Objective: To investigate the epidemiological characteristics of influenza in Nanchong City, Sichuan Province from 2016 to 2025, so as to provide references for formulating targeted influenza prevention and control strategies. Methods: Data on confirmed and clinically diagnosed influenza cases with current residence in Nanchong City reported from January 1, 2016 to December 31, 2025 were extracted from the Chinese Disease Prevention and Control Information System. The number of influenza-like illness (ILI) visits and etiological monitoring data from sentinel hospitals in Nanchong City during the same period were collected through the Chinese National Influenza Surveillance Information System. Descriptive analysis was conducted to clarify the population, temporal and regional distribution of influenza cases as well as etiological results of ILI. The average annual percent change (AAPC) was used to analyze the trend of reported influenza incidence. Seasonal index (SI) was used to identify seasonal epidemic characteristics, and spatial autocorrelation analysis was used to explore the spatiotemporal distribution of influenza incidence. Results: A total of 133 861 influenza cases were reported in Nanchong City from 2016 to 2025, with an average annual reported incidence of 240.30/105, showing a rising trend (AAPC=82.765%, P<0.05). The periods from January to March and November to December were the peak epidemic seasons with SI values over 100%. The average annual reported incidence was higher in males than in females (P<0.05). The age groups of 0-<15 years and ≥60 years had relatively higher incidence of 974.89/105 and 132.33/105 respectively. Students constituted the predominant population, accounting for 34.81% (46 600 cases). Langzhong City ranked first in both total reported cases (23 659 cases) and average annual reported incidence (378.85/105). The overall spatial distribution of influenza cases was random. Low-high clusters were found in Gaoping District in 2017 and Xichong County in 2018; low-low clusters were observed in Yingshan County in 2020 and 2021; high-low clusters existed in Shunqing District in 2025. From 2016 to 2025, the overall positive detection rate of influenza virus among ILI was 15.03%, including influenza B Victoria lineage, influenza A H1N1 subtype, influenza A H3N2 subtype and influenza B Yamagata lineage. Conclusions The reported incidence of influenza in Nanchong City presented an upward trend from 2016 to 2025, with epidemics predominantly occurring in winter and spring. Males, children and adolescents, the elderly and students are high-risk population, while Langzhong City and Shunqing District are high-incidence areas. Different influenza subtypes circulate alternately or concurrently in this region.

Nodal marginal zone B-cell lymphoma(NMZL),the least common subtype of marginal zone lymphoma,represents a low-grade malignancy arising from the marginal zone of lymph node follicles,composed of small B-cells with an inert non-Hodgkin lymphoma nature.It accounts for 1.5% to 1.8% of all non-Hodgkin lymphomas and 10% of all marginal zone lymphomas.The low incidence and lack of typical clinical and pathological features pose a challenge to the diagnosis and clinical management of NMZL.In this article,we reported the diagnosis and treatment of a case of NMZL located in the parapharyngeal space of the left neck and reviewed the relevant literature from both domestic and international sources.We summarized the clinical manifestations,histopathological features,immunohistochemical characteristics,imaging features,diagnosis and treatment modalities,and prognosis of NMZL.
Humans ; Lymphoma, B-Cell, Marginal Zone/pathology* ; Lymph Nodes/pathology* ; Neck/pathology* ; Male

Objective To observe the value of high-resolution vascular wall imaging(HR-VWI)for differentiating perforating branch subtype and other subtype basilar artery(BA)ischemic stroke.Methods Totally 147 patients with posterior circulation ischemic stroke were retrospectively enrolled and divided into perforating branch group(perforating branch BA atherosclerosis,n=57)and multi-mechanism group(artery-to-artery embolism and/or hypoperfusion,n=90)according to MRI findings and Chinese ischemic stroke subclassification(CISS).Clinical data,HR-VWI and MR angiography parameters were compared between groups,and those being significantly different were included in logistic regression analysis to construct a model.Receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of the model for differentiating perforating branch subtype and other subtype BA ischemic stroke.Results The proportion of diabetes mellitus(DM)and dorsal plaque were both higher,while proportion of ventral plaque in perforating branch group was lower than those in multi-mechanism group(all P＜0.05).No significant difference of the other clinical data,nor of the maximum wall thickness,lumen eccentricity index,lumen area,wall area,vascular stenosis rate,plaque load,vascular remodeling index and BA course of culprit plaques section was found between groups(all P＞0.05).DM and dorsal plaque were both independent risk factors for perforating BA atherosclerosis,whereas ventral plaque was the independent protective factor(all P＜0.05).The sensitivity,specificity and AUC of the model for differentiating perforating branch subtype and other subtypes of BA ischemic stroke was 82.46％,70.00％and 0.839,respectively.Conclusion HR-VWI could be used to differentiating perforating branch subtype and other subtype BA ischemic stroke.

Osteoporosis(OP) is a senile bone disease characterized by an imbalance between bone remodeling and bone formation. Targeting pathogenesis of kidney deficiency, spleen deficiency, and blood stasis, Bushen Jianpi Huoxue Decoction has a significant effect on the treatment of OP by tonifying kidney, invigorating spleen, and activating blood circulation. MicroRNA(miRNA) and the anti-apoptotic protein B-cell lymphoma-2-like protein 1(BCL2L1) are closely related to bone cell metabolism. Therefore, in this study, the binding of miR-140-5p to BCL2L1 was detected by dual luciferase assay and polymerase chain reaction(PCR). After silencing or overexpressing miR-140-5p, the apoptosis, autophagy, and osteogenic function of human fetal osteoblast cell line 1.19(HFOB1.19) were observed by flow cytometry and Western blot. Bushen Jianpi Huoxue Decoction-containing serum was prepared by intragastric administration of Bushen Jianpi Huoxue Decoction in rats. Different concentrations of Bushen Jianpi Huoxue Decoction-containing serum were used to treat HFOB1.19 with or without miR-140-5p mimic. The expression of osteogenic proteins in each group was observed, and the role of miR-140-5p/BCL2L1 in apoptosis and autophagy of HFOB1.19 was studied, along with the effect of Bushen Jianpi Huoxue Decoction on these processes. As indicated by the dual luciferase assay, miR-140-5p bound to BCL2L1. Flow cytometry and Western blot showed that miR-140-5p promoted apoptosis and inhibited autophagy in HFOB1.19. After intervention with high, medium, and low doses of Bushen Jianpi Huoxue Decoction-medicated serum, compared with the miR-140-5p NC group, the expression of osteocalcin(OCN), osteopontin(OPN), Runt-related transcription factor 2(RUNX2), and transforming growth factor beta 1(TGF-β1) decreased in the miR-140-5p mimic group, while the expression of bone morphogenetic protein 2(BMP2) showed no significant difference under high-dose intervention. Therefore, miR-140-5p/BCL2L1 can promote apoptosis and inhibit autophagy in HFOB1.19. Bushen Jianpi Huoxue Decoction can affect the osteogenic effect of miR-140-5p through BMP2.
MicroRNAs/metabolism* ; Autophagy/drug effects* ; Apoptosis/drug effects* ; Humans ; Drugs, Chinese Herbal/administration & dosage* ; Animals ; Cell Line ; bcl-X Protein/metabolism* ; Osteoblasts/metabolism* ; Rats ; Osteoporosis/physiopathology* ; Male ; Rats, Sprague-Dawley ; Osteogenesis/drug effects*

A high performance liquid chromatography-tandem mass spectrometry(HPLC-MS/MS) method was established for simultaneous determination of seven characteristic components from the active fraction of Alpiniae Officinarum Rhizoma in rat plasma, including galangin, kaempferol, kaempferide, pinocembrin, 1,7-diphenyl-4-en-3-heptanone, 5-hydroxy-7-(4-hydroxy-3-methoxyphenyl)-1-phenyl-3-heptanone(DHPA), and 7-(4-hydroxy-3-methoxyphenyl)-1-phenyl-4-en-3-heptanone(DPHB). The new developed HPLC-MS/MS method was applied to study the pharmacokinetics of the 7 characteristic components in rats with Helicobacter pylori gastritis. A Waters Sunfire C_(18) column(2.1 mm×150 mm, 3.5 μm) was used. The acetonitrile-aqueous solution(containing 0.1% formic acid) was adopted as the mobile phase for gradient elution. Seven components and internal standard(chlorogenic acid) were separated within 12 min. Mass spectrometric detection was performed in multiple reaction monitoring(MRM) mode using electrospray ionization(ESI) source with fast switching between positive and negative ions. The method was verified by specificity, linearity, precision, accuracy, recovery, matrix effect, and stability and met the requirements of pharmacokinetic study on the 7 components in rat plasma. Pharmacokinetic results showed that the average peak time(T_(max)) of the 7 components was 0.31-2.19 h, their elimination half-life(t_(1/2)) was 5.26-16.65 h, and the average residence time(MRT) was 6.29-31.03 h after the oral administration of the active fraction of Alpiniae Officinarum Rhizoma to rats with H. pylori gastritis. The plasma exposure levels of galangin and DHPA were higher than those of the other components. The concentration-time curves of four detected flavonoids showed obvious double peaks. This study elucidated the pharmacokinetic characteristics of 7 characteristic components from the active fraction of Alpiniae Officinarum Rhizoma in rats with H. pylori gastritis, providing a scientific basis for the identification of the pharmacodynamic substances of Alpiniae Officinarum Rhizoma for treatment of H. pylori gastritis and the clinical application of Alpiniae Officinarum Rhizoma in the prevention and treatment of H. pylori gastritis.
Animals ; Rats ; Chromatography, High Pressure Liquid/methods* ; Tandem Mass Spectrometry/methods* ; Drugs, Chinese Herbal/administration & dosage* ; Male ; Helicobacter pylori/drug effects* ; Alpinia/chemistry* ; Rats, Sprague-Dawley ; Gastritis/metabolism* ; Helicobacter Infections/metabolism* ; Flavonoids/blood* ; Rhizome/chemistry* ; Liquid Chromatography-Mass Spectrometry

Objective:This study aims to investigate the spillover effects of the Diagnosis-Related Groups payment reform on medical expenditures.Methods:Based on the medical record data of inpatients in a tertiary Grade A hospital in Wuhan,Hubei Province,the Difference-in-Differences method was applied to estimate the impact of the DRG reform on medical expenditures for non-local patients.Results:After the implementation of DRG payment,the total medical expenses(β=-0.13),out-of-pocket expenses(β=-0.22),drug expenses(β=-0.25),consumable expenses(β=-0.26)decreased significantly.Meanwhile,the reduction ranges of the level and proportion of out-of-pocket expenses for non-local inpatients were significantly larger than those for local inpatients.However,the reduction range of the proportion of drug expenses for non-local inpatients was significantly smaller than that for local inpatients.The gaps between the two groups in terms of the level of out-of-pocket expenses and the proportion of drug expenses gradually narrowed.Conclusion:The DRG payment reform has produced a significant spillover effect,leading to a decrease in the medical expense level and an improvement in the expense structure for non-local inpatients.However,the medical expenses of non-local inpatients remain relatively high.It is suggested to accelerate the inclusion of non-local inpatients in disease-specific payment management and strengthen the coordination between the hospital's internal operation management and the reform of medical insurance payment methods.

Objective To investigate the expression of ferritinophagy-related gene ELAV-like RNA binding protein 1(ELAVL1)in multiple myeloma(MM)and elucidate its diagnostic and prognostic value for MM.Methods First,we analyzed ELAVL1 expression level in healthy controls and MM patients using data from the GEO and TCGA databases.Subsequently,bone marrow specimens were collected from 28 newly diagnosed MM patients and 20 healthy controls,and qRT-PCR was employed to validate ELAVL1 expression.The diagnostic and prognostic potential of ELAVL1 was assessed using ROC curve analysis and Kaplan-Meier survival curves.Additionally,univariate and multivariate COX regression analyses were performed to identify independent risk factors for MM prognosis.Finally,KEGG and GO enrichment analyses were performed using the DAVID online platform.Results The level of ELAVL1 expression was significantly higher in newly diagnosed MM patients and refractory/relapsed MM patients than in the healthy controls(P＜0.001).Moreover,ELAVL1 expression was positively correlated with the International Staging System(ISS)stage of MM(P＜0.01).Furthermore,qRT-PCR validation confirmed that ELAVL1 expression was elevated in the 28 newly diagnosed MM patients compared to the 20 healthy controls(P＜0.001).ROC curve analysis demonstrated that ELAVL1 could effectively differentiate between newly diagnosed MM patients,healthy controls,and MGUS patients(P＜0.001 and P=0.000 2,respectively).Survival analysis revealed that high ELAVL1 expression was associated with shorter progression-free survival(P=0.0141)and overall survival(P=0.008 0).Univariate and multivariate COX regression analyses identified high ELAVL1 expression as an independent risk factor for poor MM prognosis(P=0.005 0).KEGG analysis suggested that ELAVL1 might be involved in the Hippo and MAPK signaling pathways.Conclusion High ELAVL1 expression in MM may serve as a biomarker for diagnosis and poor prognosis.ELAVL1 may promote MM initiation and progression via the Hippo and MAPK signaling pathways.

Objective To investigate the expression of ferritinophagy-related gene ELAV-like RNA binding protein 1(ELAVL1)in multiple myeloma(MM)and elucidate its diagnostic and prognostic value for MM.Methods First,we analyzed ELAVL1 expression level in healthy controls and MM patients using data from the GEO and TCGA databases.Subsequently,bone marrow specimens were collected from 28 newly diagnosed MM patients and 20 healthy controls,and qRT-PCR was employed to validate ELAVL1 expression.The diagnostic and prognostic potential of ELAVL1 was assessed using ROC curve analysis and Kaplan-Meier survival curves.Additionally,univariate and multivariate COX regression analyses were performed to identify independent risk factors for MM prognosis.Finally,KEGG and GO enrichment analyses were performed using the DAVID online platform.Results The level of ELAVL1 expression was significantly higher in newly diagnosed MM patients and refractory/relapsed MM patients than in the healthy controls(P＜0.001).Moreover,ELAVL1 expression was positively correlated with the International Staging System(ISS)stage of MM(P＜0.01).Furthermore,qRT-PCR validation confirmed that ELAVL1 expression was elevated in the 28 newly diagnosed MM patients compared to the 20 healthy controls(P＜0.001).ROC curve analysis demonstrated that ELAVL1 could effectively differentiate between newly diagnosed MM patients,healthy controls,and MGUS patients(P＜0.001 and P=0.000 2,respectively).Survival analysis revealed that high ELAVL1 expression was associated with shorter progression-free survival(P=0.0141)and overall survival(P=0.008 0).Univariate and multivariate COX regression analyses identified high ELAVL1 expression as an independent risk factor for poor MM prognosis(P=0.005 0).KEGG analysis suggested that ELAVL1 might be involved in the Hippo and MAPK signaling pathways.Conclusion High ELAVL1 expression in MM may serve as a biomarker for diagnosis and poor prognosis.ELAVL1 may promote MM initiation and progression via the Hippo and MAPK signaling pathways.

Objective:This study aims to investigate the spillover effects of the Diagnosis-Related Groups payment reform on medical expenditures.Methods:Based on the medical record data of inpatients in a tertiary Grade A hospital in Wuhan,Hubei Province,the Difference-in-Differences method was applied to estimate the impact of the DRG reform on medical expenditures for non-local patients.Results:After the implementation of DRG payment,the total medical expenses(β=-0.13),out-of-pocket expenses(β=-0.22),drug expenses(β=-0.25),consumable expenses(β=-0.26)decreased significantly.Meanwhile,the reduction ranges of the level and proportion of out-of-pocket expenses for non-local inpatients were significantly larger than those for local inpatients.However,the reduction range of the proportion of drug expenses for non-local inpatients was significantly smaller than that for local inpatients.The gaps between the two groups in terms of the level of out-of-pocket expenses and the proportion of drug expenses gradually narrowed.Conclusion:The DRG payment reform has produced a significant spillover effect,leading to a decrease in the medical expense level and an improvement in the expense structure for non-local inpatients.However,the medical expenses of non-local inpatients remain relatively high.It is suggested to accelerate the inclusion of non-local inpatients in disease-specific payment management and strengthen the coordination between the hospital's internal operation management and the reform of medical insurance payment methods.

Objective To observe the value of high-resolution vascular wall imaging(HR-VWI)for differentiating perforating branch subtype and other subtype basilar artery(BA)ischemic stroke.Methods Totally 147 patients with posterior circulation ischemic stroke were retrospectively enrolled and divided into perforating branch group(perforating branch BA atherosclerosis,n=57)and multi-mechanism group(artery-to-artery embolism and/or hypoperfusion,n=90)according to MRI findings and Chinese ischemic stroke subclassification(CISS).Clinical data,HR-VWI and MR angiography parameters were compared between groups,and those being significantly different were included in logistic regression analysis to construct a model.Receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of the model for differentiating perforating branch subtype and other subtype BA ischemic stroke.Results The proportion of diabetes mellitus(DM)and dorsal plaque were both higher,while proportion of ventral plaque in perforating branch group was lower than those in multi-mechanism group(all P＜0.05).No significant difference of the other clinical data,nor of the maximum wall thickness,lumen eccentricity index,lumen area,wall area,vascular stenosis rate,plaque load,vascular remodeling index and BA course of culprit plaques section was found between groups(all P＞0.05).DM and dorsal plaque were both independent risk factors for perforating BA atherosclerosis,whereas ventral plaque was the independent protective factor(all P＜0.05).The sensitivity,specificity and AUC of the model for differentiating perforating branch subtype and other subtypes of BA ischemic stroke was 82.46％,70.00％and 0.839,respectively.Conclusion HR-VWI could be used to differentiating perforating branch subtype and other subtype BA ischemic stroke.