Objective To investigate the incidence and epidemiological characteristics of herpes zoster in Jinshan District, Shanghai, in 2024, and to provide a scientific basis for the development of prevention and control measures. Methods The visit information of herpes zoster cases in 2024 was collected through the outpatient diagnosis and treatment system of medical institutions in Jinshan District. Descriptive epidemiological methods were used for statistical analysis. Results In 2024, there were a total of 7 270 cases of herpes zoster in Jinshan District, including 3 398 male cases and 3 872 female cases. The incidence rate among females was higher than that among males (χ² =125.25, P< 0.001). Cases occurred in all age groups, with an average age of 59.58 ± 15.28 years. The highest proportion of cases was in the 50-year-old group (21.99%) and the 60-year-old group (25.45%). The incidence rate increased with age (χ² = 4 505.99, P< 0.001). The main departments for consultation were dermatology, pain clinics, and neurology. The main clinical diagnoses were herpes zoster without complications, postherpetic neuralgia, and incomplete herpes zoster. Among the cases, 3,102 patients had follow-up visits, and the number of follow-up visits increased with age. From 2020 to 2024, a total of 2,032 doses of herpes zoster vaccine were administered in the district, with the highest vaccination rate in the 50-year-old group (54.48%). Conclusion The majority of herpes zoster cases in Jinshan District are concentrated in the 50- and 60-year-old groups. The main complication is postherpetic neuralgia. The incidence rate and number of follow-up visits increase with age. The vaccination rate of herpes zoster vaccine in the entire district is relatively low. It is recommended to enhance monitoring and analysis, carry out health education for key populations (aged 50 years old and above), and promote vaccination and other preventive and control measures.

BACKGROUND: The effect of the interval between previous Helicobacter pylori (H. pylori) eradication and rescue treatment on therapeutic outcomes remains unknown. The aim of this study was to investigate the association between eradication rates and treatment interval durations in H. pylori infections. METHODS: This prospective observational study was conducted from December 2021 to February 2023 at six tertiary hospitals in Shandong, China. We recruited patients who were positive for H. pylori infection and required rescue treatment. Demographic information, previous times of eradication therapy, last eradication therapy date, and history of antibiotic use data were collected. The patients were divided into four groups based on the rescue treatment interval length: Group A, ≥4 weeks and ≤3 months; Group B, >3 and ≤6 months; Group C, >6 and ≤12 months; and Group D, >12 months. The primary outcome was the eradication rate of H. pylori . Drug compliance and adverse events (AEs) were also assessed. Pearson's χ2 test or Fisher's exact test was used to compare eradication rates between groups. RESULTS: A total of 670 patients were enrolled in this study. The intention-to-treat (ITT) eradication rates were 88.3% (158/179) in Group A, 89.6% (120/134) in Group B, 89.1% (123/138) in Group C, and 87.7% (192/219) in Group D. The per-protocol (PP) eradication rates were 92.9% (156/168) in Group A, 94.5% (120/127) in Group B, 94.5% (121/128) in Group C, and 93.6% (190/203) in Group D. There was no statistically significant difference in the eradication rates between groups in either the ITT ( P = 0.949) or PP analysis ( P = 0.921). No significant differences were observed in the incidence of AEs ( P = 0.934) or drug compliance ( P = 0.849) between groups. CONCLUSION: The interval duration of rescue treatment had no significant effect on H. pylori eradication rates or the incidence of AEs. REGISTRATION ClinicalTrials.gov , NCT05173493.
Humans ; Helicobacter Infections/drug therapy* ; Helicobacter pylori/pathogenicity* ; Male ; Female ; Prospective Studies ; Middle Aged ; Anti-Bacterial Agents/adverse effects* ; Adult ; Aged ; Treatment Outcome ; Proton Pump Inhibitors/therapeutic use*

ObjectiveTo observe the clinical effectiveness and safety of Dingchan Granule （定颤颗粒） for paroxysmal atrial fibrillation with syndrome of qi stagnation and blood stasis. MethodsUsing a randomised， double-blind， placebo controlled study method， 90 patients with paroxysmal atrial fibrillation with qi stagnation and blood stasis syndrome were divided into 45 cases each in the treatment group and the control group. Both groups were given conventional western medicine treatment， and the treatment group was additionally treated with Dingchan Granule， while the control group was treated with Dingchan Granule placebo， both of which were taken orally for 8 g each time twice a day. Both groups were treated for 8 weeks. We compared the clinical effectiveness， the improvement of traditional Chinese medicine （TCM） symptoms and the recovery rate of atrial fibrillation between the two groups. We compared the number and duration of atrial fibrillation episodes， TCM symptoms score， atrial fibrillation symptom classification， 24-hour average ventricular rate， Pittsburgh Sleep Quality Index （PSQI）， anxiety index， depression index before and after treatment， and evaluated the safety of the two groups. ResultsThe total clinical effectiveness rate in the treatment group was 82.22% （37/45）， which was better than 60.00% （27/45） in the control group （P＜0.05）. The total effective rate of TCM syndrome effectiveness in the treatment group was 88.89% （40/45）， which was better than 66.67% （30/45） in the control group （P＜0.05）； and the rate of atrial fibrillation regression in the treatment group was 26.67% （12/45）， better than 6.67% （3/45） in the control group （P＜0.05）. The number and duration of atrial fibrillation episodes in both groups were significantly decreased （P＜0.01）， and the number and duration of atrial fibrillation episodes in the treatment group were lower than those in the control group （P＜0.01）. The TCM syndrome scores of both groups after treatment were significantly lower than before treatment （P＜0.01）， and the scores of the treatment group was lower than those of the control group （P＜0.05）. The severity of atrial fibrillation symptoms and the grading of atrial fibrillation symptoms in both groups after treatment were improved （P＜0.01）， and the degree of symptom improvement in the treatment group was better than that in the control group （P＜0.01）. The 24-hour average ventricular rate of both groups after treatment was significantly lower （P＜0.01）. The PSQI， anxiety index and depression index of the treatment group were all lower than before treatment （P＜0.01）， while the PSQI and anxiety index of the control group were both lower than before treatment （P＜0.01 or P＜0.05）， the PSQI， anxiety index and depression index of the treatment group being lower than those of the control group （P＜0.05 or P＜0.01）. No adverse events occurred in both groups， and no abnormalities were observed in blood， urine， stool routine， liver and kidney function， and coagulation function indexes. ConclusionDingchan Granule for paroxysmal atrial fibrillation with qi stagnation and blood stasis syndrome can alleviate clinical symptom， improve TCM symptom scores， increase atrial fibrillation recovery rate， stabilise the average ventricular rate， and significantly improve the quality of sleep， alleviate the anxiety and depression， with a good safety profile.

Chronic myeloid leukemia (CML) is a malignant hematologic disorder caused by abnormal proliferation of hematopoietic stem cells. In recent years, while the application of tyrosine kinase inhibitors (TKIs) has significantly improved the prognosis of CML patients through in-depth exploration of pathogenesis of CML and advancements in targeted therapies, some patients still face challenges including drug resistance, disease relapse, and failure to achieve treatment-free remission. Imunotherapy, as a complementary or alternative strategy, holds significant potential for overcoming these limitations, and has gradually emerged as a critical research focus in CML treatment. This review aims to summarize the current research status and latest advances in immunotherapy for CML.

Objective: To develop a rapid quantification method for neutrophil extracellular traps (NETs) by quantifying neutrophils forming NETs (NETotic cells) on routine peripheral blood smears, and to evaluate the performance of an early warning model combining NETs with traditional coagulation indicators for risk of sepsis-induced coagulopathy (SIC) in septic patients. Methods: This prospective observational study was conducted in Wuxi People's Hospital Affiliated with Nanjing Medical University between May 2023 and May 2025. A total of 147 patients with sepsis (diagnosed based on Sepsis-3.0 criteria) who had not developed SIC [the international society on thrombosis and haemostasis (ISTH SIC score <4)] were enrolled. Blood samples were collected within 2 hours of admission. Neutrophil smudge cells (NETs%) were counted using an automated cell morphology analyzer. Serum levels of myeloperoxidase-DNA (MPO-DNA) complexes, circulating free DNA (cf-DNA) and sequential organ failure assessment (SOFA) scores were also determined. Based on progression to SIC (ISTH score ≥4) within 72 hours of admission, patients were categorized into a sepsis without SIC group (n=85) and a sepsis with SIC group (n=62). Risk factors were analyzed using binary logistic regression, receiver operating characteristic (ROC) curves were plotted, and the predictive value of NETs%, SOFA, and AT-Ⅲ for coagulation dysfunction was assessed. Results: The NETs% level was significantly higher in the sepsis with SIC group [8.50% (7.00, 11.50)] compared to both the healthy control group [1.00% (0.00, 2.00)] and sepsis without SIC group [4.40%(3.50, 6.50)] (P<0.01). NETs% was identified as an independent risk factor for SIC in sepsis patients. ROC analysis showed that the area under the curve (AUC) for predicting SIC was 0.90 for NETs%, 0.85 for MPO-DNA, and 0.79 for cf-DNA. The combined model of NETs% and SOFA score demonstrated the best performance, with an optimal cut-off value of 0.33, an AUC of 0.92, a sensitivity of 77%, and a specificity of 93%. Conclusion: NETs% shows promise as a novel biomarker for SIC. Peripheral blood smear morphology provides a simple, rapid, and cost-effective method for quantifying NETs%. NETs% enhances the early clinical identification of patients at high risk for SIC, and its combination with the SOFA score facilitates SIC prediction, offering a critical time window for initiating timely preventive interventions.

OBJECTIVE To systematically evaluate the efficacy and safety of cadonilimab in patients with malignant solid tumors. METHODS The related literature was comprehensively searched from PubMed， Embase， Cochrane Library， Web of Science， CNKI， Wanfang， VIP， and CBM databases， and the search time ranged from the establishment date to August 2025. Literature screening was strictly adhered to predefined inclusion and exclusion criteria， the quality of randomized controlled trials and single-arm studies were evaluated using the Cochrane risk of bias assessment tool and the MINORS scale， respectively. Meta- analysis was conducted using RevMan and Stata software. RESULTS A total of 23 studies （2 randomized controlled trials， 21 single-arm studies） with 2 539 patients were included. Pooled analysis of RCTs showed that the objective response rate （ORR） was significantly higher in the trial group than in the control group （RR＝1.24， 95%CI：1.08-1.42； P＝0.002）， but the risk of any-grade immune-related adverse events （irAEs） was also significantly increased （RR＝5.36， 95%CI：3.88-7.42； P＜0.000 01）. Pooled analysis of single-arm studies showed that the ORR of cadonilimab was 39.8% （95%CI：31.0%-49.7%）， and the median progression free survival was 6.39 months （95%CI：4.11-8.67）. Subgroup analysis indicated that the ORR for patients with cervical cancer and gastric or gastroesophageal junction adenocarcinoma were 54.5% （95%CI：40.8%-67.6%） and 54.1% （95%CI： 45.1%-62.7%）， respectively. In terms of safety， the incidences of grade ≥3 treatment-related adverse events and irAEs were 41.0% （95%CI： 31.0%-51.0%） and 9.9% （95%CI： 7.4%-13.8%）， respectively. CONCLUSIONS Cadonilimab demonstrates significant efficacy advantages in multiple solid tumors， with manageable safety， holding particularly important clinical value in cervical cancer and gastric or gastroesophageal junction adenocarcinoma.

Objective To investigate the effects of microRNA-34a(miR-34a-5p)on the progression of chronic lymphocytic leukemia(CLL)through the Wnt/β-catenin signaling pathway.Methods Human chronic B-cell leukemia MEC-1 cells were selected for experimentation.MEC cells were divided into two groups,group one:the p53 agonist group and the control group;group two:the control group,the miR-34a-5p mimic group and its corresponding negative control,the miR-34a-5p inhibitor group and its corresponding negative control,as well as the miR-34a-5p inhibitor+Wnt inhibitor XAV-939 group.The expression levels of miR-34a-5p in each group were measured using real-time fluorescence quantitative PCR(qPCR).Cell proliferation was assessed by CCK-8 assay,while cell migration ability was evaluated using Transwell migration assay.Dual-luciferase reporter assay was employed to validate the targeting relationships between p53 and miR-34a-5p,as well as between miR-34a-5p and Wnt1.Western blot analysis was used to detect the protein expressions of β-catenin and Cyclin D1,which were key components of the Wnt/β-catenin signaling pathway.Results In MEC-1 cells:① compared with the control group,there was a increased miR-34a-5p expression and inhibited cell proliferation in the p53 agonist group(P＜0.05).Dual-luciferase reporter assay confirmed a negative regulatory correlation between miR-34a-5p and p53.② the miR-34a-5p mimic group showed significantly upregulated miR-34a-5p expression compared to the control group,leading to suppressed cell proliferation,reduced migration capability and decreased protein expressions of β-catenin and Cyclin D1(P＜0.05).Conversely,the miR-34a-5p inhibitor group demonstrated significantly downregulated miR-34a-5p expression,resulting in enhanced cell proliferation,increased migratory capacity and upregulated protein levels of β-catenin and Cyclin D1 compared to those of the control group(P＜0.05).③ A targeting relationship was observed between miR-34a-5p and Wnt1.④ Compared with the miR-34a-5p inhibitor group,the XAV-939 group exhibited significantly upregulated miR-34a-5p expression,markedly decreased numbers of migrated cells and substantially reduced protein expression levels of β-catenin and Cyclin D1(P＜0.05).Conclusion miR-34a plays the role of a tumor suppressor gene in CLL.Overexpression of miR-34a can inhibit the Wnt/β-catenin signaling pathway,reduce the proliferation activity and migration ability of cells,and promote cell apoptosis.

Objective·To compare the effects of calcium hydroxide(CH)residues in root canals and root canal filling methods on apical closure,and to provide reference for clinical selection of root canal sealing drugs and filling methods.Methods·Seventy-five permanent mandibular premolar teeth with single root canals that were extracted due to orthodontic treatment or periodontal problems were collected from the Department of Oral and Maxillofacial Surgery of the Affiliated Hospital of Qingdao University.The crowns were removed,the root canals were prepared,and the specimens were randomly assigned into 3 groups:a water-soluble calcium hydroxide group(Group A,n=30),an oil-soluble calcium hydroxide group(Group B,n=30),and an unsealed control group(Group C,n=15).After 2 weeks of sealing,Groups A and B underwent manual preparation with a#35 K-file,followed by ultrasonic agitation and irrigation of the root canal to ensure that the calcium hydroxide residue was located roughly at the root apex and that the residue was 15%to 20%.Groups A,B,and C were randomly divided into 3 groups:the iRoot SP single-tip group(Group 1),the hot compression group(Group 2),and the cold compression group(Group 3),and root canals were filled using the iRoot SP single-tip method,the hot adhesive vertical compression filling method,and the cold adhesive lateral compression filling method,respectively.A dye penetration test was used to evaluate apical microleakage,and scanning electron microscopy was used to observe the microscopic morphology of the dentin-root canal sealer interface in each group.Statistical analysis was performed using two-way ANOVA.Results·Both root canal sealing drugs and root canal filling methods affected the apical sealing,and there was an interaction between them.The effects of residual calcium hydroxide on apical closure were analyzed.The difference between Group B and Group C was statistically significant only in Group 1.There were statistically significant differences between Group A and Group C in Group 2 and Group 3,and statistically significant differences between Group A and Group B regardless of the root filling method.Among the three root filling methods,there was a statistically significant difference between Group 1 and Group 3 in Group C(P=0.013).In Group A and Group B,there were statistically significant differences between Group 2,Group 3 and Group 1(P<0.001).Conclusion·The residual water-soluble calcium hydroxide in the root canal has a negative effect on the apical closure,but the residual oil-soluble calcium hydroxide has a small negative effect on the apical closure.iRoot SP can reduce the negative effect of residual water-soluble calcium hydroxide on root canal closure.

Objective The aim of this study was to clarify the role and mechanism of Pseudomonas aeruginosa vaccine subunit OprI in the fusion protein vaccine rePO(PcrV-OprI).Methods The in vitro stability of rePO,PcrV and OprI at 4 ℃,25 ℃,and 37 ℃ was examined.After immunizing mice with rePO,OprI and PcrV,respectively,the specific antibody potency in serum and the proportion of cells secreting IFN-γ and IL-4 in the spleen were examined;Additionally,detection of the levels of protein uptake by DC2.4 cells in vitro using laser confocal microscopy and flow cytometry,and their ability to promote the maturation of mouse bone marrow-derived dendritic cells(BMDC).Results The heat stability of fusion protein rePO was significantly better than that of PcrV.The induced anti-PcrV IgG and anti-OprI IgG potency of rePO was significantly higher than that of monomeric PcrV and OprI.Additionally,the number of cells secreting IFN-γ and IL-4 induced by immunization with rePO was significantly higher than that of PcrV and OprI.The uptake rate of fusion protein rePO by DC2.4 cells was significantly higher than that of PcrV and OprI.Furthermore,rePO promoted the maturation of mouse BMDC more effectively than PcrV and OprI.Conclusion OprI in the fusion protein rePO can significantly improve its thermal stability and immunogenicity,which lays the foundation for the successful development of Pseudomonas aeruginosa vaccine.

Depression is closely associated with a neuro-endocrine-immune(NEI)system imbalance.The"excessive vitality leading to restraint and counter-regulation(Kang Hai Cheng Zhi)"theory elucidates the self-regulating mechanism for maintaining dynamic equilibrium in the body,and serves as an importance principle guiding treatment formulation and medication selection.Based on the correlation between NEI system imbalance and the traditional Chinese medicine pathogenesis of depression,and integrating the"Kang Hai Cheng Zhi"theory,the author posits that the pathogenesis of depression lies in overactive liver invading spleen,earth dampness impeding wood′s ascendancy,and disharmony between body and mind,as well as imbalance in storage and discharge functions of liver and kidney,disharmony between Yin and Yang,and disrupted counter-regulation.This dosely aligns with two key pathological methanisms at the micro level:microglial-limbic system homeostatic imbalance and hypothalamic-pituitary-adrenal axis-inflammatory circuit dysregulation.Clinically,the treatment principle for depression adheres to supporting the counter-regulation to restrain excess,with herbal interventions using strategies such as restraining wood to support earth,dredging earth to unblock wood,and harmonizing pivotal functions,as well as nourishing water to nurture wood,warming kidney to tonify liver,and relieving depression to calm the spirit.These approaches aim to regulate the liver,spleen,and kidney,embodying the core therapeutic tenet of"striving for equilibrium,"thereby restoring the body′s self-regulating capability.