Objective: To analyze the serotypes and drug resistance of Salmonella isolated from food-borne disease surveillance samples in Longwan District, Wenzhou City, Zhejiang Province, so as to provide evidence for the prevention and treatment of Salmonella infection. Methods: Salmonella strains isolated from feces or anal swabs of patients with foodborne diarrhea in Longwan District People's Hospital from 2018 to 2024 were collected. After re-identification, slide agglutination test was used to identify serotypes. The drug susceptibility test of live Salmonella strains was performed using the broth microdilution method, and the resistance patterns were analyzed. Results: A total of 2 293 samples were collected, and 186 strains of Salmonella were isolated, with a detection rate of 8.11%. The detection rate was higher from May to October. A total of 28 Salmonella serotypes were identified, with S. typhimurium (72 isolates, 38.71%), S. enteritidis (31 isolates, 16.67%), and S. London (30 isolates, 16.13%) being dominant. Among the 121 Salmonella live strains, 20 strains were susceptible to 14 antibacterial drugs. A total of 101 strains were resistant to antibacterial drugs, and the drug resistance rate was 1.65%-67.77%, with the drug resistance rate of ampicillin being the highest, and the drug resistance rate of imipenem was the lowest. S. typhimurium had the highest resistance rate to tetracycline (78.26%). S. enteritidis had the highest resistance rate to ampicillin (100.00%). S. London had the highest resistance rate to tetracycline (66.67%). Fifty-five types of drug resistance patterns were detected, showing a number of drug resistance of 1-10, of which 76 strains were multi-drug resistant, accounting for 75.25%. The predominant multidrug resistance patterns were ampicillin/sulbactam-cefazolin-ampicillin-nalidixic acid (10.53%), tetracycline-ampicillin-nalidixic acid (9.21%), and ampicillin/sulbactam-ampicillin-nalidixic acid (7.89%). Conclusions Salmonella strains isolated from foodborne diseases in Longwan District were mainly detected in summer and autumn. S. typhimurium, S. enteritidis, and S. London were the predominant serotypes. The drug resistance of Salmonella to different antibacterial drugs was different, and the drug resistance spectrum showed diversity.

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

Background and objective Lung cancer is the malignant tumor with the highest incidence rate and the heaviest disease burden in China.In recent years,lung cancer has shown a high incidence trend,seriously affecting the health of the population.In this paper,we analyze the characteristics of lung cancer incidence in 2019 and the trend of incidence rate from 2010-2019 in the tumor registration area of Gansu province,in order to provide a reference basis for the development of lung cancer prevention and control strategies in Gansu province.Methods By analyzing the cases of lung cancer incidence in the tumor registration area of Gansu province in 2019,we calculated the incidence rate,medium incidence rate,world in-cidence rate and other related indexes;we used Joinpoint to calculate the annual percentage change(APC)for trend analysis.Results In 2019,a total of 3757 new cases of lung cancer were reported in Gansu province,accounting for 14.96%of all new malignant tumors.The incidence rate,medium incidence rate and world incidence rate and world rate of lung cancer were 40.52/105,25.78/105,25.86/105;and the cumulative rate of 0-74 years old,and the truncation rate of 35-64 years old were 3.23%,40.03/105,respectively.The incidence of lung cancer rises with age,and is high in the age group of 40 years and above,and the incidence peaks in the male and female populations in the group of 75 years and above,and the group of 80 years and above,respectively.The crude incidence rate of lung cancer in the tumor registration area of Gansu province from 2010-2019 showed an overall increasing trend,and the rate of increase was relatively fast,with an APC 5.39%(P<0.05);Separately,accord-ing to gender,urban and rural areas,the incidence of lung cancer in all populations showed an increasing trend,and the APC of male,female,urban and rural populations were 4.98%,6.39%,6.26%,and 4.64%,respectively(all P<0.05).According to the trend analysis of lung cancer incidence rate by age group,only lung cancer incidence in the age group of 65 years and above increased at an annual average rate of 4.15%(P<0.05).Conclusion The incidence rate of lung cancer in the tumor registration area of Gansu province from 2010 to 2019 shows a rising trend year by year,and there are differences in the incidence of lung cancer in people of different genders,regions and age groups,so comprehensive prevention and control work should be carried out for the key populations of lung cancer incidence.

Objective To investigate the MRI features of primary retroperitoneal leiomyosarcoma(PRLS).Methods Thirty-three cases of pathologically confirmed PRLS were analyzed retrospectively,and their multi-parameter MRI features were analyzed qualitatively and quantitatively.Results Of the 33 PRLS,24 cases were located in the renal hilum,inferior vena cava,or the area around the bifurcation of the iliac vessels.Twenty-four cases had relatively intact capsule,25 cases had necrosis,and 15 cases had coagulated geographic necrosis.The mean diameter of the tumors was(9.9±5.1)cm,ranging from 3.0 to 20.7 cm,among which 27 cases with a diameter larger than 5 cm.The tumor parenchyma of the 33 PRLS all showed significantly high signal intensity on diffusion weighted imaging(DWI),and significantly low signal intensity on apparent diffusion coefficient(ADC)map.The tumor parenchyma showed moderate to obvious degree of progressive enhancement,and the signal intensity value of the tumor in each phase after contrast injection was higher than that of the psoas major muscle(P＜0.001).Conclusion PRLS are usually large but have a relatively intact capsule and are closely related to the major retroperitoneal veins.The coagulated geographic necrosis,significantly limited diffusion of water molecules,and progressive enhancement pattern all show certain MRI characteristics.

Objectives To investigate the relationship between self-reported occupational noise exposure and levels of plasma inflammatory cytokines in asthmatic patients. Methods A total of 910 adult asthmatic patients were selected as the study subjects, and their occupational noise exposure history and other related information were collected. The peripheral blood samples were collected from the patients, and the expression levels of plasma soluble CD14 (sCD14), complement factor D (CFD), Eotaxin-11 (CCL11), and IL-9 were determined. The relationship between self-reported occupational noise exposure and the expression levels of the four inflammatory cytokines in patients’ plasma were analyzed using multiple linear regression models. The interactions between confounding factors and self-reported occupational noise exposure were further analyzed by interaction analysis. Results The plasma CCL11, sCD14 and CFD expressions in asthmatic patients with self-reported occupational noise exposure were significantly higher than those in patients without the exposure (P<0.05). After adjusting for confounding factors, compared with patients reporting no occupational noise exposure, the plasma CFD expression was increased by 0.17 (95% CI: 0.02, 0.31) natural logarithm units in patients with self-reported occupational noise exposure. During remission, the levels of plasma CCL11 and sCD14 in asthmatic patients with self-reported occupational noise exposure were increased by 0.27 (95% CI: 0.05, 0.49) and 0.22 (95% CI: 0.02, 0.41) natural logarithm units, respectively, when compared with patients without the exposure. Interaction analysis showed that self-reported occupational noise exposure had significant multiplicative interaction with smoking or pet ownership on plasma CCL11 or CFD expressions in asthmatic patients (all P<0.05). Conclusion Self-reported occupational noise exposure is significantly associated with increased expression levels of plasma CFD, CCL11, and sCD14 in adult asthmatic patients.

Objective To investigate the incidence and causes of medication errors(MEs)related to aspirin in the eld-erly(≥60 years old)of China,to provide data for targeted precautions,and to promote medication safety in the elderly.Methods Reports about aspirin-related MEs in the elderly were extracted from the National Monitoring Network for Clinical Safe Drug Medication from September 22,2012 to September 22,2022.The severity of errors,content of errors,where errors were made,the personnel who made these errors,and causes of errors were analyzed retrospectively and statistically.Results A total of 386 MEs reports were extracted,235 males and 151 females,with a median age of 70(60-98)years old.Regarding the severity of MEs,errors of class B were dominating(314 cases,81.35%).As for the severe MEs(9 cases,2.33%),5 cases of ME were as-sociated with bleeding.There are four patients suffering from gastrointestinal bleeding:one patient took aspirin three times a day,one patient broke off enteric-coated tablets,one patient took aspirin as acarbose mistakenly,one patient took aspirin with Xuesai-tong for long time.One patient had urinary urgency,but did not seek medical attention in time,then developed into visible hema-turia.Two patients missed taking aspirin led to stent thrombosis.One patient suffered from diarrhea after overdosing on 29 pills of aspirin by mistake.One patient with hyperuricemia had gout after taking aspirin.Among these 386 MEs,224(58.03%)cases were triggered by physicians,the first three error factors were frequency(multiple times a day),dosage(the dosage of enteric-coated tablets is not the whole tablet),and variety.Most of these MEs were due to a lack of knowledge or training,and fatigue.Regarding the MEs caused by pharmacists(87 cases,22.54%).Pharmacists identified 274 cases(70.98%)of errors.Conclusion When it comes to aspirin-related MEs,it ought to be noticed that the drug usage and dosage,drug interaction,and selection of drug varieties when combining with other diseases(such as atrial fibrillation and hyperuricemia).It is recommended that information construction be fortified to decrease the ME of the prescription link,and the clinicians be better informed of rational drug use.At the same time,patient medication education should be improved.

Objective:To investigate the clinical efficacy of continuous veno-venous hemodia-filtration (CVVHDF) combined with hemoperfusion (HP) HA380 in the treatment of heat stroke patients with multiple organ dysfunction syndrome (MODS).Methods:A retrospective and observational study was conducted. A total of 15 patients with heat stroke combined with MODS who were admitted to the department of intensive care unit (ICU)of Suizhou Central Hospital/Hubei University of Medicine from July to September 2022 were selected as the study objects. All 15 patients were treated with CVVHDF combined with HA380 based on the comprehensive management strategy for severe illness. Organ function indicators [including total bilirubin (TBil), aspartate aminotransferase (AST), creatine kinase (CK), lactate dehydrogenase (LDH), creatinine (Cr), cardiac troponin T (cTnT), myoglobin (Myo), MB isoenzyme of creatine kinase (CK-MB), sequential organ failure assessment (SOFA)] and inflammatory indicators [including white blood cell count (WBC), neutrophil count (NEU), C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6)] were collected. The improvements of the above indexes at admission, after the first HP, after the second HP, after the third HP, and on the 5th day of treatment were compared. Combined with the clinical outcome of patients, the comprehensive efficacy of CVVHDF combined with HA380 in the treatment of severe heat radiation disease was evaluated.Results:There were 10 males and 5 females among the 15 patients. The average age was (64.5±11.5) years old. There were 6 cases of classical heat stroke and 9 cases of exertional heat stroke. Glasgow coma scale (GCS) was 3-8 at admission; SOFA score was 9-17 within 12 hours after admission; acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) was 25-45 within 24 hours after admission. After treatment, the IL-6 level and SOFA score gradually decreased, and there were significant differences in the decrease after the second HP compared to admission [IL-6 (ng/L): 48.37 (15.36, 113.03) vs. 221.90 (85.87, 425.90), SOFA: 8.3±3.3 vs. 11.1±2.4, both P < 0.05]. The PCT level reached its peak after the first HP [12.51 (6.07, 41.65) μg/L], and then gradually decreased, and the difference was statistically significant after the third HP [1.26 (0.82, 5.40) μg/L, P < 0.05]. Compared those at admission, Cr level significantly improved after the first HP (μmol/L: 66.94±25.57 vs. 110.80±31.13, P < 0.01), Myo significantly decreased after the second HP [μg/L: 490.90 (164.98, 768.05) vs. 3?000.00 (293.00, 3?000.00), P < 0.05], After the third HP, the CK level also showed significant improvement [U/L: 476.0 (413.0, 922.0) vs. 2?107.0 (729.0, 2?449.0), P < 0.05]. After CVVHDF combined with 3 times HP treatment, the patient's inflammatory response was gradually controlled and organ function gradually recovered. On the 5th day of the disease course, WBC, PCT and IL-6 levels were significantly improved compared to admission, and AST, CK, LDH, Cr, Myo, CK-MB, and SOFA score were significantly corrected compared with those on admission. The 24-hour survival rate of 15 patients was 86.67%, and the 24-hour, 7-day and 28-day survival rates were both as high as 73.33%. The average mechanical ventilation time of 11 surviving patients was (101.8±22.0) hours, the average continuous renal replacement therapy (CRRT) time was (58.8±11.0) hours, the average length of ICU stay was (6.3±1.0) days, and the average total hospitalization was (14.6±5.2) days. Conclusion:CVVHDF combined with HP HA380 in the treatment of heat stroke patients with MODS can effectively improve organ function and alleviate the inflammatory storm, which is an effective means to improve the rescue rate and reduce the mortality of severe heat stroke patients.

Objective To observe the effect of Liuhe Pills combined with sitz bath in povidone iodine diluent for nursing of perianal infection in patients with hematologic malignancy. Methods A total of 180 hematologic malignancy patients complicated with perianal infection in the Department of Hematology from January 2020 to December 2022 were selected as research objects. According to the order of hospital admission, they were divided into control group (n=90) and experimental group (n=90). The control group was treated with sitz bath in 1∶200 povidone iodine diluent on the basis of routine perianal cleaning care, while the experimental group was treated with external application of Liuhe Pills on the basis of the control group. The clinical efficacy, perianal pain score and perianal adverse reactions were compared between the two groups. Results After intervention, the total effective rate of the experimental group was 95.56%, which was significantly higher than 83.33% of the control group (P < 0.01). There were significant differences in perianal pain scores between two groups at 2, 3, 7 and 14 days after intervention (P < 0.05 or P < 0.01). Patients in both groups did not have serious adverse reactions; the incidence of adverse reactions was 14.44% in the control group, which showed no significant difference when compared to 16.67% in the experimental group (P>0.05). Conclusion Application of Liuhe Pills combined with sitz bath in povidone iodine diluent is effective in the nursing of perianal infection in patients with hematologic malignancy, which can alleviate the pain and promote the recovery.

Objective:To investigate the clinical value of electronic laryngoscope combined with narrow band imaging（NBI） endoscope and its classification in the diagnosis of vocal cord leukoplakia. Methods:A retrospective analysis was performed on 115 cases of patients treated in the Department of Otolaryngology, Head and Neck Surgery, Nanjing Drum Tower Hospital from September 2020 to November 2022. All 115 cases were diagnosed with vocal cord leukogramma using the electronic laryngoscopy and narrow band imaging endoscopy, followed by pathological examination in the outpatient tissue biopsy. The morphological characteristics of vocal cord leukoplakia and the correlation between narrow band imaging classification and pathological results were investigated. Results:Among 115 cases of vocal cord leukoplakia, 46 cases（40.00%） were diagnosed as benign lesions. Low grade intraepithelial neoplasia occurred in 29 cases（25.22%）. High-grade intraepithelial neoplasia（including carcinoma in situ） occurred in 22 cases（19.13%）. Invasive carcinoma（including suspected invasive carcinoma） was found in 18 cases（15.65%）. There were no statistical differences in the unilateral and bilateral distribution of vocal cord leukoplakia and pathological results（P>0.05）, but there were statistical differences in the size, thickness, lesion uniformity, clear boundary, pre-invasion commissure, symmetry,age over 55 years old, morphological classification, NBI classification and pathological results distribution（P<0.05）. The two-by-two comparison among the three groups of morphological classification（flat type, raised type, rough type） showed that P<0.017 was only compared between flat type and rough type, and P>0.017 was compared between the other two groups. The pairwise comparison among the three groups of NBI classification（Ⅲ, Ⅳ, Ⅴ） was statistically significant（P<0.017）. There was a high correlation between NBI classification and pathological diagnosis, and the correlation coefficient was 0.705（P<0.05）. The risk of high intraepithelial neoplasia and cancerization in type Ⅳ was 9.125 times higher than that in type Ⅲ, and the risk of high intraepithelial neoplasia and cancerization in type Ⅴ was 271.078 times higher than that in type Ⅲ. The area under the curve of morphological classification and NBI classification were 0.672 and 0.896, respectively. Conclusion:There is a high match and correlation between NBI classification and pathological diagnosis. Electronic laryngoscope combined with narrow band imaging endoscope has a high diagnostic value for vocal cord leukoplakia, and a strong predictive ability for malignant leukoplakia.
Humans ; Vocal Cords/pathology* ; Male ; Female ; Leukoplakia/diagnosis* ; Narrow Band Imaging/methods* ; Retrospective Studies ; Laryngoscopy/methods* ; Middle Aged ; Laryngeal Neoplasms/diagnosis* ; Aged ; Laryngoscopes ; Adult

Objective To analyze the chemical constituents in the water extract of Bupleuri Radix and investigate the active ingredients of Bupleuri Radix for the treatment of depression.Methods The chemical constituents in the water extract of Bupleuri Radix were identified by Ultra-high-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF/MS).CORT-induced poorly differentiated PC12 depression cell model was launched,and PC12 cells were pretreated with monomeric compounds from Bupleuri Radix for 24 h.The cell viability and LDH release rate were measured by CCK-8 assy kit and LDH assay kit,respectively.Results A total of 53 compounds were identified in the water extract of Bupleuri Radix,mainly including type Ⅰ,type Ⅱ and type Ⅲsaikosaponins.Among them,saikosaponin A,saikosaponin B2,saikosaponin C,saikosaponin E,saikosaponin F and 6″-acetyl saikosaponin A contributed the most to the metabolite profile of Bupleuri Radix,and could improve the viability of CORT-induced PC12 cells(P<0.05,P<0.01).Furthermore,saikosaponin A,saikosaponin B2,saikosaponin C,saikosaponin E and saikosaponin F could decrease the LDH release rate of CORT-induced PC12 cells(P<0.05,P<0.01).Conclusion The major anti-depression active ingredients in Bupleuri Radix may be Saikosaponin A,saikosaponin B2,saikosaponin C,saikosaponin E and saikosaponin F,which lays a foundation for the research of the quality control and pharmacodynamic material basis of Bupleuri Radix.