 24-hour observation period ended. All subjects were followed up at the occurrence of skin lesions after mosquito bites, 0 to 3 hours after the first treatment, as well as 24 hours after the first treatment. During the follow-up, the effects of both topical agents on pruritus, erythema, papules, or wheals were evaluated, differences in treatment frequency were analyzed, and treatment-related adverse events were recorded. The time to disappearance of pruritus after treatment was statistically analyzed using Kaplan-Meier survival analysis, and intergroup differences were analyzed using the log-rank (Mantel-Cox) test. Two independent samples t-test was used for comparisons of other measurement data, and Pearson's chi-square test or Fisher's exact test was used for comparisons of count data between groups. Results:Within 3 hours after the first treatment, the time to initial disappearance of pruritus was significantly shorter in the LBO group (20.71 ± 1.92 min) than in the wind medicated oil group (28.30 ± 2.20 min, P < 0.05). The cumulative pruritus rate (the proportion of participants with pruritus among all participants) over time showed an overall stable fluctuation, and the cumulative pruritus rates at all observation points were significantly lower in the LBO group than in the wind medicated oil group ( P<0.05). After 3 hours of treatment, the mean values of changes in erythema diameters were 25.83 mm in the LBO group and 26.24 mm in the wind medicated oil group, while the mean values of changes in papule or wheal diameters were 8.25 mm in the LBO group and 9.18 mm in the wind medicated oil group; within 24 hours after the first treatment, the average time to disappearance of papules or wheals was 71.85 minutes in the LBO group and 73.01 minutes in the wind medicated oil group, while the average time to disappearance of erythema was 82.27 minutes in the LBO group and 84.86 minutes in the wind medicated oil group; there were no significant differences in the above observational indices between the two groups (all P > 0.05). The number of pruritus episodes within 24 hours of treatment was 56 in both the LBO group and wind medicated oil group, and the treatment frequency was 107 in both two groups; there were also no significant differences in the frequencies of pruritus episodes or treatment (both P > 0.05). No adverse events or reactions occurred during the trial. Conclusion:LBO was more effective than wind medicated oil in reducing the time to disappearance of pruritus after Aedes albopictus bites, with a high safety profile.

Objective To explore the interaction between estrogen-related receptor β(ERRB)gene rs12437118 polymorphism and serum 25-hydroxyvitamin D[25(OH)D]level on tuberculosis multidrug resistance in patients with pulmonary tuberculosis.Methods A total of 104 multidrug resistant tuberculosis(MDR-TB)patients admitted to People's Hospital of Xinjiang Uygur Autonomous Re-gion from January 2018 to December 2023 were selected as the MDR-resistant group,and 102 non-MDR-resistant tuberculosis pa-tients treated of People's Hospital in Xinjiang Uygur Autonomous Region during the same period were selected as the control group.The gene frequency was compared between the two groups.Multivariate Logistic regression was used to analyze the influencing factors of MDR.Multiple linear regression was used to analyze the association of ERRB gene rs12437118 polymorphism with mul-tidrug resistance and 25(OH)D.The interaction between ERRB gene rs12437118 genotype and 25(OH)D on multidrug resistance was analyzed by unconditional Logistic regression model.Results The frequencies of GG(50.96%)and AA(13.46%)genes in MDR group were significantly higher than those in control group(37.25%,9.80%),and the difference was statistically significant(χ2=6.296,P<0.05).There was no significant difference in the frequencies of G and A alleles between the two groups(χ2=1.163,P>0.05).Mul-tivariate Logistic regression analysis showed that age,place of residence,treatment history,smoking history,empty number,regular medication,occupation,rs12437118 G allele and 25(OH)D were all independent influencing factors on multidrug resistance(Wald χ2=0.873～3.152,all P<0.05).Multiple linear regression analysis showed that rs12437118 was significantly associated with MDR risk in allele model,additive model,dominant model and recessive model(all P<0.05).The results of interaction analysis showed that the effects of rs12437118 genotype G allele and 25(OH)D on multidrug resistance were interactive in additive and multiplica-tive models.Conclusion The effects of rs12437118 genotype G allele of ERRB gene and 25(OH)D on multidrug resistance in pulmonary tuberculosis patients interacted in additive model and multiplicative model,and the risk of multidrug resistance is higher when both exist together.

Objective:To examine the longitudinal relationships between perceived social support,life satis-faction and acceptance by others among relocated residents for poverty alleviation.Methods:A two-wave longitudi-nal survey was conducted with 383 relocated residents from 39 resettlement communities in Guizhou Province,with a six-month interval.Participants completed the Perceived Social Support Scale(PSSS),the Acceptance by Others Scale of the Acceptance of others Scale(AOS),and the Satisfaction With Life Scale(SWLS).Results:T1 PSSS scores positively predicted T2 acceptance by others scores(β=0.20,P＜0.001).T2 acceptance by others scores positively predicted T2 SMLS scores(β=0.45,P＜0.001).Perceived acceptance by others fully mediated the lon-gitudinal relationship between perceived social support and life satisfaction(effect=0.09,95％CI:0.03-0.18).Conclusion:Perceived social support predicts life satisfaction of relocated residents for poverty alleviation through perceived acceptance by others.

A 34-year-old male patient was diagnosed with adult-onset Still's disease.After treatment with methylprednisolone and tocilizumab,the levels of aminotransferase and bilirubin increased significantly,and decreased to normal levels after drug withdrawal and liver protective treatment.After the patient was treated with methylprednisolone again,the aminotransferase and bilirubin levels significantly increased.The treatment was changed from methylprednisolone to prednisolone,the levels of aminotransferase and bilirubin decreased significantly,the patient's condition improved and was discharged.Using the Naranjo Assessment Scale score of 9 points,the causal relationship between severe liver injury and methylprednisolone in this patient can be judged as"very likely".Clinical pharmacists conducted a comprehensive analysis of patients'medication usage and provided evidence-based recommendations for subsequent treatment regimens,thereby serving as a valuable reference for promoting rational drug use in clinical practice.