Objective: To investigate the epidemiological characteristics and spatial-temporal clustering of severe fever with thrombocytopenia syndrome (SFTS) in Huai'an City, Jiangsu Province from 2011 to 2024, so as to provide a basis for optimizing local SFTS prevention and control strategies, and identifying high-risk areas and key populations. Methods: Data on SFTS incidence and deaths in Huai'an City from 2011 to 2024 were collected from the Infectious Disease Reporting Information System of the Chinese Disease Prevention and Control Information System. The reported incidence, mortality, and fatality rates were calculated. Descriptive analysis was performed on temporal, population, and regional distribution. The average annual percent change (AAPC) was used to analyze the trend in the reported incidence of SFTS. Global and local spatial autocorrelation analyses were employed to examine the spatial distribution patterns and spatial association patterns of SFTS incidence while spatio-temporal scanning analyses was used to assess the spatial-temporal clustering of SFTS. Results: A total of 337 SFTS cases were reported in Huai'an City from 2011 to 2024, with the reported incidence rising from 0.17/100 000 to 1.88/100 000. There were 20 deaths, with an average annual mortality of 0.03/100 000, and a fatality rate of 5.93%. The incidence showed obvious seasonality, with a peak in May and June (148 cases, accounting for 43.92%). Spring and summer accounted for 107 cases (31.75%) and 159 cases (47.18%), respectively. The reported SFTS cases were mainly male, farmers, and individuals aged ≥41 years, accounting for 56.38%, 79.23%, and 96.74%, respectively. The population distribution of death cases was basically consistent with that of incident cases. Xuyi County was a high-incidence area, with a total of 332 reported cases, accounting for 98.52%. All death cases were reported in this county. Spatial autocorrelation analyses revealed a positive spatial correlation in SFTS incidence from 2019 to 2024, with Moran's I values ranging from 0.214 to 0.336 (all P<0.05). Heqiao Town, Tianquanhu Town, and Guiwu Town in Xuyi County were identified as high-high clustering areas. Spatio-temporal scanning analyses showed that cluster 1 was consistent with the high-high clustering areas, with an aggregation time from the second quarter of 2019 to the second quarter of 2022. Conclusions From 2011 to 2024, the reported incidence of SFTS in Huai'an City showed an upward trend, with a high incidence in spring and summer. Males, farmers, and the middle-aged and elderly population were the key populations for prevention and control. Xuyi County was the key area for prevention and control.

Objective To analyze the epidemiological characteristics of hepatitis E (HE) in Huai'an City from 2015 to 2024, and construct and validate the prediction effect of the Seasonal Autoregressive Integrated Moving Average (SARIMA) model, and to provide a scientific basis for HE prevention and control. Methods Data of reported HE cases in Huai'an City from January 2015 to December 2024 were extracted from the National Disease Control and Prevention Information System. Descriptive epidemiological methods were used to analyze the temporal, regional and population distribution characteristics of HE incidence. After data preprocessing, stationarity test and randomness test, the SARIMA model was constructed. The optimal model was selected by minimizing the Akaike Information Criterion (AIC). The model performance was evaluated by adjusted R-squared (Adj R²) and root mean square error (RMSE). The monthly incidence rate of HE in Huai'an City in 2025 was predicted and compared with the actual incidence data to validate the model. Results A total of 1 713 HE cases were reported in Huai'an City from 2015 to 2024, showing a fluctuating upward trend. Huaiyin District (339 cases) and Lianshui County (334 cases) were high-incidence areas. The cases were mainly concentrated in people aged 45 and above (83.3%), males (gender ratio 2.37:1) and farmers (70.8%). The optimal model was SARIMA (1,1,1)×(2,0,1)₁₂, with residual as white noise sequence. There was no statistical difference between the actual incidence and predicted value from January to August 2025 (P>0.05). Conclusion HE incidence in Huai'an has obvious aggregation and temporal fluctuation characteristics. The SARIMA model has a good prediction effect, which can provide reference for formulating targeted prevention and control strategies.

ObjectiveTo explore the potential categories and characteristics of the public hospice care demand in Hainan Province， and analyze different potential types of influencing factors， so as to provide reference for relevant departments to improve the public awareness and demand of hospice care. MethodsUsing convenience sampling method， select 6484 cities of the public as the survey object， using the general data questionnaire， the hospice care demand questionnaire of the potential profile analysis， and analyze the influencing factors of the public hospice care demand category. ResultsThe characteristics of the hospice care demand in Hainan Province were divided into three potential categories： low demand group （14.19%）， medium demand group （49.99%） and high demand group （35.82%）. Multivariate analysis showed that gender， age， education level， cultural belief， and life-death education experience were the main influencing factors of public hospice care demand （p<0.05）. Males， those aged 41-60 years， and those with high school education or below had relatively lower hospice care demand， while those with life-death education experience had relatively higher demand. ConclusionRelevant departments should focus on hospice care knowledge popularization and demand enhancement for males， middle-aged groups， and people with low education levels， while strengthening universal life-death education through stratified and classified publicity strategies and educational interventions to improve different populations’ awareness and acceptance of hospice care.

Objective To explore value of peritumoral radiomics models for predicting lymphovascular invasion(LVI)of gastric adenocarcinoma based on portal-venous phase enhanced CT images.Methods Totally 351 patients with gastric adenocarcinoma were collected and randomly divided into training set(n=246)and test set(n=105)at a ratio of 7∶3.ROI of tumors were manually delineated on portal-venous phase enhanced CT images,then radiomics features of tumoral areas and peritumoral areas(1,3 and 5 mm expanded from lesions)were extracted,respectively.Clinical-CT,tumoral and peritumoral(1 mm,3 mm,5 mm)radiomics and comprehensive model nomograms were established,and their predictive performances for LVI were compared.Calibration curve was used to evaluate the consistency between the predicted and actual LVI of gastric adenocarcinoma,while decision curve analysis(DCA)was used to assess the net clinical benefit of each model.Results The area under the curve of clinical-CT,tumoral,peritumoral(1 mm,3 mm,5 mm)radiomics models and the comprehensive model for predicting LVI in training set was 0.741,0.732,0.713,0.728,0.708 and 0.755,respectively,which in test set was 0.748,0.725,0.759,0.724,0.704 and 0.764,respectively.The comprehensive model demonstrated the highest prediction efficiency,also good calibration and clinical practicability.Conclusion Portal-venous phase CT peritumoral radiomics models could be used to predict LVI of gastric adenocarcinoma.Combining with CT features,tumoral and optimal peritumoral radiomics features could further improve predictive efficiency.

Objective To explore the clinical effect and mechanism of Shenqi Shiyiwei granules(SQSYW)on improving colorectal cancer anemia.Methods Through database and network pharmacology analysis,the potential targets and core genes of SQSYW in the treatment of colorectal cancer anemia were obtained.The potential gene targets were analyzed by Gene Ontology and Kyoto Encyclopedia of Genes and Genomes.A total of 80 patients with colorectal cancer anemia admitted in Sichuan Provincial Hospital of Integrated Traditional Chinese and Western Medicine were selected as subjects,according to the treatment plan,they were divided into experimental group(n=40)and control group(n=40).Control group received standard Western medical treatment including subcutaneous erythropoietin injections,while experimental group received additional administration of SQSYW on the base of control group's treatment regimen.Effective treatment rates,TCM symptom score,hemoglobin levels,and red blood cell counts were compared between two groups.Results Five key active ingredients,10 core targets and 30 main pathways were identified through pharmacological screening.Red blood cell count,hemoglobin,TCM syndrome and overall western medicine efficacy were better in experimental group than in control group(P＜0.05).Conclusion SQSYW can treat colorectal cancer anemia through multiple components,multiple targets and multiple pathways.The treatment effect of colorectal cancer anemia combined with SQSYW is better than that of simple western medicine.

Background: Nasopharyngeal carcinoma (NPC) is characterized by high programmed death-ligand 1 (PD-L1) expression and abundant infiltration of non-malignant lymphocytes, which renders patients potentially suitable candidates for immune checkpoint blockade therapies. Palate, lung, and nasal epithelium clone (PLUNC) inhibit the growth of NPC cells and enhance cellular apoptosis and differentiation. Currently, the relationship between PLUNC (as a tumor-suppressor) and PD-L1 in NPC is unclear. Methods: We collected clinical samples of NPC to verify the relationship between PLUNC and PD-L1. PLUNC plasmid was transfected into NPC cells, and the variation of PD-L1 was verified by western blot and immunofluorescence. In NPC cells, we verified the relationship of PD-L1, activating transcription factor 3 (ATF3), and β-catenin by western blot and immunofluorescence. Later, we further verified that PLUNC regulates PD-L1 through β-catenin. Finally, the effect of PLUNC on β-catenin was verified by co-immunoprecipitation (Co-IP). Results: We found that PLUNC expression was lower in NPC tissues than in paracancer tissues. PD-L1 expression was opposite to that of PLUNC. Western blot and immunofluorescence showed that β-catenin could upregulate ATF3 and PD-L1, while PLUNC could downregulate ATF3/PD-L1 by inhibiting the expression of β-catenin. PLUNC inhibits the entry of β-catenin into the nucleus. Co-IP experiments demonstrated that PLUNC inhibited the interaction of DEAD-box helicase 17 (DDX17) and β-catenin. Conclusions PLUNC downregulates the expression of PD-L1 by inhibiting the interaction of DDX17/β-catenin in NPC.

Traditional development of small protein scaffolds has relied on display technologies and mutation-based engineering, which limit sequence and functional diversity, thereby constraining their therapeutic and application potential. Protein design tools have significantly advanced the creation of novel protein sequences, structures, and functions. However, further improvements in design strategies are still needed to more efficiently optimize the functional performance of protein-based drugs and enhance their druggability. Here, we extended an evolution-based design protocol to create a novel minibinder, BindHer, against the human epidermal growth factor receptor 2 (HER2). It not only exhibits super stability and binding selectivity but also demonstrates remarkable properties in tissue specificity. Radiolabeling experiments with ^99mTc, ⁶⁸Ga, and ¹⁸F revealed that BindHer efficiently targets tumors in HER2-positive breast cancer mouse models, with minimal nonspecific liver absorption, outperforming scaffolds designed through traditional engineering. These findings highlight a new rational approach to automated protein design, offering significant potential for large-scale applications in therapeutic mini-protein development.

Background: Nasopharyngeal carcinoma (NPC) is characterized by high programmed death-ligand 1 (PD-L1) expression and abundant infiltration of non-malignant lymphocytes, which renders patients potentially suitable candidates for immune checkpoint blockade therapies. Palate, lung, and nasal epithelium clone (PLUNC) inhibit the growth of NPC cells and enhance cellular apoptosis and differentiation. Currently, the relationship between PLUNC (as a tumor-suppressor) and PD-L1 in NPC is unclear. Methods: We collected clinical samples of NPC to verify the relationship between PLUNC and PD-L1. PLUNC plasmid was transfected into NPC cells, and the variation of PD-L1 was verified by western blot and immunofluorescence. In NPC cells, we verified the relationship of PD-L1, activating transcription factor 3 (ATF3), and β-catenin by western blot and immunofluorescence. Later, we further verified that PLUNC regulates PD-L1 through β-catenin. Finally, the effect of PLUNC on β-catenin was verified by co-immunoprecipitation (Co-IP). Results: We found that PLUNC expression was lower in NPC tissues than in paracancer tissues. PD-L1 expression was opposite to that of PLUNC. Western blot and immunofluorescence showed that β-catenin could upregulate ATF3 and PD-L1, while PLUNC could downregulate ATF3/PD-L1 by inhibiting the expression of β-catenin. PLUNC inhibits the entry of β-catenin into the nucleus. Co-IP experiments demonstrated that PLUNC inhibited the interaction of DEAD-box helicase 17 (DDX17) and β-catenin. Conclusions PLUNC downregulates the expression of PD-L1 by inhibiting the interaction of DDX17/β-catenin in NPC.

Objective To observe the clinical efficacy of therapy of tonifying heart and spleen for the treatment of patients with postpartum depression of heart and spleen deficiency syndrome based on the theory of intestinal flora-neurotransmitter-brain axis(shortened as brain-intestine axis),and to explore its effect on the improvement of patients'depression and anxiety.Methods A total of 136 patients with postpartum depression of heart and spleen deficiency syndrome who admitted to The 908th Hospital of the Joint Logistics Support Force of the People's Liberation Army of China from June 2021 to July 2023 were randomly divided into the conventional treatment group(control group)and the tonifying heart-spleen group(observation group)according to the random number table method,with 68 cases in each group.The control group was treated with conventional antidepressant drugs,and the observation group was treated with therapy of tonifying heart and spleen by utilization of Shen Qi Jieyu Prescription Granules)on the basis of treatment for the control group.Both groups were treated for six continuous weeks.Before and after the treatment,the two groups were observed in the changes of main symptom scores of traditional Chinese medicine(TCM)syndrome,Hamilton Depression Scale(HAMD)scores,7-Item Generalized Anxiety Disorder Scale(GAD-7)scores,and the levels of serum neurotransmitters of 5-hydroxytryptamine(5-HT),dopamine(DA),norepinephrine(NE),as well as microflora metabolites such as short-chain fatty acids(SCFAs),glutamic acid(GLU),gamma-aminobutyric acid(GABA).Moreover,the clinical efficacy and safety of the two groups of patients were evaluated.Results(1)After six weeks of treatment,the total effective rate of the observation group was 89.71%(61/68)and that of the control group was 73.53%(50/68),and the intergroup comparison(tested by chi-square test)showed that the efficacy of the observation group was significantly superior to that of the control group(P<0.05).(2)After treatment,the scores of TCM syndrome main symptoms such as emotional upset,slow thinking,poor appetite,abdominal distension and loose stools in the two groups were decreased compared with those before treatment(P<0.05),and the decrease in the observation group was significantly superior to that in the control group(P<0.01).(3)After treatment,the HAMD scores and GAD-7 scores in the two groups of patients were all decreased compared with those before treatment(P<0.05),and the decrease in the observation group was significantly superior to that in the control group(P<0.01).(4)After treatment,the serum levels of neurotransmitters 5-HT,DA,and NE in the two groups of patients were all increased compared with those before treatment(P<0.05),and the increase in the observation group was significantly superior to that in the control group(P<0.01).(5)After treatment,the serum levels of microflora metabolites SCFAs,GLU and GABA in the two groups of patients were all increased compared with those before treatment(P<0.05),and the increase in the observation group was significantly superior to that in the control group(P<0.01).(6)The incidence of adverse reactions in the observation group was 8.82%(6/68)and that in the control group was 5.88%(4/68),and the intergroup comparison showed that the difference was not statistically significant(P>0.05).Conclusion The application of therapy of tonifying heart and spleen for the treatment of patients with postpartum depression of heart and spleen deficiency syndrome based on brain-intestine axis exerts certain efficacy and safety through correcting the imbalance of neurotransmitters and regulating the microflora metabolites of the patients,thus to alleviate depression and anxiety.

BACKGROUND: To evaluate the efficacy and safety of the first cohort of people in China treated with a responsive neurostimulation system (Epilcure TM , GenLight MedTech, Hangzhou, China) for focal drug-resistant epilepsy in this study. METHODS: This multicenter, before-and-after self-controlled study was conducted across 8 centers from March 2022 to June 2023, involving patients with drug-resistant epilepsy who were undergoing responsive neurostimulation (RNS). The study was based on an ongoing multi-center, single-blind, randomized controlled study. Efficacy was assessed through metrics including median seizure count, seizure frequency reduction (SFR), and response rate. Multivariable linear regression analysis was conducted to explore the relationships of basic clinical factors and intracranial electrophysiological characteristics with SFR. The postoperative quality of life, cognitive function, depression, and anxiety were evaluated as well. RESULTS: The follow-up period for the 19 participants was 10.7 ± 3.4 months. Seizure counts decreased significantly 6 months after device activation, with median SFR of 48% at the 6th month (M6) and 58% at M12 ( P  <0.05). The average response rate after 13 months of treatment was 42%, with 21% ( n  = 4) of the participants achieving seizure freedom. Patients who have previously undergone resective surgery appear to achieve better therapeutic outcomes at M11, M12 and M13 ( β  <0, P  <0.05). No statistically significant differences were observed in patients' scores of quality of life, cognition, depression and anxiety following stimulation when compared to baseline measurements. No serious adverse events related to the devices were observed. CONCLUSIONS: The preliminary findings suggest that Epilcure TM exhibits promising therapeutic potential in reducing the frequency of epileptic seizures. However, to further validate its efficacy, larger-scale randomized controlled trials are required. REGISTRATION Chinese Clinical Trial Registry (No. ChiCTR2200055247).
Humans ; Female ; Male ; Drug Resistant Epilepsy/therapy* ; Adult ; Young Adult ; Middle Aged ; China ; Adolescent ; Treatment Outcome ; Quality of Life ; Single-Blind Method ; Seizures ; Electric Stimulation Therapy/methods*