Objective To analyse medication patterns for treating menstrual disorders with disharmony between the Chong and Ren pattern based on data mining.Methods Medical records from the gynecological outpatient department of Wenzhou TCM Hospital of Zhejiang Chinese Medical University from October 2023 to March 2024 were collected.A database was established based on Traditional Chinese Medicine Inheritance Computer System(V3.0),and data mining methods such as frequency statistics,association rule analysis and cluster analysis were used to analyze the medication patterns of traditional Chinese medicine in the treatment of menstrual disorders with disharmony between the Chong and Ren pattern.Results A total of 9003 effective prescriptions were collected,involving 410 Chinese medicinal herbs.The top five herbs by frequency were Danggui,Tusizi,Cuxiangfu,Xuduan,and Danshen.Tonic medicines,circulate blood and transform stasis medicines and interior heat-clearing medicines were used more frequently.The four qi were mainly warm and cold,the five lavours were mainly bitter and sweet,and the channel were mainly liver and spleen channel.By association analysis,a combination of drugs with Tusizi,Gouqizi,Danggui,Xuduan,Cuxiangfu were obtained.After cluster analysis,five groups of effective class squares were obtained.Conclusion Treatment of menstrual disorders with disharmony between the Chong and Ren pattern is used to tonic medicines,circulate blood and transform stasis medicines and interior heat-clearing medicines,pay attention to the balance of liver,spleen,kidney.The prescribing strategy considers both superficial and underlying conditions,employs a gradual rather than abrupt approach,integrates both cold and warm remedies,and ensures mutual reinforcement and restriction among the treatments.

Fatty liver is common disease of nutritional metabolism in the perinatal period,character-ized by elevated levels of NEFA in the blood and disorders of lipid metabolism.High concentra-tions of NEFA damage mitochondria and promote the release of reactive oxygen species(ROS).At the same time,lipid peroxidation occurs in lipid accumulation in hepatocytes,producing free radi-cals such as ROS,which leads to oxidative stress in the liver.When the level of intracellular ROS increases,thioredoxin-interacting protein(TXNIP)activates nucleotide-binding oligomerization structure-like protein 3(NLRP3)inflammasomes,and oxidative stress can regulate pyroptosis,but it is unclear whether reactive oxygen species(ROS)produced by oxidative stress in hepatocytes can mediate pyroptosis and induce liver injury in dairy cows through the TXNIP/NLRP3 pathway.In this study,liver tissue samples from healthy dairy cows and fatty liver cows were collected,and NEFA was used to construct a fatty liver cell model,and triglyceride(TG)content and oxidative stress related indicators were detected by kit.Western blot was used to detect the activation of NL-RP3 inflammasomes,the inflammatory pathway of NF-κB and the expression levels of pyroptosis-related proteins.Fluorescence quantitative PCR was used to detect the relative expression level of inflammatory factor mRNA.The results showed that compared with the healthy(control)group,the TG content of fatty liver tissue and fatty liver cells was significantly increased(P＜0.05),the activities of SOD and GSH-Px were significantly decreased(P＜0.05),and the protein expression levels of TXNIP,NLRP3,GSDMD-N and Caspase-1 were significantly up-regulated(P＜0.05).The results of the antioxidant model of fatty hepatocytes using NEFA and antioxidants(NAC)showed that compared with the fatty hepatocyte model,the content of ROS in hepatocytes was sig-nificantly reduced,and oxidative stress,NLRP3 inflammasome activation and pyroptosis were alle-viated.In summary,this study found that when fatty liver disease occurs in dairy cows,ROS pro-duced by oxidative stress in the liver can mediate pyroptosis through the TXNIP/NLRP3 path-way,which can lead to liver injury in fatty liver cows.

Fatty liver is common disease of nutritional metabolism in the perinatal period,character-ized by elevated levels of NEFA in the blood and disorders of lipid metabolism.High concentra-tions of NEFA damage mitochondria and promote the release of reactive oxygen species(ROS).At the same time,lipid peroxidation occurs in lipid accumulation in hepatocytes,producing free radi-cals such as ROS,which leads to oxidative stress in the liver.When the level of intracellular ROS increases,thioredoxin-interacting protein(TXNIP)activates nucleotide-binding oligomerization structure-like protein 3(NLRP3)inflammasomes,and oxidative stress can regulate pyroptosis,but it is unclear whether reactive oxygen species(ROS)produced by oxidative stress in hepatocytes can mediate pyroptosis and induce liver injury in dairy cows through the TXNIP/NLRP3 pathway.In this study,liver tissue samples from healthy dairy cows and fatty liver cows were collected,and NEFA was used to construct a fatty liver cell model,and triglyceride(TG)content and oxidative stress related indicators were detected by kit.Western blot was used to detect the activation of NL-RP3 inflammasomes,the inflammatory pathway of NF-κB and the expression levels of pyroptosis-related proteins.Fluorescence quantitative PCR was used to detect the relative expression level of inflammatory factor mRNA.The results showed that compared with the healthy(control)group,the TG content of fatty liver tissue and fatty liver cells was significantly increased(P＜0.05),the activities of SOD and GSH-Px were significantly decreased(P＜0.05),and the protein expression levels of TXNIP,NLRP3,GSDMD-N and Caspase-1 were significantly up-regulated(P＜0.05).The results of the antioxidant model of fatty hepatocytes using NEFA and antioxidants(NAC)showed that compared with the fatty hepatocyte model,the content of ROS in hepatocytes was sig-nificantly reduced,and oxidative stress,NLRP3 inflammasome activation and pyroptosis were alle-viated.In summary,this study found that when fatty liver disease occurs in dairy cows,ROS pro-duced by oxidative stress in the liver can mediate pyroptosis through the TXNIP/NLRP3 path-way,which can lead to liver injury in fatty liver cows.

Objective To analyse medication patterns for treating menstrual disorders with disharmony between the Chong and Ren pattern based on data mining.Methods Medical records from the gynecological outpatient department of Wenzhou TCM Hospital of Zhejiang Chinese Medical University from October 2023 to March 2024 were collected.A database was established based on Traditional Chinese Medicine Inheritance Computer System(V3.0),and data mining methods such as frequency statistics,association rule analysis and cluster analysis were used to analyze the medication patterns of traditional Chinese medicine in the treatment of menstrual disorders with disharmony between the Chong and Ren pattern.Results A total of 9003 effective prescriptions were collected,involving 410 Chinese medicinal herbs.The top five herbs by frequency were Danggui,Tusizi,Cuxiangfu,Xuduan,and Danshen.Tonic medicines,circulate blood and transform stasis medicines and interior heat-clearing medicines were used more frequently.The four qi were mainly warm and cold,the five lavours were mainly bitter and sweet,and the channel were mainly liver and spleen channel.By association analysis,a combination of drugs with Tusizi,Gouqizi,Danggui,Xuduan,Cuxiangfu were obtained.After cluster analysis,five groups of effective class squares were obtained.Conclusion Treatment of menstrual disorders with disharmony between the Chong and Ren pattern is used to tonic medicines,circulate blood and transform stasis medicines and interior heat-clearing medicines,pay attention to the balance of liver,spleen,kidney.The prescribing strategy considers both superficial and underlying conditions,employs a gradual rather than abrupt approach,integrates both cold and warm remedies,and ensures mutual reinforcement and restriction among the treatments.

Objective:To analyze the clinical characteristics of intracranial infection caused by Mycobacterium lentiflavum. Methods:The clinical data of a patient with intracranial infection caused by Mycobacterium lentiflavum admitted to Tianjin Haihe Hospital in May 2023 were collected. Meanwhile relevant literatures in databases were searched. Only 1 English literature (1 patient) was obtained. The clinical characteristics of this patient and the case reported in the literature were analyzed and summarized. Results:Totally 2 patients, including this case, and the patient with meningoencephalitis caused by Mycobacterium lentiflavum reported in the literature, both are females, 42 and 55 years old respectively, both manifested a chronic course, without fever, and presented progressive headache and cognitive impairment. Clinical manifestations also included abnormal mental behavior, limb weakness, and seizure. At the early stage, only intracranial pressure increased, and cerebrospinal fluid tests were negative. As the disease aggravated, there was an elevation of cerebrospinal fluid cells and protein, with normal levels of glucose and chloride. Using brain tissue obtained by biopsy for polymerase chain reaction or next-generation sequencing examination, the pathogenic microorganism was confirmed, which made accurate diagnosis possible. Antibiotic treatment had good efficacy, with a long treatment course and a good prognosis. Conclusions:Central nervous system infection caused by Mycobacterium lentiflavum is very rare, and a chronic disease course makes diagnosis very difficult. The treatment effect is significant, and the prognosis is excellent.

Abstract: Objective　To investigate the antimicrobial activity of omadacycline (OMC) against clinical Streptococcus agalactiae (GBS) isolates, as well as its relationship with biofilm formation, resistance genes and virulence genes. Methods　A total of 136 strains of Streptococcus agalactiae isolated from Shenzhen Nanshan People's Hospital between 2015 to 2020. The minimum inhibitory concentration (MIC) of OMC against Streptococcus agalactiae was determined by broth microdilution. Crystal violet staining was used to detect the biofilm formation ability of GBS. Resistance genes (tetM, tetO, tetK, ermB, OptrA) and virulence genes (cpsⅢ, bca, fbsA, cpsA, scpB) were investigated by polymerase chain reaction (PCR). Results　Among the 136 clinical isolates of GBS, 20 strains (14.7%) were resistant to OMC, 64 (47.1%) were intermediate, and 52 (38.2%) were sensitive. Fifty-seven strains (41.9%) were biofilm-positive, 20 of which (35.1%) were sensitive to OMC. Seventy-nine strains (58.1%) were biofilm-negative, 32 of which (40.5%) were susceptible to OMC. There was a statistically significant difference in the sensitivity rates between the two groups of strains (χ2=63.062, P<0.001), but there was no significant difference in the sensitivity of OMC among the biofilm-positive strains (Fisher's exact test, P=0.824). The resistance rates of tetM, tetO, ermB and OptrA positive strains were higher than those of negative strains, while tetK was opposite. The presence of tetM (Z=0.815, P=0.415), tetO (Z=0.151, P=0.88), tetK (Z=0.567, P=0.571), ermB (Z=1.198, P=0.231) resistance genes in Streptococcus agalactiae had no significant impact on the sensitivity of OMC. However, the presence of the OptrA resistance gene showed a statistically significant effect on the sensitivity of OMC (Z=2.913, P=0.004). The virulence factors cpsⅢ, bca, fbsA, cpsA and scpB were all detected at a rate higher than 50%. The presence of the virulence genes cpsⅢ (Z=0.222, P=0.824), bca (Z=0.141, P=0.888), fbsA (Z=0.813, P=0.416), and cpsA (Z=1.615, P=0.106) in Streptococcus agalactiae had no significant impact on the sensitivity of OMC. However, there was a significant inter-group difference in the scpB virulence gene (Z=2.844, P=0.004), but the rank mean values and resistance rates of scpB-positive strains were lower than those of the negative strains. Conclusions　The formation of biofilm in Streptococcus agalactiae reduces its sensitivity to OMC, but there was no significant difference in the sensitivity to OMC among the biofilm-positive strains. The presence of resistance genes tetM, tetO, tetK, ermB, and virulence genes cpsⅢ, bca, fbsA, cpsA, scpB in Streptococcus agalactiae is not associated with OMC resistance, but the presence of the resistance gene OptrA is correlated with OMC resistance..

Objective:To discuss the challenges and problems of the prevention and control of emerging infectious diseases in Shanghai as a megacities.Methods:An imported case of cutaneous anthrax occurred in Shanghai on May 30, 2019. Shanghai Municipal Center for Disease Control & Prevention conducted an epidemiological investigation and treatment of the cases; after this case, the data of patients with cutaneous anthrax were collected, and an epidemiological study was conducted. Meanwhile, the wound and blood samples of the patient were collected for laboratory testing.Results:Of the seven wound samples of the patient, 6 were positive for the Bacillus anthracis nucleic acid test, and the double serological test results showed a 4-fold increase in the titer of anthrax antibodies. Shanghai CDC conducted an epidemiological investigation of the confirmed cases and observed its contacts. After treatment, the patients recovered, and no other issues appeared among the 19 contacts. Conclusions:Shanghai must strengthen the training of clinicians on emerging infectious diseases to achieve early detection, diagnosis, and treatment of imported infectious diseases and reduce the incidence, spread, and death of the diseases. At the same time, multi-department joint prevention and control are needed to prevent and control secondary cases.

Objective To understand the prevalence situation and influence factors of diabetes mellitus(DM) among adults in Dandong City to provide a reference basis for the prevention and treatment of DM and relevant department implementing the regional health plan.Methods A total of 10 267 permanent residents aged ≥18 years old in Dandong City were extracted to conduct the survey by using the multi-stage stratified cluster sampling method.The non-conditional multivariate Logistic regression analysis method was used to analyze its influencing factors.Results The prevalence rates of DM was 6.9％ among the adults in Dandong City,the standardization rates was 4.0 ％,in which 5.5 ％ for male standardization rate was 3.1％,8.2 ％ for female,standardization rate was 4.9 ％,female was higher than male,the difference was statistically significant (P＜0.05) The Logistic analysis results showed that male(OR=1.381)had higher prevalence risk than female;the prevalence risks in the age groups of 35-＜45 years old,45-＜55 years old,55-＜65 years old and ≥65 years old were 4.040,11.446,19.488 and 25.302 times of 18-＜35 years old group;the prevalence risk in the drinking group (OR=1.413) was higher than that in the non-drinking group;the prevalence risk in the group with preference for sweet,salty,fried and hot food (OR=1.274) was higher than that in the group without this preference;the prevalence risk in the hypertensive group(OR=1.773) was higher than that in the non-hypertensive group;physical exercises and sleep quality were the protective factor of DM(P＜0.05).Conclusion The prevalence rate of DM in Dandong is higher,and sex,age,alcohol consumption,exercise,sleep quality,preference for sweet salty fried overheating foods and hypertension are the main influencing factors of DM.

Objective To observe the clinical efficacy of herbs by internal and external administration combined with semiconductor laser irradiation in the treatment of chronic eczema.Methods Eighty-six patients with chronic eczema were divided into the herb group and the laser group by the randomized digital table,43 patients in each group.The patients in the herb group received oral administration with Chinese herbs together with application of herbs on the affected foci.The patients in the laser group received the same treatment as in the herb group and meanwhile treated with additional semiconductor laser therapy.The clinical effects were evaluated according to their itch degree and skin lesions.Result The cure rate and total effective rate were both significantly higher in the laser group than those in the herb group(P<0.05).Conclusion Compared with herbal internal and external administration only,the clinical efficacy of herbal internal and external administration combined with semiconductor laser irradiation is more effective in the treatment of chronic eczema.

Objective To evaluate the clinical value of ultrasonography in the diagnosis of hermaphroditism.Methods Ultrasonographic appearances of 45 cases with hermaphroditism were reviewed retrospectively,and the results were compared with clinical data.Results All cases were confirmed pathologically.5 cases showed true hermaphroditism (11.1％),14 cases showed male pseudohermaphroditism (31.1 ％),24 cases showed female pseudohermaphroditism (53.3 ％),2 cases showed gonadal dysgenesis(4.4％).Compared with pathological results in the ultrasound examination,4 cases showed true hermaphroditism,the coincidence rate was 80％.11 cases showed male pseudohermaphroditism,the coincidence rate was 78.6％.20 cases showed female pseudohermaphroditism,the coincidence rate was 83.3％.1 cases showed gonadal dysgenesis,the coincidence rate was 50.0％.Conclusions Ultrasonography can not only evaluate internal reproductive organs in the patients,but also estimate the site,size,morphology and structure,which provides important imaging evidence for the clinical diagnosis and treatment.