Objective: To analyze the school tuberculosis (TB) outbreaks and preventive treatment in Hefei from 2022 to 2024, so as to provide reference for TB prevention and control in schools. Methods: Data were collected on all school based TB outbreaks occurring during 2022-2024 in Hefei, defined as ≥2 epidemiologically linked TB cases within the same school during a single semester. Statistical analyses were performed using the Chi square test. Results: Close contacts exhibited significantly higher TB incidence (2.88%) and latent mycobacterium tuberculosis infection (LTBI) rates (13.80%) in the school TB outbreaks, compared to non close contacts (0.12% and 2.63%, respectively). Among close contacts, secondary school students showed lower TB incidence (0.48%) and LTBI prevalence (3.42%) than both primary school or younger children (0.68%, 6.95%) and college students ( 0.78% , 6.50%), with statistically significant differences ( χ 2=360.91, 6.37; 791.71, 102.03, all P <0.05). The proportion of LTBI individuals recommended for preventive therapy was higher in primary school or younger groups (98.59%) than in secondary (95.25%) or college students (86.34%) ( χ 2=25.86, P <0.01). However, among those recommended, close contacts had higher uptake (85.82%) and completion rates (87.25%) of preventive therapy than non close contacts (69.63% and 70.57%); similarly, secondary school students demonstrated higher uptake (91.21%) and completion rates (86.45%) compared to primary school or younger (88.57%, 83.87%) and college students (57.28%, 64.08%) ( χ 2=30.52, 26.72; 125.17, 38.84, all P <0.01). Subsequent TB incidence among LTBI close contacts (13.30%) and among those who did not complete preventive therapy (22.73%) were significantly higher than among non close contacts (2.80%, 2.41%), respectively ( χ 2=32.19, 13.87, both P <0.05). Conclusions In school TB outbreaks, close contacts face higher LTBI prevalence and subsequent TB risk than non close contacts. College students show notably low adherence to preventive therapy. It is necessary to take targeted measures to improve the compliance of preventive measures among students.

Objective To investigate the effect of extracellular heat shock protein(HSP)22 on Toll-like receptor(TLR)4/nuclear factor-κB(NF-κB)signaling pathway in oxidative-low-density lipoprotein(ox-LDL)-induced inflammatory damage in coronary endothelial cells(HCAECs).Methods HCAECs were cul-tured in vitro and pretreated with ox-LDL to establish a model of high-lipid-induced endothelial cell injury.Re-combinant human HSP22(rhHSP22)was exogenously treated.The effects of rhHSP22 on the expression of inflammation-related proteins such as interleukin(IL)-8,vascular cell adhesion molecule(VCAM)-1 and NF-κB in endothelial cells and endothelial cell apoptosis were observed.The relationship between HSP22 and TLR4/NF-κB signaling pathway was investigated under the action of TLR4 inhibitor E5564.Western blot was used to detect the expression of IL-8,VACM-1 and NF-κB proteins,and flow cytometry was used to detect the apoptosis of endothelial cells in each group.Results Compared with the CNT group,the relative expression levels of IL-8,VACM-1 and NF-κB protein in the rhHSP22 group,rhHSP22+ox-LDL group,rhHSP22+E5564 group and rhHSP22+E5564+ox-LDL group were significantly increased,and the differences were sta-tistically significant(P<0.05).Compared with the rhHSP22 group,the relative expression levels of IL-8,VACM-1 and NF-κB protein in the rhHSP22+ox-LDL group were significantly increased,and the differences were statistically significant(P<0.05).Compared with the rhHSP22+ox-LDL group,the relative expression levels of IL-8 and VACM-1 in the rhHSP22+E5564+ox-LDL group were decreased,and the differences were statistically significant(P<0.05).Compared with the CNT group,the apoptosis rate in the rhHSP22 group,rhHSP22+ox-LDL group and rhHSP22+E5564+ox-LDL group was significantly increased,and the differ-ence was statistically significant(P<0.05).Compared with the rhHSP22 group,the apoptosis rate in the rhHSP22+ox-LDL group was increased,and the difference was statistically significant(P<0.05).Compared with the rhHSP22+ox-LDL group,the apoptosis rate in the rhHSP22+E5564+ox-LDL group was de-creased,and the difference was statistically significant(P<0.05).Conclusion In ox-LDL-induced inflamma-tory damage of HCAECs,extracellular HSP22 induces the expression of IL-8,VACM-1 and NF-κB proteins by activating the TLR4/NF-κB signaling pathway,and promotes endothelial cell apoptosis.

Objective To explore the medication patterns of the"phlegm-stasis co-treatment"in the treatment of stroke and the regulatory mechanisms of its key components.Methods The relevant literature on the treatment of stroke with intertwined phlegm and blood stasis pattern by traditional Chinese medicine in CNKI,Wanfang Data Knowledge Service Platform and VIP was collected.Excel 2019 and SPSS Modeler 18.0 were applied to statistically analyze the nature,taste,meridian tropism and frequency of the drugs included in the prescriptions.The Apriori algorithm was used to perform association rule analysis and cluster analysis.The potential mechanism of action of the core drug pair was explored by using the network pharmacology method.Results A total of 69 prescriptions involving 161 herbs with 902 cumulative frequency uses were included.The four natures were mainly warm,neutral and cold,the five flavors were mainly bitter,sweet and pungent.and channel tropism were mainly liver meridian and spleen meridian.The analysis of association rules indicates that there was a strong correlation among chuanxiong,Taoren,Dannanxing,Dilong,Honghua,Shichangpu and Fuling.The main active components of the drug combination were quercetin,gallic acid,baicalein and hederagenin.They can regulate signaling pathways such as hypoxia-inducible factor-1,advanced glycation end product/advanced glycation end product receptor,nuclear factor κB,and mixed lineage kinase 3 by acting on genes such as STAT3,SRC,JUN,TP53,and MAPK1.Conclusion The core drugs of"phlegm-stasis co-treatment"method can act on multiple targets and pathways through components such as quercetin,gallic acid,baicalein and hederagenin,thereby exerting a therapeutic effect on stroke.

Objective:To investigate the expression and clinical value of integrin-associated protein 47 (CD47) and soluble programmed death receptor-ligand 1 (sPD-L1) in patients with primary immune thrombocytopenia (ITP).Methods:The method of retrospective study was adopted, 76 patients with ITP admitted to the Affiliated Hospital of Jining Medical University from July 2016 to July 2022 were regarded as the study group, and another 76 cases of physical examination were regarded as the control group. The levels of serum CD47, sPD-L1, interleukin-33(IL-33) and transforming growth factor beta (TGF-β) were determined by the enzyme-linked immunosorbent assay, the diagnostic value of CD47 and sPD-L1 for ITP was analyzed by the receiver operating characteristic (ROC) curve, Pearson test was applied to analyze the correlation between serum CD47 and sPD-L1 in ITP patients, multivariate Logistic regression analysis was applied to analyze the risk factors affecting ITP.Results:The levels of serum CD47, sPD-L1 and IL-33 in the study group were higher than those in the control group: (40.31 ± 6.59) μg/L vs. (32.16 ± 6.33) μg/L, (78.42 ± 10.22) ng/L vs. (64.49 ± 10.36) ng/L, (73.29 ± 14.26) ng/L vs. (26.54 ± 5.16) ng/L; the level of serum TGF-β in the study group was lower than that in the control group: (1 752.66 ± 310.73) ng/L vs. (2 625.88 ± 389.58) ng/L, there were statistical differences ( P<0.05). The result of the Pearson test showed that there was a positive correlation between serum CD47 and sPD-L1 in ITP patients ( r = 0.572, P<0.05). The result of the ROC curve showed that the area under the curve predicted by the combination of serum CD47 and sPD-L1 was 0.948 (95% CI 0.916 - 0.979), which was better than that predicted by CD47 and sPD-L1 alone ( P<0.05). The result of multivariate Logistic regression analysis showed that CD47, sPD-L1, and IL-33 were the risk factors affecting ITP ( P<0.05), and TGF-β was the protective factor affecting ITP ( P<0.05). Conclusions:The serum levels of CD47 and sPD-L1 in patients with ITP are elevated, and the combined detection of the two indicators has a good diagnostic value for ITP.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

Ischemic stroke is the leading cause of disability and mortality worldwide. The blood‒brain barrier (BBB) is the first line of defense after ischemic stroke. Disruption of the BBB induced by brain microvascular endothelial cells (BMECs) dysfunction is a key event that triggers secondary damage to the central nervous system, where blood-borne fluids and immune cells penetrate the brain parenchyma, causing cerebral edema and inflammatory response and further aggravating brain damage. Here, we develop a novel artificial mesenchymal stem cell (MSC) extracellular vesicles by integrating MSC membrane proteins into liposomal bilayers, which encapsulated miR-132-3p with protective effects on BMECs. The artificial extracellular vesicles (MSCo/miR-132-3p) had low immunogenicity to reduce non-specific clearance by the mononuclear phagocytosis system (MPS) and could target ischemia-injured BMECs. After internalization into the damaged BMECs, MSCo/miR-132-3p escaped the lysosomes via the H_II phase transition of 1,2-dioleoyl-sn-glycero-3-phosphoethanolamine (DOPE) and decreased cellular reactive oxygen species (ROS) and apoptosis levels by regulating the RASA1/RAS/PI3K/AKT signaling pathway. In the transient middle cerebral artery occlusion (tMCAO) models, MSCo/miR-132-3p targeted impaired brain regions (approximately 9 times the accumulation of plain liposomes at 12 h), reduced cerebral vascular disruption, protected BBB integrity, and decreased infarct volume (from 44.95% to 6.99%).

Objective:This study aimed to evaluate the therapeutic effect of intratympanic injection of ganglioside in patients with refractory sudden deafness. Methods:A total of 120 patients with sudden deafness, aged 18-65 years, whose onset was within 11-42 days, failed to respond to conventional treatment, and had an average hearing threshold（500-4 000 Hz）>60 dB were selected. They were prospectively and randomly divided into a control group of 61 cases and an experimental group of 59 cases. The control group was treated according to the recommended protocol of the Chinese Medical Association（postauricular injection of methylprednisolone）, while the experimental group was treated with intratympanic injection of monosialotetrahexosylganglioside sodium+postauricular injection of methylprednisolone. Both groups were simultaneously administered oral ginkgo biloba extract and citicoline tablets. Hearing was re-examined two weeks after the completion of treatment, and the therapeutic effects of the two different treatment methods were compared and analyzed. Results:The effective rate was 29.51% in the control group and 54.24% in the experimental group（P<0.01）. The average hearing threshold improved by 11.57 dB HL in the control group and 22.50 dB HL in the experimental group（P<0.05）. Conclusion:The combination of postauricular injection of methylprednisolone and intratympanic injection of ganglioside is more effective than postauricular injection of methylprednisolone alone in the treatment of refractory sudden deafness. The earlier the treatment, the better the therapeutic effect.
Humans ; Middle Aged ; Hearing Loss, Sudden/drug therapy* ; Adult ; Prospective Studies ; Young Adult ; Aged ; Adolescent ; Male ; Female ; Injection, Intratympanic ; Gangliosides/administration & dosage* ; Methylprednisolone/therapeutic use* ; Treatment Outcome

Allergen-specific immunotherapy（AIT） remains the only therapeutic approach with the potential to modify the natural course of allergic rhinitis（AR）. Nevertheless, considerable inter-individual variability exists in patients'responses to AIT. To facilitate more reliable assessment of treatment efficacy, the China Rhinopathy Research Cooperation Group（CRRCG） convened young and middle-aged nasal experts in China to formulate the present consensus. The recommended subjective outcome measures for AIT comprise symptom scores, medication scores, combined symptom and medication scores, quality-of-life assessments, evaluation of disease control, and assessment of comorbidities. Objective indicators may supplement these measures. Currently available objective approaches include skin prick testing, nasal provocation testing, and allergen exposure chambers. However, these methods remain constrained by practical limitations and are not yet appropriate for routine implementation in clinical efficacy evaluation. In addition, several biomarkers, including sIgE and the sIgE/tIgE ratio, sIgG4, serum IgE-blocking activity, IgA, cytokines and chemokines, as well as immune cell surface molecules and their functional activity, have been shown to have associations with AIT outcomes. While these biomarkers may complement subjective assessments, they are subject to significant limitations. Consequently, large-scale multicenter trials and real-world evidence are required to strengthen the evidence base. The present consensus underscores the necessity of integrating patients'subjective experiences with objective testing throughout the treatment process, thereby providing a more comprehensive and accurate framework for efficacy evaluation. Looking forward, future investigations should prioritize the incorporation of multi-omics data and artificial intelligence methodologies, which hold promise for overcoming current limitations in assessment strategies and for advancing both the standardization and personalization of AIT.
Humans ; Allergens/immunology* ; China ; Consensus ; Desensitization, Immunologic ; Immunoglobulin E ; Quality of Life ; Rhinitis, Allergic/therapy* ; Treatment Outcome ; East Asian People

Purpose To explore the consistency between T2 mapping and three-dimensional water-selective cartilage(3D-WATSc)sequence measurement of knee cartilage volume.Materials and Methods A total of 30 healthy volunteers were recruited and underwent 3D-WATSc and T2 mapping sequence scans of the left knee joint in the Affiliated Lihuili Hospital of Ningbo University from May to December 2022.A total of 20 subjects'T2 mapping sequences were randomly selected and eight groups of raw images with different TE(13,26,39,52,65,78,91,104 ms)were analyzed.The quality of the raw images was rated by two observers,and the consistency of two observers'scores were subjected by Kappa test.The TE value with the best image quality was determined via Welch analysis of variance and Games-Howell text post hoc test.Based on T2 mapping and 3D-WATSc sequences,semi-automatic segmentation measurements were performed on the cartilage volume of femoral condyle,tibial plateau and patellar posterior margin in 30 subjects.Intra group correlation coefficient(ICC)and Bland-Altman plot were used to test the consistency of cartilage volume between two observers under T2 mapping sequence,as well as between T2 mapping and 3D-WATSc sequences.Results The consistency of the scores of the two observers was moderate except for poor consistency at TE 104 ms(Kappa=0.318)and no statistical difference at TE 78 ms(P=0.052),with Kappa values greater than 0.40 and P<0.05,further analysis showed that the cartilage display quality score was optimal at TE 26 ms(M=2.90).Comparing TE 26 ms with the scores of the other seven groups in Games Howell text,except for TE 26 ms and TE 13 ms(M=2.55),TE 26 ms and TE 39 ms(M=2.62),which had no statistically significant difference in scores(P>0.05),there were significant differences in scores between TE 26 ms and the other TE groups(all P<0.05).On the T2 mapping(TR 2 000 ms,TE 26 ms)sequence,the ICC values of the cartilage volumes of each part segmented by two observers were all greater than 0.6,P<0.05,with the consistency of femoral condyle cartilage volume being the best(ICC=0.877,P<0.01).The consistency of the cartilage volumes of each part measured by 3D-WATSc and T2 mapping sequences was good(ICC>0.75,P<0.01),with the consistency of tibial plateau cartilage volume being the best(ICC=0.857,P<0.01).Conclusion The T2 mapping original grayscale image(TR 2 000 ms,TE 26 ms)can clearly display the morphology of knee joint cartilage,the consistency between T2 mapping and 3D-WATSc sequences in quantifying knee cartilage volume is good,and the T2 mapping single sequence provides a reliable scanning scheme for one-stop quantitative analysis of knee joint cartilage morphology and function.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.