Objective:To investigate the clinical, epidemic and laboratory characteristics of brucellosis in Hainan, and to summarize the experience of diagnosis and treatment.Methods:The epidemiological characteristics, clinical manifestations, laboratory results, treatment and prognosis of 27 inpatients with brucellosis admitted to the Second Affiliated Hospital of Hainan Medical University from January 2019 to December 2023 were retrospectively analyzed.Results:In 27 cases, the male to female ratio was 2.38 ∶ 1.00 (19 ∶ 8). Occupational distribution was dominated by farmers and herdsmen, with a total of 21 cases (77.8%). Twenty-one patients (77.8%) had a clear history of contact with cattle, sheep, and related products, and there was a phenomenon of family clustering. Eighteen patients (66.7%) developed symptoms from March to July. The clinical manifestations of the patients were lack of specificity, mainly fever (24 cases, 88.9%), dizziness and headache (13 cases, 48.1%), and low back pain (11 cases, 40.7%). Some patients also had symptoms and signs such as fatigue (8 cases), muscle pain (6 cases), chest tightness (4 cases), and splenomegaly (6 cases). Complications commonly included pulmonary infection (13 cases, 48.1%) and spinal involvement (11 cases, 40.7%). The positive rates of Brucella blood culture, tube agglutination test, Rose Bengal plate agglutination test, and cerebrospinal fluid or joint cavity effusion culture were 76.9% (20/26), 100.0% (21/21), 100.0% (11/11), and 3/4, respectively. The combination therapy of doxycycline and rifampicin showed good therapeutic effects, and 22 patients were cured. Conclusions:Hainan is not an epidemic area of brucellosis, and the clinical manifestations of the disease are not specific. The epidemic and clinical characteristics of the disease should be paid attention to in order to improve the level of diagnosis and treatment and control effectiveness.

Objective:To study the epidemiological and clinical characteristics of patients infected with Streptococcus suis in Hainan Province. Methods:Clinical data of patients diagnosed with human infection with Streptococcus suis at the Second Affiliated Hospital of Hainan Medical University from January 2017 to December 2023 were collected, and their epidemiological characteristics, clinical manifestations, auxiliary examination results, treatment and prognosis were retrospectively analyzed. Results:A total of 29 patients infected with Streptococcus suis were included, with 26 males (89.66%) and 3 females (10.34%). The age of the patients was (54.52 ± 10.89) years old, with the highest number of patients aged 51 to 60 years, accounting for 41.38% (12 cases). Farmers were the main occupation (72.41%, 21/29). Forty-four point eighty-three percent (13/29) of the patients had a history of direct or indirect contact with dead or sick pigs. The number of cases from January to December was 0, 0, 2, 2, 4, 8, 2, 3, 2, 2, 3, and 1, respectively. June was the peak period of incidence (27.59%, 8/29). The main clinical manifestations were fever (100.00%, 29/29), altered state of consciousness (51.72%, 15/29), headache (48.28%, 14/29), and hearing impairment (44.83%, 13/29). In clinical classification, common type, meningitis type, and mixed type accounted for 20.69% (6/29), 75.86% (22/29), and 3.45% (1/29), respectively. In the pathogen examination, all 29 patients underwent blood culture, and 18 patients (62.07%, 18/29) had positive blood culture; 26 patients underwent cerebrospinal fluid culture, and 8 cases (30.77%) tested positive for cerebrospinal fluid culture. Eighty-nine point sixty-six percent (26/29) of the patients were treated with ceftriaxone sodium; 55.17% (16/29) of the patients were treated with combined treatment of ceftriaxone sodium and glucocorticoids, including 11 cases treated with dexamethasone and 5 cases treated with methylprednisolone. After treatment, 7 patients were cured and discharged, and 22 patients showed improvement in their condition and discharged from hospital. At discharge, both blood and/or cerebrospinal fluid cultures turned negative. Telephone follow-up was conducted 6 months after discharge, and 20 patients had no sequelae, 9 patients still had hearing impairment, including one who also developed walking difficulties. Conclusions:The patients infected with Streptococcus suis in Hainan Province are mainly middle-aged, elderly, male and farmers, with June being the peak period of the disease. The main clinical manifestations are fever, altered state of consciousness, headache, and hearing impairment. After follow-up, there are still patients with residual hearing impairment. In clinical practice, patients with fever and hearing impairment should be considered as this disease as early as possible.

Objective:To investigate the clinical, epidemic and laboratory characteristics of brucellosis in Hainan, and to summarize the experience of diagnosis and treatment.Methods:The epidemiological characteristics, clinical manifestations, laboratory results, treatment and prognosis of 27 inpatients with brucellosis admitted to the Second Affiliated Hospital of Hainan Medical University from January 2019 to December 2023 were retrospectively analyzed.Results:In 27 cases, the male to female ratio was 2.38 ∶ 1.00 (19 ∶ 8). Occupational distribution was dominated by farmers and herdsmen, with a total of 21 cases (77.8%). Twenty-one patients (77.8%) had a clear history of contact with cattle, sheep, and related products, and there was a phenomenon of family clustering. Eighteen patients (66.7%) developed symptoms from March to July. The clinical manifestations of the patients were lack of specificity, mainly fever (24 cases, 88.9%), dizziness and headache (13 cases, 48.1%), and low back pain (11 cases, 40.7%). Some patients also had symptoms and signs such as fatigue (8 cases), muscle pain (6 cases), chest tightness (4 cases), and splenomegaly (6 cases). Complications commonly included pulmonary infection (13 cases, 48.1%) and spinal involvement (11 cases, 40.7%). The positive rates of Brucella blood culture, tube agglutination test, Rose Bengal plate agglutination test, and cerebrospinal fluid or joint cavity effusion culture were 76.9% (20/26), 100.0% (21/21), 100.0% (11/11), and 3/4, respectively. The combination therapy of doxycycline and rifampicin showed good therapeutic effects, and 22 patients were cured. Conclusions:Hainan is not an epidemic area of brucellosis, and the clinical manifestations of the disease are not specific. The epidemic and clinical characteristics of the disease should be paid attention to in order to improve the level of diagnosis and treatment and control effectiveness.

Objective:To study the epidemiological and clinical characteristics of patients infected with Streptococcus suis in Hainan Province. Methods:Clinical data of patients diagnosed with human infection with Streptococcus suis at the Second Affiliated Hospital of Hainan Medical University from January 2017 to December 2023 were collected, and their epidemiological characteristics, clinical manifestations, auxiliary examination results, treatment and prognosis were retrospectively analyzed. Results:A total of 29 patients infected with Streptococcus suis were included, with 26 males (89.66%) and 3 females (10.34%). The age of the patients was (54.52 ± 10.89) years old, with the highest number of patients aged 51 to 60 years, accounting for 41.38% (12 cases). Farmers were the main occupation (72.41%, 21/29). Forty-four point eighty-three percent (13/29) of the patients had a history of direct or indirect contact with dead or sick pigs. The number of cases from January to December was 0, 0, 2, 2, 4, 8, 2, 3, 2, 2, 3, and 1, respectively. June was the peak period of incidence (27.59%, 8/29). The main clinical manifestations were fever (100.00%, 29/29), altered state of consciousness (51.72%, 15/29), headache (48.28%, 14/29), and hearing impairment (44.83%, 13/29). In clinical classification, common type, meningitis type, and mixed type accounted for 20.69% (6/29), 75.86% (22/29), and 3.45% (1/29), respectively. In the pathogen examination, all 29 patients underwent blood culture, and 18 patients (62.07%, 18/29) had positive blood culture; 26 patients underwent cerebrospinal fluid culture, and 8 cases (30.77%) tested positive for cerebrospinal fluid culture. Eighty-nine point sixty-six percent (26/29) of the patients were treated with ceftriaxone sodium; 55.17% (16/29) of the patients were treated with combined treatment of ceftriaxone sodium and glucocorticoids, including 11 cases treated with dexamethasone and 5 cases treated with methylprednisolone. After treatment, 7 patients were cured and discharged, and 22 patients showed improvement in their condition and discharged from hospital. At discharge, both blood and/or cerebrospinal fluid cultures turned negative. Telephone follow-up was conducted 6 months after discharge, and 20 patients had no sequelae, 9 patients still had hearing impairment, including one who also developed walking difficulties. Conclusions:The patients infected with Streptococcus suis in Hainan Province are mainly middle-aged, elderly, male and farmers, with June being the peak period of the disease. The main clinical manifestations are fever, altered state of consciousness, headache, and hearing impairment. After follow-up, there are still patients with residual hearing impairment. In clinical practice, patients with fever and hearing impairment should be considered as this disease as early as possible.

Objective: To investigate the current status of myopia in children and adolescents in Qamdo, Tibet, and analyze related influencing factors, so as to provide a basis for the prevention and control of adolescents in plateau areas. Methods: A cross sectional study was conducted among 959 children and adolescents randomly selected from one district and two counties in Qamdo (from the fourth grade of elementary school to the second grade of high school) for visual acuity and refraction tests and filled out a vision related behavior questionnaire to analyze the incidence of myopia among adolescents in the region and its associated factors. Results: The myopia rate of adolescents in grades 4-11 was 54.43%, the rate of undercorrection of refractive errors was 85.25%, and the percentage of students wearing eyeglasses was 34.67%,fully vision correction rate was 42.54%. The myopia rate of students in grades 4-6 was 35.14%, 64.71% in grades 7-9, and 73.48% in grades 10-11. The myopia rate increased with grades( χ 2= 101.18 , P <0.01). The myopia rate (70.40%) of urban students (grades 4-9) was higher than that of county level(41.45%), and the myopia rate of students with myopia from either parent (68.24%) was higher than that of students without myopia (51.91%) , the myopia rate of girls (59.96%) was higher than that of boys (48.36%)( χ 2=53.19，13.46，12.98， P <0.01). Use electronic products for more than 2.5 hours per day, electronic devices usage after bedtime, the light low indoor brightness when studying on a sunny day, and only use one of the table lamps or roof lights when studying at night, preference for fried food, poor sleep quality, in the morning the students who still feel tired are at higher risk of myopia( χ 2=10.35, 10.91, 6.87, 4.25, 4.97, 5.71, 12.11, P < 0.05). Multivariate regression analysis showed that the occurrence of myopia was related to region, grade, gender, parental myopia, time spent on electronic products every day in the past 5 months, and sleep quality( P <0.05). Conclusion The high rate of myopia in children and adolescents in Qamdo may be related to the quality of sleep, the length of time electronic products are used, the eye environment, and the frequency of eating fried foods. Outdoor activities do not show significant differences.

Objective:To investigate the role of vitamin D analogue paricalcitol in activating vitamin D receptor/glutathione peroxidase 4 (VDR/GPX4) pathway in ventilator-induced lung injury (VILI).Methods:Twenty-four male C57BL/6J mice were randomly divided into control group, high tidal volume (HVT) induced VILI model group (HVT group), paricalcitol control group (P group), and paricalcitol pretreatment group (P+HVT group), with 6 mice in each group. The mice were endotracheal intubated and ventilated at 40 mL/kg tidal volume to prepare VILI model, while those in the control group were intubated without ventilation. The mice in the P+HVT group were intraperitoneally injected with paricalcitol 0.2 μg/kg once a day 1 week before modeling, while those in the P group were intraperitoneally injected paricalcitol 0.2 μg/kg once a day for 1 week before the experiment. After ventilation for 4 hours, the mice were sacrificed for lung tissue collection. Lung injury was evaluated by wet/dry (W/D) ratio, hematoxylin-eosin (HE) staining and Masson staining. The expressions of VDR and GPX4 were determined by Western blotting and immunohistochemistry. Malondialdehyde (MDA) and glutathione (GSH) contents were determined by micro method.Results:After HVT for 4 hours, compared with the control group, lung injury score and W/D ratio were significantly higher (lung injury score: 0.430±0.035 vs. 0.097±0.025, lung W/D ratio: 4.860±0.337 vs. 3.653±0.332, both P < 0.05), collagen fiber deposition was significantly increased, the content of MDA in lung tissue was significantly increased (nmol/g: 212.420±8.757 vs. 97.073±5.308, P < 0.05), GSH content and the protein expressions and immunoreactive score (IRS) of VDR and GPX4 were significantly decreased [GSH (μg/g): 44.229±1.690 vs. 70.840±0.781; VDR protein (VDR/GAPDH): 0.518±0.029 vs. 0.762±0.081, GPX4 protein (GPX4/GAPDH): 0.452±0.032 vs. 0.649±0.034; IRS score: VDR was 4.168±0.408 vs. 10.167±0.408, GPX4 was 4.333±1.033 vs. 10.333±0.516; all P < 0.05], which meant that the mice in HVT group showed obvious lung injury. After VDR was activated by paricalcitol, compared with the HVT group, lung injury score and W/D ratio were significantly decreased (lung injury score: 0.220±0.036 vs. 0.430±0.035, lung W/D ratio: 4.015±0.074 vs. 4.860±0.337, both P < 0.05), collagen fiber deposition was reduced, MDA content in lung tissue was decreased (nmol/g: 123.840±8.082 vs. 212.420±8.757, P < 0.05), GSH content and the protein expressions and IRS score of VDR and GPX4 were significantly up-regulated [GSH (μg/g): 63.094±0.992 vs. 44.229±1.690; VDR protein (VDR/GAPDH): 0.713±0.056 vs. 0.518±0.029, GPX4 protein (GPX4/GAPDH): 0.605±0.008 vs. 0.452±0.032; IRS score: VDR was 9.000±0.632 vs. 4.168±0.408, GPX4 was 8.833±0.408 vs. 4.333±1.033; all P < 0.05], which meant that lung injury in P+HVT group was significantly improved. Conclusion:Vitamin D analogue paricalcitol ameliorates pulmonary oxidation-reduction imbalance by activating the VDR/GPX4 pathway, thereby alleviating VILI.

Objective:To analyze the epidemiological and clinical characteristics of patients with tsutsugamushi disease in Hainan Province, so as to provide basis for diagnosis, treatment, prevention and control of the disease.Methods:Clinical data of 93 patients with tsutsugamushi disease in the Second Affiliated Hospital of Hainan Medical University from January 2018 to December 2019 were collected. Epidemiological data, clinical manifestations, examination results, treatment and outcome of the patients were retrospectively analyzed.Results:Of totally 93 patients with tsutsugamushi disease, 48 were male and 45 were female, with an average age of 50.73 years old. The peak time of onset was from June to October, with 46 cases (49.46%). Seventy cases (75.27%) were farmers, and 84 cases (90.32%) had a clear history of field work or grassland contact before onset. The clinical manifestations were fever (93/93, 100.00%), eschar or ulcer (42/93, 45.16%), headache (65/93, 69.89%), chills (60/93, 64.52%), rash (35/93, 37.63%), lymphadenopathy (51/93, 54.84%) and fatigue (40/93, 43.01%). Laboratory examination results: eosinophil reduced (74/93, 79.57%), platelet reduced (32/93, 34.41%); alanine aminotransferase, C reactive protein (CRP), procalcitonin (PCT) and erythrocyte sedimentation rate (ESR) were increased in 81.72% (76/93), 97.85% (91/93), 20.43% (19/93) and 72.04% (67/93) of the patients, respectively. Eighty-four cases (90.32%) had abnormal results of chest imaging. All patients were cured by doxycycline.Conclusions:Tsutsugamushi disease is prevalent in summer and autumn in Hainan. It has various clinical manifestations. Doxycycline is an effective treatment drug. It is suggested that the relevant departments should strengthen the training of clinical diagnosis and treatment of tsutsugamushi disease by local clinicians to reduce the misdiagnosis rate.