Objective:To study the epidemiological characteristics and clinical diagnosis of human brucellosis in Qujing City, Yunnan Province.Methods:Through the Infectious Disease Reporting Information Management System of the China Disease Prevention and Control Information System, the basic information and clinical diagnostic data of brucellosis cases reported in Qujing City from January 2008 to December 2023 were retrospectively collected. Descriptive epidemiological methods were used to analyze the epidemic profile, three distribution characteristics (time, population, region), and diagnosis of brucellosis.Results:A total of 1 417 brucellosis cases were reported in Qujing City from 2008 to 2023, with no death. The annual average incidence of brucellosis was 1.49/100 000, with no cases reported in 2009 and 2010, and the highest incidence in 2023 (7.82/100 000). The incidence of brucellosis showed an increasing trend year by year (χ 2trend = 1 874.58, P < 0.001). The number of cases from June to November accounted for 61.54% (872/1 417). The majority of brucellosis cases were in the age group of 36 - 65 years old, accounting for 67.82% (961/1 417). Among them, there were 954 males and 463 females, with a gender ratio of 2.06 ∶ 1.00. Farmers were the main occupation, accounting for 84.33% (1 195/1 417). The cases were mainly distributed in Luliang County (621 cases), Xuanwei City (282 cases) and Shizong County (137 cases), accounting for 73.39% (1 040/1 417). The median interval between onset and diagnosis was 13 days, and the cases with intervals ≤7 d, 8 - 30 d, and ≥31 d accounted for 32.11% (455/1 417), 40.16% (569/1 417), and 27.73% (393/1 417), respectively. Totally 63.94% (906/1 417) of the cases were confirmed in medical institutions in Qujing City. Conclusions:The incidence of brucellosis in Qujing City is increasing year by year, with men, middle-aged and elderly people and farmers as the main population, summer and autumn as the peak period, and Luliang County, Xuanwei City and Shizong County as the high incidence areas. Most cases have an interval of less than 30 days between onset and diagnosis, and can be diagnosed within the jurisdiction.

Objective:To study the effects of remimazolam on stress response index, T lymphocyte subsets and postoperative delirium in patients undergoing modified radical mastectomy.Methods:A total of 120 patients with breast cancer who underwent modified radical mastectomy in our hospital from Aug. 2024 to Dec. 2024 were separated into the control group (n=60, anesthetic induction and maintenance with Propofol) and the observation group (n=60, anesthetic induction and maintenance with remimazolam) according to random number table method, and the other anesthetic drugs were the same. The operation time, anesthesia recovery time, postoperative delirium and cognitive dysfunction of the two groups were observed, and the changes of stress response indexes and T lymphocyte subsets indexes at different time points were compared, and the adverse reactions after anesthesia were counted.Results:The incidence of postoperative delirium and cognitive dysfunction in the observation group was lower than that in the control group ( x2=4.62, 5.18, P < 0.05), and there was no statistically significant difference in operation time or anesthesia recovery time between the two groups ( t=0.43, 1.71, P > 0.05). The observation group had lower serum cortisol (Cor), norepinephrine (NE) and epinephrine (E) levels 30 min after anesthesia induction (T 1) and immediately after surgery (T 2) ( t=5.53, 6.71, 9.33, 6.74, 7.26, 8.77, P < 0.05), while the comparison of those indexes before surgery (T 0) and 12 h after surgery (T 3) showed no statistically significant difference ( t=1.19, 1.85, 0.90, 1.55, 1.64, 1.81, P > 0.05). The levels of CD3 +T, CD4 +T and CD4 +/CD8 + in the observation group were higher than those in the control group at T 1, T 2 and T 3 ( t=2.21, 4.94, 4.77, 4.44, 6.24, 7.07, 2.11, 2.56, 2.15, P < 0.05), and there was no statistically significant difference in those indexes between the two groups at T 0 ( t=0.76, 0.79, 1.51, P > 0.05). The incidence of adverse reactions after anesthesia showed no statistically significant difference between the two groups [25.00% (15/60) and 33.33% (20/60) ] ( χ2=1.008, P > 0.05) . Conclusion:The induction and maintenance of remimazolam anesthesia can effectively reduce the incidence of postoperative delirium and cognitive dysfunction in patients with modified radical mastectomy, relieve the body stress response of patients, and effectively reduce the influence of anesthesia on T lymphocytes.

Objective:To determine the clinical issues in the Clinical practice guidelines for postoperative pain management in adults (2024 edition). Methods:A preliminary list of clinical issues for the guidelines was developed through literature review, clinical surveys, and expert interviews. This was followed by two rounds of Delphi questionnaire surveys, with quality control and statistical analysis conducted using expert positive coefficient, mean item scores, full score ratio, coefficient of variation, Cronbach′s α coefficient, and expert authority level to finalize the list of clinical issues.Results:The experts participating in the Delphi questionnaire surveys had multidisciplinary collaborative backgrounds and regional representativeness, with a high level of authority. The overall positive coefficient of expert participation in the surveys was 78.9%. Through two rounds of the Delphi method and based on the screening criteria of a mean score ≥3.5, coefficient of variation ≤30%, and full score ratio ≥30%, 17 clinical issues were ultimately included following an expert consensus meeting.Conclusions:Through the Delphi method and rigorous quality control, the clinical issues in the Clinical practice guidelines for postoperative pain management in adults (2024 edition) are determined, laying a foundation for the subsequent development of the guidelines.

Objective:To study the epidemiological characteristics and clinical diagnosis of human brucellosis in Qujing City, Yunnan Province.Methods:Through the Infectious Disease Reporting Information Management System of the China Disease Prevention and Control Information System, the basic information and clinical diagnostic data of brucellosis cases reported in Qujing City from January 2008 to December 2023 were retrospectively collected. Descriptive epidemiological methods were used to analyze the epidemic profile, three distribution characteristics (time, population, region), and diagnosis of brucellosis.Results:A total of 1 417 brucellosis cases were reported in Qujing City from 2008 to 2023, with no death. The annual average incidence of brucellosis was 1.49/100 000, with no cases reported in 2009 and 2010, and the highest incidence in 2023 (7.82/100 000). The incidence of brucellosis showed an increasing trend year by year (χ 2trend = 1 874.58, P < 0.001). The number of cases from June to November accounted for 61.54% (872/1 417). The majority of brucellosis cases were in the age group of 36 - 65 years old, accounting for 67.82% (961/1 417). Among them, there were 954 males and 463 females, with a gender ratio of 2.06 ∶ 1.00. Farmers were the main occupation, accounting for 84.33% (1 195/1 417). The cases were mainly distributed in Luliang County (621 cases), Xuanwei City (282 cases) and Shizong County (137 cases), accounting for 73.39% (1 040/1 417). The median interval between onset and diagnosis was 13 days, and the cases with intervals ≤7 d, 8 - 30 d, and ≥31 d accounted for 32.11% (455/1 417), 40.16% (569/1 417), and 27.73% (393/1 417), respectively. Totally 63.94% (906/1 417) of the cases were confirmed in medical institutions in Qujing City. Conclusions:The incidence of brucellosis in Qujing City is increasing year by year, with men, middle-aged and elderly people and farmers as the main population, summer and autumn as the peak period, and Luliang County, Xuanwei City and Shizong County as the high incidence areas. Most cases have an interval of less than 30 days between onset and diagnosis, and can be diagnosed within the jurisdiction.

Objective:To study the effects of remimazolam on stress response index, T lymphocyte subsets and postoperative delirium in patients undergoing modified radical mastectomy.Methods:A total of 120 patients with breast cancer who underwent modified radical mastectomy in our hospital from Aug. 2024 to Dec. 2024 were separated into the control group (n=60, anesthetic induction and maintenance with Propofol) and the observation group (n=60, anesthetic induction and maintenance with remimazolam) according to random number table method, and the other anesthetic drugs were the same. The operation time, anesthesia recovery time, postoperative delirium and cognitive dysfunction of the two groups were observed, and the changes of stress response indexes and T lymphocyte subsets indexes at different time points were compared, and the adverse reactions after anesthesia were counted.Results:The incidence of postoperative delirium and cognitive dysfunction in the observation group was lower than that in the control group ( x2=4.62, 5.18, P < 0.05), and there was no statistically significant difference in operation time or anesthesia recovery time between the two groups ( t=0.43, 1.71, P > 0.05). The observation group had lower serum cortisol (Cor), norepinephrine (NE) and epinephrine (E) levels 30 min after anesthesia induction (T 1) and immediately after surgery (T 2) ( t=5.53, 6.71, 9.33, 6.74, 7.26, 8.77, P < 0.05), while the comparison of those indexes before surgery (T 0) and 12 h after surgery (T 3) showed no statistically significant difference ( t=1.19, 1.85, 0.90, 1.55, 1.64, 1.81, P > 0.05). The levels of CD3 +T, CD4 +T and CD4 +/CD8 + in the observation group were higher than those in the control group at T 1, T 2 and T 3 ( t=2.21, 4.94, 4.77, 4.44, 6.24, 7.07, 2.11, 2.56, 2.15, P < 0.05), and there was no statistically significant difference in those indexes between the two groups at T 0 ( t=0.76, 0.79, 1.51, P > 0.05). The incidence of adverse reactions after anesthesia showed no statistically significant difference between the two groups [25.00% (15/60) and 33.33% (20/60) ] ( χ2=1.008, P > 0.05) . Conclusion:The induction and maintenance of remimazolam anesthesia can effectively reduce the incidence of postoperative delirium and cognitive dysfunction in patients with modified radical mastectomy, relieve the body stress response of patients, and effectively reduce the influence of anesthesia on T lymphocytes.

Objective:To identify the serotype and genotype characteristics of the first cluster infection of Brucella in Nujiang Lisu Autonomous Prefecture of Yunnan Province. Methods:The information of seven suspected cluster brucellosis cases reported in Lanping County, Nujiang Lisu Autonomous Prefecture in April 2023 were collected, blood samples were collected, and the strains were isolated and cultured. Serological methods were employed for brucellosis diagnosis, bacterial species identification was performed using BCSP31-PCR and AMOS-PCR. Multilocus locus variable-number tandem repeat analysis (MLVA) was conducted for strain genotyping, followed by phylogenetic analysis comparing the strains with those from other regions of China.Results:All seven cases were diagnosed with brucellosis, they were all villagers from the same village and had daily contact with sheeps. Four suspected Brucella strains were isolated, identified as Brucella melitensis biotype by BCSP31-PCR and AMOS-PCR. The four isolated strains exhibited identical MLVA-16 genotype, with MLVA-8 genotype 42 and MLVA-11 genotype 180, belonging to the Eastern Mediterranean lineage. Compared with the MLVA-16 of the isolated strains from other regions of China, the four isolated strains formed an independent cluster. Conclusion:The first cluster infection of Brucella in Nujiang Lisu Autonomous Prefecture of Yunnan Province is caused by Brucella melitensis biotype, and the four isolated strains have showed unique MLVA genotype.

Objective:To learn about the geographical distribution and bio-tying diversity characteristics of Brucella strains isolated in Yunnan Province. Methods:From March 2017 to December 2023, 516 suspected Brucella strains were collected from brucellosis surveillance sites and hospitals in Yunnan Province, and Yunnan Institute of Endemic Disease Control and Prevention. The Brucella isolates were confirmed to genus level by BCSP31-PCR, and subsequently identified to species and biovar level using conventional biotyping methods and AMOS-PCR. The geographical distribution of the strains was visualized using ArcGIS 10.8 software, simultaneously analyze the general characteristics of brucellosis patients. Results:Among the 516 suspected Brucella strains, 514 strains were isolated from patient blood samples and 2 strains were isolated from sheep blood samples. BCSP31-PCR identification showed that all strains were Brucella spp. The results of conventional biotyping and AMOS-PCR identification revealed that the isolates comprised 514 Brucella melitensis strains (16 strains of Brucella melitensis biovar 1 and 498 strains of Brucella melitensis biovar 3), one Brucella abortus (biovar 1) strain, and one Brucella canis strain. The strain was distributed in 69 counties/cities of 13 prefectures/cities in Yunnan Province, involving 390 administrative villages in 186 townships. Brucella melitensis was the dominant epidemic strain, and the largest number of Brucella melitensis was distributed in Kunming City( n = 205), followed by Honghe Hani and Yi Autonomous Prefecture ( n = 98) and Qujing City ( n = 72). Brucella abortus was only distributed in Lincang City ( n = 1), and Brucella canis was distributed Wenshan Zhuang and Miao Autonomous Prefecture ( n = 1). The age range of 514 brucellosis patients ranged from 10 months to 88 years, with the majority being between 40 and 60 years old (52.72%, 271/514). The predominant occupational group was farmers (89.11%, 458/514), followed by students (5.06%, 26/514). Conclusion:Brucella exhibits a wide distribution and species/biovar diversity in Yunnan Province, with infection among the farming population emerging as a serious public health problem in the area.

Objective To investigate the efficacy of cannabidiol(CBD)in improving renal function and protecting the kidney in mice with unilateral ureteral obstruction(UUO).Methods A total of 24 healthy,8-week-old,WTC57BL/6 male mice were divided into the Sham group,UUO group and UUO+CBD group,with 8 rats in each group.The UUO models were established by ligating one side of the ureter and removing the contralateral kidney to ensure unilateral kidney hydronephrosis.In the UUO+CBD group,5 mg/kg CBD was intraperitoneally injected immediately after the operation,once a day for 10 days.The Sham and UUO groups were given the same amount of normal saline.Blood sample was collected through the inner canthus venous plexus of the orbit 24 hours after the last administration.The levels of serum creatinine(Scr),blood urea nitrogen(BUN),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),superoxide dismutase(SOD),and malondialdehyde(MDA)were detected with an automatic biochemistry analyzer.The histopathological sections were prepared,the pathological changes of renal tissues were observed under a light microscope,and the pathological injuries were scored.Mitochondrial quantity and morphological structure changes were observed with a transmission electron microscopy.Results Compared with the Sham group,the UUO group exhibited significantly higher levels of Scr[(22.55±3.29)μmol/L vs.(12.11±3.32)μmol/L],BUN[(18.62±2.15)mmol/L vs.(10.05±1.19)mmol/L],TNF-α[(21.04±2.56)pg/mL vs.(9.26±0.47)pg/mL],IL-1β[(10.25±1.25)pg/mL vs.(5.44±0.99)pg/mL],and MDA[(31.26±1.17)nmol/mL vs.(17.12±1.39)nmol/mL],but significantly lower level of SOD[(90.26±2.11)U/mL vs.(136.54±3.05)U/mL],all P＜0.000 1.Compared with the UUO group,the UUO+CBD group showed a significant decrease in the levels of Scr[(16.82±0.89)μmol/L vs.(22.55±3.29)μmol/L],BUN[(14.35±0.99)mmol/L vs.(18.62±2.15)mmol/L],TNF-α[(16.29±0.88)pg/mL vs.(21.04±2.56)pg/mL],IL-1β[(6.23±0.95)pg/mL vs.(10.25±1.25)pg/mL],MDA[(20.36±1.23)nmol/mL vs.(31.26±1.17)nmol/mL],and renal pathological damage score[(1.88±0.64)vs.(2.50±0.76)],but a significant increase in SOD level[(117.84±1.57)U/mL vs.(90.26±2.11)U/mL],all P＜0.000 1.Under electron microscopy,mitochondrial swelling,loss of inner membrane structure,and membrane rupture were observed in the UUO group,while the UUO+CBD group showed milder morphological changes.Conclusion CBD improves renal function in UUO model mice through anti-inflammatory,antioxidant and mitochondrial protection,and is a potential therapeutic drug for renal protection in clinic.

Objective:To assess the feasibility and efficacy of transperineal laser ablation(TPLA)with single laser fiber in treating benign prostatic obstruction(BPO).Methods:From April 2021 to March 2024,a total of 13 BPO patients were selected from Beijing Friendship Hospital.TPLA was performed using a single laser fiber,which was guided by transrectal biplane ultrasound.The single laser fiber was used to undergo TPLA under the guidance of trans-rectal dual-plane ultrasound.The intraoperative time,ablation time,energy consumption,indwelling time of catheter,and complications were observed.The postoperative 6 months was chosen as the cut-off point of follow-up,and the pre and postoperative changes of international prostate symptom score(IPSS),quality of life index(QoL),prostate volume(PV),residual urine volume(RUV)and the maximum urine flow rate(Qmax)were compared.Results:All 13 patients successfully underwent TPLA with single laser fiber.The average operation time was(55.1±18.3)min,and the average ablation time was(16.3±1.7)min,and average energy consumption was(3951.6±459.7)J,and the median value of indwelling time of catheter was 7(7,10)days.The number of postoperative complication was 2 cases,and both them belonged to Clavien-Dindo grade II complication.At the postoperative 6th month,the IPSS,QoL,PV,Qmax and RUV of all patients were improved,all of which were better than preoperative these indicators,and the differences were significant(t=12.102,-3.228,-3.181,-2.581,-2.936,P<0.05).Conclusion:The application of single laser fiber in conducting TPLA operation is feasibility at technical aspect,and it can achieve the therapeutic goals of improving patients'symptoms and enhancing their quality of life.Although its operational time is slightly longer than that of using multiple fibers simultaneously,it can effectively reduce the cost of expenditure for consumables.

Objective To explore the effects and mechanism of Dahuang Tangluo Pills on intestinal inflammatory injury in type 2 diabetes mellitus(T2DM)rats based on TLR4/NF-κB signaling pathway.Methods Eight ZDF(fa/+)rats were used as the blank group,and 40 ZDF(fa/fa)rats were fed with high-fat diet and then randomly divided into model group,metformin group(0.18 g/kg metformin)and TCM high-,medium-and low-dosage groups(2.16,1.08,0.54 g/kg Dahuang Tangluo Pills),respectively.The medication groups were gavaged with corresponding dosages for 12 consecutive weeks.The body mass and fasting blood glucose(FBG)of rats before and after intervention were detected.After the intervention,an oral glucose tolerance test(OGTT)was performed,the serum glucose(GLU),glycosylated serum protein(GSP),triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C)contents were detected.ELISA was used to detect serum fasting insulin(FINS),free fatty acids(FFA)and tumor necrosis factor-α(TNF-α),interleukin(IL)-6,IL-22,lipopolysaccharide(LPS),secreted immunoglobulin A(SIgA)contents in colonic tissue.HE staining was used to observe the morphology of colonic tissue,and Western blot was used to detect the expressions of Toll like receptor 4(TLR4),nuclear factor-κB p65(NF-κB p65),p-NF-κB p65,NF-κB inhibitor α(IκBα),p-IκBα,myeloid differentiation factor 88(MyD88)and zona pellucida protein-1(ZO-1)in colonic tissue.Results Compared with the blank group,the body mass and FBG significantly increased in the model group(P<0.01),blood glucose significantly increased at all time points of OGTT(P<0.01),serum GLU,GSP,TG,TC,LDL-C,FINS,FFA and TNF-α,IL-6,IL-22,LPS contents in colonic tissue significantly increased,serum HDL-C and colonic tissue SIgA contents significantly decreased(P<0.01),with colonic tissue nuclear condensation,cytoplasmic dissolution,inflammatory cell infiltration.The protein expressions of TLR4,NF-κB p65,p-NF-κB p65,p-IκBα and MyD88 in colonic tissue significantly increased,while the protein expressions of IκBα and ZO-1 significantly decreased(P<0.01).Compared with the model group,the body mass and FBG significantly decreased in metformin group,TCM high-and medium-dosage groups(P<0.01),blood glucose decreased at different time points of OGTT,and serum GLU,GSP,TG,TC,LDL-C,FINS,FFA and TNF-α,IL-6,IL-22,LPS contents in colonic tissue significantly decreased,serum HDL-C and colonic tissue SIgA contents significantly increased(P<0.05,P<0.01),with significant improvement in colonic tissue structure and reduction in inflammatory cell infiltration.The protein expressions of TLR4,NF-κB p65,p-NF-κB p65,p-IκBα and MyD88 in colonic tissue significantly decreased,while the proteins expression of IκBα and ZO-1 significantly increased(P<0.05,P<0.01).Conclusion Dahuang Tangluo Pills may inhibit the activation of the TLR4/NF-κB signaling pathway,reduce the release of inflammatory factors,improve intestinal inflammatory injury,restore intestinal homeostasis,thereby improving glucose and lipid metabolism and exerting therapeutic effects on T2DM.