This study identified the types and pathogen carrying status of fleas on the surface of sheep in some areas of southern Xinjiang,and analyzed the genetic evolution differences with respect to related pathogens.The aim was to provide a reference for the local prevention and control of fleas and insect borne infectious diseases.A total of 1 586 fleas were collected from agricultural and pas-toral areas of Tumushuke City and Hotan Prefecture.Flea species were identified on the basis of morphology and the Pulex irritans mi-tochondrial COII gene.Flea DNA was extracted,and PCR was conducted to amplify the Bartonella gltA gene;Arsenophonus,Ana-plasma,Ehrlichia,and Wolbachia 16S rRNA genes;RickettsiaOmpA,17kDa,16S rRNA genes,and Yersinia pestis 16S rDNA gene.The amplified products were sequenced,and the homology of the genes of the three detected pathogens(gltA gene of Bartonella,16S rRNA gene of Wolbachia,and Anaplasma phagocytophilum)with respect to known corresponding genes of the same pathogen in Gen-Bank was analyzed.Phylogenetic trees were constructed with the adjacency method in MEGA 11.0.According to morphological and mo-lecular biology identification results,all fleas collected in this study were Pulex irritans.PCR indicated that the target gene fragments had been added to the mitochondrial COII,BartonellagltA,Wolbachia,and autophagosomal 16S rRNA genes of human fleas,all of which were consistent with the expected fragment sizes.Target bands were not amplified from Ehrlichia,Arsenophonus,spotted fever group Rickettsia,and Yersinia pestis.According to homology and genetic evolution analysis of human flea mitochondrial COII and the corresponding genes of the above-described pathogens,the COX2 gene(ON455234.1)of human fleas in Tumushuke city and Iran ob-tained in this study showed the highest homology(99.84%).The COII gene(NC_063709.1)of human fleas in Hetan City and Hunan region showed the highest homology(100%).Our findings further confirmed that the flea species was Pulex irritans.The PCR amplifi-cation results indicated that the collected Pulex irritans carried multiple pathogens,among which Bartonella and Wolbachia had the highest infection rates,and the infection rate with Anaplasma phagocytophilum was relatively low.This study is the first to discover flea species on the surface of sheep in some areas of southern Xinjiang.Our findings preliminarily confirmed that Bartonella,Wolba-chia,and Anaplasma phagocytophilum are the main Pulex irritans pathogens.

This study identified the types and pathogen carrying status of fleas on the surface of sheep in some areas of southern Xinjiang,and analyzed the genetic evolution differences with respect to related pathogens.The aim was to provide a reference for the local prevention and control of fleas and insect borne infectious diseases.A total of 1 586 fleas were collected from agricultural and pas-toral areas of Tumushuke City and Hotan Prefecture.Flea species were identified on the basis of morphology and the Pulex irritans mi-tochondrial COII gene.Flea DNA was extracted,and PCR was conducted to amplify the Bartonella gltA gene;Arsenophonus,Ana-plasma,Ehrlichia,and Wolbachia 16S rRNA genes;RickettsiaOmpA,17kDa,16S rRNA genes,and Yersinia pestis 16S rDNA gene.The amplified products were sequenced,and the homology of the genes of the three detected pathogens(gltA gene of Bartonella,16S rRNA gene of Wolbachia,and Anaplasma phagocytophilum)with respect to known corresponding genes of the same pathogen in Gen-Bank was analyzed.Phylogenetic trees were constructed with the adjacency method in MEGA 11.0.According to morphological and mo-lecular biology identification results,all fleas collected in this study were Pulex irritans.PCR indicated that the target gene fragments had been added to the mitochondrial COII,BartonellagltA,Wolbachia,and autophagosomal 16S rRNA genes of human fleas,all of which were consistent with the expected fragment sizes.Target bands were not amplified from Ehrlichia,Arsenophonus,spotted fever group Rickettsia,and Yersinia pestis.According to homology and genetic evolution analysis of human flea mitochondrial COII and the corresponding genes of the above-described pathogens,the COX2 gene(ON455234.1)of human fleas in Tumushuke city and Iran ob-tained in this study showed the highest homology(99.84%).The COII gene(NC_063709.1)of human fleas in Hetan City and Hunan region showed the highest homology(100%).Our findings further confirmed that the flea species was Pulex irritans.The PCR amplifi-cation results indicated that the collected Pulex irritans carried multiple pathogens,among which Bartonella and Wolbachia had the highest infection rates,and the infection rate with Anaplasma phagocytophilum was relatively low.This study is the first to discover flea species on the surface of sheep in some areas of southern Xinjiang.Our findings preliminarily confirmed that Bartonella,Wolba-chia,and Anaplasma phagocytophilum are the main Pulex irritans pathogens.

ObjectiveTo explore new targets and herbal medicines of total ginsenosides in ameliorating alcoholic hepatitis （AH） by data mining and experimental validation and to provide new directions for the clinical treatment of AH. MethodGSE28619 was selected as the test set from the GEO database and GSE83148 and GSE103580 were selected as the validation sets. The limma package and weighted gene co-expression network analysis （WGCNA） were employed to identify the AH-related differentially expressed genes and modular genes， and Venny was used to extract the common genes. The protein-protein interaction （PPI） network was constructed and the enrichment analysis was carried out. The hub genes were further screened and evaluated for their diagnostic value. After validation with the datasets， new potential targets of AH and traditional Chinese medicine were predicted. Molecular docking between the targets and active ingredients of traditional Chinese medicine was performed， and the results were validated by experiments. Eight out of 48 SD rats were randomly selected into a blank group and received an equal amount of normal saline. The rest rats were subjected to modeling with ethanol by gavage and then randomized into low- （10 mg·kg^-1）， medium- （20 mg·kg^-1）， and high-dose （40 mg·kg^-1） total ginsenosides， model， and positive control （metadoxine， 117 mg·kg^-1） groups. After 3 weeks of gavage， serum samples were collected for the measurement of aspartate aminotransferase （AST） and alanine aminotransferase （ALT） levels， and liver samples were collected for hematoxylin-eosin （HE） staining. Western blot and Real-time PCR were employed to determine the protein and mRNA levels， respectively， of potential targets in the liver tissue. ResultData mining predicted the potential genes： Proto-oncogene FOS and collagen type Ⅰ alpha 2 （COL1A2）. Experimental validation showed that the liver injury was alleviated after drug administration compared with that after modeling. The serum AST and ALT levels were reduced after drug administration. The protein and mRNA levels of FOS were significantly up-regulated， while those of COL1A2 were down-regulated after drug administration. ConclusionTotal ginsenosides ameliorate HA via FOS and COL1A2.

Objective:To investigate the intention to obtain disease related information and its influencing factors among the elderly at their end-of-life stage.Methods:A cross-sectional survey was conducted among 414 elderly people aged ≥60 in 7 long-term residential care facilities and 15 communities in the central urban area of Fuzhou using the late-life care preference questionnaire from October 2016 to June 2017. Univariate analysis, multiple linear regression analysis and ordered multi-classification logistic regression analysis were used to identify information preference of the disease-related information and influencing factors among the elderly.Results:The level of disease-related information needs of the elderly was scored (17.1±4.9); 48.8% (202/414) preferred detailed or maximum information; 30.7% (127/414) wanted selective and partial information; 20.5% (85/414) did not want to know any information. Multiple linear regression analysis showed that age, education, and whether or not they had received or seen other life-sustaining treatments were the main factors affecting the level of disease-related information needs (standardized regression coefficients were -0.141, 0.116, 0.115, all P<0.05); ordered multi-classification logistic regression analysis showed that age (compared with 60-69 years old, 70-79 years old: OR=0.544, 95% CI: 0.310-0.957; 80-89 years old: OR=0.526, 95% CI: 0.289-0.956), education level (compared with primary school and below, college or above: OR=2.166, 95% CI: 1.093-4.290), main sources of living expenses (compared with other allowance, family support: OR=7.303, 95% CI: 1.157-46.108, pension: OR=9.288, 95% CI: 1.502-57.415; provident fund scheme/saving: OR=15.676, 95% CI: 2.122-115.793), whether or not they had received or seen other life-sustaining treatments (compared with yes, OR=1.985, 95% CI: 1.150-3.425) were the main factors affecting the level of disease-related information needs. Conclusions:Most of the elderly prefer to know disease-related information. Age, educational level, main sources of living expenses and whether or not they had received or seen other life-sustaining treatments are the main influencing factors.

OBJECTIVES: Glioma is the most common intracranial primary tumor in central nervous system. Glioma grading possesses important guiding significance for the selection of clinical treatment and follow-up plan, and the assessment of prognosis. This study aims to explore the feasibility of logistic regression model based on radiomics to predict glioma grading. METHODS: Retrospective analysis was performed on 146 glioma patients with confirmed pathological diagnosis from January, 2012 to December, 2018. A total of 41 radiomics features were extracted from contrast-enhanced T RESULTS: A total of 5 imaging features selected by LASSO were used to establish a logistic regression model for predicting glioma grading. The model showed good discrimination with AUC value of 0.919. Hosmer-Lemeshow test showed no significant difference between the calibration curve and the ideal curve ( CONCLUSIONS The logistic regression model using radiomics exhibits a relatively high accuracy for predicting glioma grading, which may serve as a complementary tool for preoperative prediction of giloma grading.
Brain Neoplasms/diagnostic imaging* ; Glioma/diagnostic imaging* ; Humans ; Logistic Models ; Magnetic Resonance Imaging ; ROC Curve ; Retrospective Studies

A new electrochemical sensor for organophosphate pesticide(methyl-paraoxon)detection based on bifunctional cerium oxide(CeO2)nanozyme is here reported for the first time.Methyl-paraoxon was degraded into p-nitrophenol by using CeO2 with phosphatase mimicking activity.The CeO2 nanozyme-modified electrode was then synthesized to detect p-nitrophenol.Cyclic voltammetry was applied to investigate the electrochemical behavior of the modified electrode,which indicates that the signal enhancement effect may attribute to the coating of CeO2 nanozyme.The current research also studied and discussed the main parameters affecting the analytical signal,including accumulation potential,accumulation time,and pH.Under the optimum conditions,the present method provided a wider linear range from 0.1 to 100 μmol/L for methyl-paraoxon with a detection limit of 0.06 μmol/L.To validate the proof of concept,the electrochemical sensor was then successfully applied for the determination of methyl-paraoxon in three herb samples,i.e.,Coix lacryma-jobi,Adenophora stricta and Semen nelum-binis.Our findings may provide new insights into the application of bifunctional nanozyme in electro-chemical detection of organophosphorus pesticide.

Objective:To investigate the clinical effect of fingertip reconstruction using the toenail osteocutaneous flap without vascular anastomosis.Methods:From January 2015 to October 2020, the clinical data of patients with fingertip injuries were analyzed retrospectively, which were treated with the toenail osteocutaneous flap without vascular anastomosis in Chang’an Xin’an Hospital. The donor site was closed primarily or covered by a local flap. The appearance and function of the patients’ fingers were followed up. All cases were evaluated by the standard of thumb finger reconstruction function evaluation of the Chinese Medical Association of Hand Surgery. Appearance and function of nail bed after reconstruction was evaluated from four aspects.Results:A total of 11 cases (12 fingers) were enrolled, including eight males and three females. The average age was 35.6 years (range, 17-50 years). The etiologies included crush-related injury, cutting injury, mangled injury, and chemical corrosion injury. The injuries were found in thumb, index finger, middle finger, ring finger, or combined with multiple fingers. All fingertip defects were located distal to the nail root, including the defects distal to lunula in four cases, the defects distal to middle of the nail in five fingers , and the defects distal to 1/3 of the nail in three cases. Elective surgery was performed in 7 cases and emergency surgery in 4 cases. The defects ranged from 0.2 cm/0.5 cm/0.5 cm to 0.6 cm/0.8 cm/1.0 cm (phalanx/nail/finger pulp). The size of the toenail osteocutaneous flap ranged from 0.2 cm/0.5 cm/0.7 cm to 0.6 cm/0.8 cm/1.0 cm (phalanx/nail/flap). The defects length of the finger pulp were less than 1.0 cm. All reconstructed fingers survived, and the follow-up was 6-30 months (average, 12.5 months). The appearances of the reconstructed fingers were pulmp and ruddy, and the nails were flat. There was no dysfunction in the donor site. The average healing time of bone was 2.1 months (range, 1.5-3.0 months). According to the evaluation of index function, seven cases were excellent, four cases were good. The appearance and function of the nail bed were excellent in six fingers, good in five fingers, and poor in one finger.Conclusion:It is a simple and effective way to reconstruct the fingertip using the toenail osteocutaneous flap without vascular anastomosis.

Objective:To investigate the clinical effect of fingertip reconstruction using the toenail osteocutaneous flap without vascular anastomosis.Methods:From January 2015 to October 2020, the clinical data of patients with fingertip injuries were analyzed retrospectively, which were treated with the toenail osteocutaneous flap without vascular anastomosis in Chang’an Xin’an Hospital. The donor site was closed primarily or covered by a local flap. The appearance and function of the patients’ fingers were followed up. All cases were evaluated by the standard of thumb finger reconstruction function evaluation of the Chinese Medical Association of Hand Surgery. Appearance and function of nail bed after reconstruction was evaluated from four aspects.Results:A total of 11 cases (12 fingers) were enrolled, including eight males and three females. The average age was 35.6 years (range, 17-50 years). The etiologies included crush-related injury, cutting injury, mangled injury, and chemical corrosion injury. The injuries were found in thumb, index finger, middle finger, ring finger, or combined with multiple fingers. All fingertip defects were located distal to the nail root, including the defects distal to lunula in four cases, the defects distal to middle of the nail in five fingers , and the defects distal to 1/3 of the nail in three cases. Elective surgery was performed in 7 cases and emergency surgery in 4 cases. The defects ranged from 0.2 cm/0.5 cm/0.5 cm to 0.6 cm/0.8 cm/1.0 cm (phalanx/nail/finger pulp). The size of the toenail osteocutaneous flap ranged from 0.2 cm/0.5 cm/0.7 cm to 0.6 cm/0.8 cm/1.0 cm (phalanx/nail/flap). The defects length of the finger pulp were less than 1.0 cm. All reconstructed fingers survived, and the follow-up was 6-30 months (average, 12.5 months). The appearances of the reconstructed fingers were pulmp and ruddy, and the nails were flat. There was no dysfunction in the donor site. The average healing time of bone was 2.1 months (range, 1.5-3.0 months). According to the evaluation of index function, seven cases were excellent, four cases were good. The appearance and function of the nail bed were excellent in six fingers, good in five fingers, and poor in one finger.Conclusion:It is a simple and effective way to reconstruct the fingertip using the toenail osteocutaneous flap without vascular anastomosis.

Objective:To introduce some rare clinical features of the variant Guillain-barre syndrome (GBS) and to explore its possible pathogenesis for the early diagnosis.Methods:The clinical data, laboratory data and treatment outcomes of four patients, who admitted to Shenzhen People′s Hospital from October 2017 to June 2018 and diagnosed with variant GBS were analyzed and summarized.Results:All the four patients presented limb weakness as a first manifestation. However, they all had clinical features that were inconsistent with typical GBS, and the clinical features were shown differently in each patient. One patient showed asymmetrical limb paralysis. The first manifestation of one patient was severe and persistent back pain accompanied by paraplegia. One patient was accompanied by obvious headache and positive meningeal irritation. One patients had the plane of sensory obstacles, paraplegia, and positive pathological sign. Cerebrospinal fluid examination showed protein cell dissociation in four patients. Electromyogram was consistent with peripheral neurogenic damage. Magnetic resonance imaging (MRI) of the brain and the spinal cord showed no obvious abnormalities. The four patients with obvious improvement in symptoms were treated with gamma globulin and glucocorticoid.Conclusions:Variant GBS is rare and clinical symptoms are various. Patients with atypical clinical symptoms should still be diagnosed by relevant auxiliary examinations to avoid delayed illness.

Objective:To explore the diagnostic efficacy of nomogram based on multi-parameter MRI for assessment of bowel fibrosis in patients with Crohn disease（CD).Methods:The clinical and imaging data of CD patients diagnosed by surgical histopathology in the First Affiliated Hospital of Sun Yat-sen University from June 2015 to March 2018 were prospectively collected. All the patients underwent conventional MRI and diffusion kurtosis imaging（DKI) within 2 weeks before surgery. Patients who underwent surgery between June 2015 and September 2017 were included in the model building group, and those who underwent surgery between October 2017 and March 2018 were included in the model validation group. We measured the apparent diffusion coefficient（ADC) from monoexponential model of diffusion-weighted imaging（DWI), apparent diffusional kurtosis（K app), and apparent diffusion for non-Gaussian distribution（D app) from non-Gaussian DKI model, and observed T 2WI signal intensity and enhancement pattern of the same segment. One to three intestinal specimens per patient were stained with Masson′s trichrome for the histological grading of fibrosis. Correlations between qualitative/quantitative MRI indexes and histological grades were evaluated using the Spearman rank test. Multivariate logistic regression analysis was performed to identify independent factors to be included into the nomogram for predicting the degree of bowel fibrosis and its diagnostic performance was assessed by internal and external validation. Results:A total of 40 CD patients were included, including 31 in the model construction group and 9 in the model verification group. A total of 81 intestinal specimens from 31 patients were graded as none-to-mild bowel fibrosis（ n=32) and moderate-to-severe bowel fibrosis（ n=49) according to a scoring system of fibrosis. In the training cohort, the K app value of moderate-to-severely fibrotic bowel walls was significantly higher than that of none-to-mildly fibrotic bowel walls, and the D appand ADC values of moderate-to-severely fibrotic bowel walls were significantly lower than those of none-to-mildly fibrotic bowel walls（ Z=-5.999, -4.521 and -3.893; P<0.001). There was no significant difference in T 2WI signal intensity or enhancement pattern between these two groups（χ2=1.571 and 0.103; P>0.05). Moderate and mild correlations of histological fibrosis grades with K appand D app( r=0.721 and -0.483; P<0.001), and a mild correlation with ADC（ r=-0.445, P<0.001) were found. Independent factors derived from multivariate logistic regression analysis to predict the degree of bowel fibrosis were K app and D app. Internal and external validation revealed good performance of the nomogram with concordance index of 0.901（95% confidence interval, 0.824-0.978) and 1.000, respectively, for differentiating none-to-mild from moderate-to-severe fibrosis. Conclusion:The DKI-based nomogram can be used to evaluate the bowel fibrosis in CD patients and provides a visual and simple prediction method for clinic.