ObjectiveTo understand the epidemiological characteristics and post-exposure prophylaxis of rabies exposure cases in Suqian City of Jiangsu Province from 2021 to 2024, providing a reference for optimizing the allocation of health resources and formulating scientific prevention and control measures. MethodsData on individuals exposed to rabies and treated at Suqian’s rabies post-exposure prophylaxis (PEP) clinics from 2021 to 2024 were collected. Descriptive epidemiological methods were used to analyze patient characteristics, exposure classification, animal species responsible for injuries, wound management, and vaccination status. ResultsBetween 2021 and 2024, the number of outpatient visits for rabies PEP clinics in Suqian City totaled 333 450. The median age and the 25th and 75th percentiles of exposed individuals was 23 (9, 47) years. The highest proportion of exposed individuals was recorded in 2023 (27.09%); the majority were female (52.22%), aged 5‒9 years (17.49%), and in other occupations (37.05%). The rabies exposure rate in Suqian City from 2021 to 2024 was 16.75‰. The overall rabies exposure rate showed an upward trend (χtrend2=1 994.80, P<0.001). The exposure rate among males was lower than that among females (χ²=890.43, P<0.001). The highest exposure rate was observed in the 5‒9 age group (χ²=67 063.20, P<0.001). The number of individuals seeking medical care for rabies exposure exhibited a weak bimodal distribution, with the primary peak occurring in August and the secondary peak in January. The primary animal responsible for injuries was the cat (53.70%), and the source of these animals was predominantly domestic pets (88.90%). The proportion of exposed individuals bitten by cats showed an upward trend from 2021 to 2024 (χtrend2=548.44, P<0.001). Grade Ⅲ exposure accounted for the highest proportion (53.53%), and 301 652 cases (90.46%) presented within 24 hours of exposure. The coverage rate of rabies vaccine was 98.18% (13 625/13 877) for those with Grade Ⅰ exposure and 99.95% (319 413/319 573) for those with Grade Ⅱ and Ⅲ exposures; 64 042 individuals received rabies immunoglobulin or anti-rabies serum; 8 360 exposed individuals received tetanus vaccine, with the usage rate of tetanus vaccine among exposed individuals was only 2.51%, though the rate was on the rise (χtrend2=618.26, P<0.001). ConclusionBetween 2021 and 2024, the overall incidence of rabies exposure in Suqian City showed an upward trend, with a higher incidence among women than men. The incidence was particularly high among children and adolescents aged 14 and under, with the majority of injuries caused by cats; most injuries were inflicted by domestic animals. The overall uptake of tetanus vaccines showed an upward trend. Suqian City should step up health education on rabies exposure during January and August each year, with a particular focus on raising awareness of rabies exposure prevention among people aged 14 and under and women. It should also strengthen the management of domestic animals and ensure that they receive regular rabies vaccinations, particularly for pet cats. Preventive measures against tetanus should be strengthened for individuals exposed to rabies. Medical staff at rabies PEP clinics should receive enhanced training on the management of rabies exposures and the completion of information system reports to ensure the standardized operation of these clinics.

This article reports a patient with long-term ulcerative colitis (UC) who was initially diagnosed as eosinophilic gastroenteritis due to a increase in peripheral blood eosinophils. During the diagnosis and treatment process, acute myocardial infarction was repeatedly induced. The patient was eventually diagnosed as UC complicated by amoebic infection and improved after anti-infective therapy. Through case analysis and literature review, this article discusses the diagnosis and treatment strategies for UC complicated by rare opportunistic infections.

This article reports a patient with long-term ulcerative colitis (UC) who was initially diagnosed as eosinophilic gastroenteritis due to a increase in peripheral blood eosinophils. During the diagnosis and treatment process, acute myocardial infarction was repeatedly induced. The patient was eventually diagnosed as UC complicated by amoebic infection and improved after anti-infective therapy. Through case analysis and literature review, this article discusses the diagnosis and treatment strategies for UC complicated by rare opportunistic infections.

Objective:To summarize the clinical manifestations, diagnosis, treatment and prognosis of acute flaccid myelitis (AFM) in children.Methods:Clinical characteristics of 4 AFM cases from Department of Neurology, Children′s Hospital Affiliated to Capital Institute of Pediatrics, from September 2018 to November 2022, were analyzed retrospectively.Results:The age of 4 children with AFM was 7 years, 4 years and 3 months, 7 years and 1 month, 6 years and 5 months, respectively. There were 2 boys and 2 girls. Prodromal infection status showed 3 children of respiratory tract infection and 1 child of digestive tract infection. The main manifestation was asymmetrical limb weakness after infection, and the affected limb range was from monoplegia to quadriplegia. Cranial nerve injury was involved in 1 child, no encephalopathy. Magnetic resonance imaging in the spinal cord of all 4 children showed long T1 and T2 signals, mainly involving gray matter. Cerebrospinal fluid cell-protein separation was observed in 2 children. Pathogen detected in 1 child pharyngeal swab was enterovirus D68. Antibody IgM to adenovirus was positive in the blood of 1 child. Antibody IgG against Echo and Coxsackie B virus were positive in the blood of another child. After glucocorticoid, human immunoglobulin or simple symptomatic treatment and at the same time under later rehabilitation training, muscle strength recovered to different degrees, but there were disabilities left in 3 children.Conclusions:AFM should be considered in children with acute and asymmetrical flaccid paralysis accompanied by abnormal magnetic resonance imaging signal in the central region of spinal cord, especially post-infection. The effective treatment is limited and the prognosis is poor.

Objective To predict the structure and antigenic epitope of the Strongyloides stercoralis serine protease inhibitor 1 (Ss-SRPN-1) protein using bioinformatics tools, and to construct prokaryotic expression plasmids for expression of recombinant Ss-SRPN-1 protein, so as to provide the basis for unraveling the function of the Ss-SRPN-1 protein. Methods The amino acid sequence of the Ss-SRPN-1 protein was downloaded from the NCBI database, and the physicochemical properties, structure and antigenic epitopes of the Ss-SRPN-1 protein were predicted using bioinformatics tools, including ExPASy, SWISS-MODEL and Protean. Primers were designed according to the nucleotide sequences of Ss-SRPN-1, and the Ss-SRPN-1 gene was amplified, cloned and sequenced with genomic DNA extracted from the infective third-stage larvae of S. stercoralis as a template. The Ss-SRPN-1 protein sequence was cloned into the pET28a (+) expression vector and transformed into Escherichia coli BL21 (DE) cells for induction of the recombinant Ss-SRPN-1 protein expression. The recombinant Ss-SRPN-1 protein was then purified and identified using Western blotting and mass spectrometry. Results Bioinformatics analysis showed that the Ss-SRPN-1 protein, which was composed of 372 amino acids and had a molecular formula of C₁₉₄₈H₃₀₄₆N₄₈₈O₅₇₅S₁₆, was a stable hydrophilic protein, and the subcellular localization of the protein was predicted to be extracellular. The Ss-SRPN-1 protein was predicted to contain 11 dominant B-cell antigenic epitopes and 20 T-cell antigenic epitopes. The Ss-SRPN-1 gene with a length of 1 119 bp was successfully amplified, and the recombinant plasmid pET28a (+)/Ss-SRPN-1 was constructed and transformed into E. coli BL21(DE) cells. The expressed recombinant Ss-SRPN-1 protein had a molecular weight of approximately 43 kDa, and was characterized as a Ss-SRPN-1 protein. Conclusions The recombinant Ss-SRPN-1 protein has been expressed successfully, and this recombinant protein may be a potential vaccine candidate against strongyloidiasis.

Objective:To investigate the effect of S100 calcium-binding protein A9(S100A9)activation of nuclear factor kappa-B(NF-κB)on the upregulation of toll-like receptor 7(TLR7)expression and the release of inflammatory factors in microglia,as well as its underlying mechanism.Methods:The viability of BV2 microglia was assessed using CCK-8 kit.Transcriptome sequencing was employed to compare differential genes(DEGs)and identify target genes from the pool of differentially expressed genes.This analysis was complemented by GO analysis,KEGG enrichment analysis and the STRING database.The expression of TLR7 mRNA was verified by real time RT-PCR.The expressions of CD68 and CD206 were detected using immunofluorescence.The expressions of CD68,CD206,TLR7,p65,and p-p65 were detected using Western Blot.The level of interleukin 6(IL-6)and tumor necrosis factor alpha(TNF-α)were verified by ELISA.Results:Moderate concentrations of S100A9 had no inhibitory effect on microglial viability.Compared to the control group,the experimental group showed a significant increase in the expression level of CD68 pro-tein,while the CD206 protein was decreased.This suggests that S100A9 promotes the activation of BV2 microglia into pro-inflammatory types.TAK-242,an inhibitor of toll-like receptor 4(TLR4),significantly inhibited the expression levels of TNF-α and IL-6 after S100A9 stimulated BV2 cells.Activation of the TLR4/NF-κB pathway promoted the ex-pression of TLR7 protein.Conclusion:The moderate concentration of S100A9 can promote the polarization of microglia towards a proinflammatory direction.It also promotes the expression of TLR7 and the release of various inflammatory factors,including TNF-α and IL-6,through the activation of the TLR4/NF-κB pathway.This activation has an obvious proinflammatory effect.

Objective:To explore the application effect of the caregiver self-management support project in main caregivers of adolescents with epilepsy.Methods:Using the convenient sampling method, the main caregivers of adolescents with epilepsy who were enrolled before implementation of the caregiver self-management support project of the First Affiliated Hospital of Zhengzhou University from January to August 2019 were included in the control group ( n=101) , and they were given routine follow-up. The main caregivers of adolescents with epilepsy who were enrolled after the implementation of the project from September 2019 to June 2020 were included in the study group ( n=101) . Before and after the intervention, the Connor-Davidson Resilience Scale (CD-RISC) , Simplified Coping Style Questionnaire (SCSQ) , Zarit Burden Interview (ZBI) , Life Satisfaction Index A (LSIA) and Medical Outcome Study Social Support Survey (MOS-SSS) were used to compare the psychological resilience, coping style, quality of life and social support of caregivers between the two groups. Finally, a total of 98 caregivers in the study group and 97 caregivers in the control group completed the study. Results:After the intervention, the scores of dimensions of CD-RISC, positive coping score of SCSQ, LSIA score and dimensions scores of MOS-SSS of main caregivers in the study group were higher than those in the control group, while the scores of negative coping of SCSQ and ZBI were lower than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The caregiver self-management support project helps to strengthen the psychological resilience of the main caregivers of adolescents with epilepsy, enhance their active coping style and social support and improve their quality of life.

Objective: To observe the effect of the respiratory rehabilitation and TCM exercises combined with conventional western medicine therapy for the patients with COPD. Methods: A total of 84 patients with COPD were randomized into the control group and observation group, 42 in each group. The control group were treated with conventional Western medicine treatment, and the observation group was treated with traditional Chinese exercises "sixth tactic" treatment on the basis of control group treatment. All patients were taken one year course of treatment. The changes in lung function, AECOPD occurrence, changes in symptom scores, Hamilton heart questionnaire integration were observed; and possible changes in the factors affecting the efficacy was analyzed by Logistic regression. Results: There were not significant differences in FEV1, FEV1/FVC, PEF and SpO₂ between the two groups before treatment. After 1 year of treatment, the FEV1 (1.58 ± 0.21 L vs.1.33 ± 0.22 L, t=8.092), FEV1/FVC (82.92% ± 8.42% vs. 62.81% ± 8.94%, t=10.013), PEF (358.27 ± 27.03 L/min vs. 324.13 ± 32.03, t=6.272), SpO₂ (99.58% ± 2.72% vs. 91.92% ± 2.89%, t=10.142) in the observation group were significantly higher than those in the control group (P<0.05). After treatment, Chinese medicine syndrome scores (6.3 ± 2.2 vs. 9.2 ± 2.0, t=4.652), HAMA score (6.0 ± 1.7 vs. 9.0 ± 2.0, t=4.563), HAMD score (6.1 ± 2.0 vs. 8.7 ± 1.7, t=5.094) in the observation group were superior to the subcontrol group (P<0.05). Regression analysis showed that there was a linear correlation between patient group, course of disease and outcome effect (P<0.05). Conclusions The respiratory rehabilitation and traditional Chinese medicine exercises "sixth tactic" combined with conventional treatment could release anxiety, depression and negative emotions, and improve clinical symptoms of the patients with COPD.

Objective To estimate the diagnostic value of cytology, DNA-ICM(DNA-image cytometry),cytology combined with DNA-ICM for pancreatic malignancy,and to explore the cut-off value for DNA-ICM. Methods Patients with suspicious pancreatic malignancy were retrospectively identified. In total,145 EUS-FNA specimens acquired from 140 separate patients were examined by cytology and DNA-ICM. Diagnostic values among cytology, DNA-ICM and the combination of the techniques in detecting pancreatic malignancy were compared. Results Compared with cytology, DNA-ICM had a lower sensitivity (63.0% VS 82.4%)and accuracy(69.7% VS 85.5%). After combining the techniques, the diagnostic value for pancreatic malignancy significantly improved compared with that by cytology(0.941 VS 0.912, P=0.007 0)or DNA-ICM only(0.941 VS 0.815, P<0.000 1). By using the Youden index, the cut-off value for DNA-ICM to detect pancreatic malignancy was one cell with DI(DNA index)≥2.5. Notably,with this standard, the sensitivity and accuracy of DNA-ICM significantly increased to 72.3% and 77.2%, and those of the combined techniques increased to 91.6% and 93.1%, respectively. Conclusion Automated DNA-ICM is an objective and effective method for pancreatic malignancy. Although DNA-ICM has a lower diagnostic value than that of conventional cytology, an improved value was obtained after combining the techniques.

Objective To compare the effect of progressive teaching pattern with traditional long-term training on improvement of trainees ability of endoscopic ultrasonography ( EUS ) . Methods Ten learners who have achieved competence on routine endoscopic procedures but without any knowledge and skills on EUS procedures were enrolled in the study, and were randomly divided into two groups according to the sequence number. Learners with odd number received traditional long-term training, and the even number learners received progressive teaching. The proficiency of EUS knowledge and skills in the two groups were compared after one-year learning. Results At the final examination, the learners′ ability of mastering EUS was higher, and the study leave time was shorter in the progressive teaching group than that in the traditional long-term training group. however, we didn′t have a statistical comparison owing to the few numbers of trainees. Conclusion Progressive teaching pattern is superior to the traditional training, and it should be advocated when hospitals are relatively understaffed.