Objective To investigate the spatiotemporal distribution characteristics and potential influencing factors of newly diagnosed echinococcosis cases in Qinghai Province from 2016 to 2022, so as to provide insights into the formulation of the echinococcosis control strategy in Qinghai Province. Methods The number of individuals screened for echinococcosis, number of newly diagnosed echinococcosis cases, number of registered dogs and number of stray dogs were captured from the annual reports of echinococcosis control program in Qinghai Province from 2016 to 2022, and the detection of newly diagnosed echinococcosis cases was calculated. The number of populations, precipitation, temperature, wind speed, sunshine hours, average altitude, number of year-end cattle stock, number of year-end sheep stock, gross domestic product (GDP) per capita, and number of village health centers in each county (district) of Qinghai Province were captured from the Qinghai Provincial Statistical Yearbook, and county-level electronic maps in Qinghai Province were downloaded from the National Platform for Common Geospatial Information Services. The software ArcGIS 10.8 was used to map the distribution of newly diagnosed echinococcosis cases in Qinghai Province, and the spatial autocorrelation analysis of newly diagnosed echinococcosis cases was performed. In addition, the spacetime scan analyses of number of individuals screened for echinococcosis, number of newly diagnosed echinococcosis cases and geographical coordinates in Qinghai Province were performed with the software SaTScan 10.1.2, and the spatial stratified heterogeneity of the detection of newly diagnosed echinococcosis cases was investigated with the software GeoDetector. Results A total of 6 569 426 residents were screened for echinococcosis in Qinghai Province from 2016 to 2022, and 5 924 newly diagnosed echinococcosis cases were found. The detection of newly diagnosed echinococcosis cases appeared a tendency towards a decline over years from 2016 to 2022 (χ² = 11.107, P < 0.01), with the highest detection in Guoluo Tibetan Autonomous Prefecture in 2017 (82.12/10⁵). There were spatial clusters in the detection of newly diagnosed echinococcosis cases in Qinghai Province from 2016 to 2018 (Moran’s I = 0.34 to 0.65, all Z values > 1.96, all P values < 0.05), and the distribution of newly diagnosed echinococcosis cases appeared random distribution from 2019 to 2022 (Moran’s I = −0.09 to 0.04, all Z values < 1.96, all P values > 0.05). Local spatial autocorrelation analysis showed high-high clusters and low-low clusters in the detection of new diagnosed echinococcosis cases in Qinghai Province from 2016 to 2022, and space-time scan analysis showed that the first most likely cluster areas of newly diagnosed echinococcosis cases in Qinghai Province from 2016 to 2022 were mainly distributed in Yushu Tibetan Autonomous Prefecture and Guoluo Tibetan Autonomous Prefecture. GeoDetector-based analysis of the driving factors for the spatial stratified heterogeneity of detection of newly diagnosed echinococcosis cases in Qinghai Province showed that average altitude, number of village health centers, number of cattle and sheep stock, GDP per capita, annual average sunshine hours, and annual average temperature had a strong explanatory power for the spatial distribution of newly diagnosed echinococcosis cases, with q values of 0.630, 0.610, 0.600, 0.590, 0.588, 0.537 and 0.526, respectively. Conclusions The detection of newly diagnosed echinococcosis cases appeared a tendency towards a decline in Qinghai Province over years from 2016 to 2022, showing spatial clustering. Targeted control measures are required in cluster areas of newly diagnosed echinococcosis cases for further control of the disease.

Objective:Cholangiocarcinoma (CCA) is a malignant tumor derived from bile duct epithelial cells with extremely poor prognosis. The Hippo-Yes-associated protein (YAP)/transcription activator with PDZ binding motif (TAZ) signaling plays a critical role in cancer stem cell biology. Previous studies have shown that the positive expression of YAP/TAZ in CCA predicts larger tumor size and unfavorable clinical outcomes. We aim to evaluate the prognostic value of YAP/TAZ detection in CCA patients.Methods:CCA patients who underwent radical resection were retrospectively analyzed at our institution from January 2011 to June 2016. Postoperative pathological specimens were scored by YAP/TAZ immunohistochemical staining. The prognostic value of YAP/TAZ was analyzed by multivariate Cox-proportional hazards model.Results:A total of 91 CCA patients were enrolled. During a median follow-up time of 11.0 months, 69.2% patients relapsed and 45.1% died. The median OS and DFS were 10.7 months and 8.8 months respectively. The YAP/TAZ dual positive patients owned a worse TNM stage ( P=0.015), poorer tissue differentiation ( P=0.007), and a higher CA199 than those in negative patients. Multivariate Cox analysis identified that YAP/TAZ dual positivity as a significant factor predicted poorer OS ( P=0.010) and DFS ( P=0.028) in CCA patients after radical resection. In subgroup analysis, YAP/TAZ combination also significantly predicted OS ( P=0.044) and DFS ( P=0.043) in CCA patients with positive lymphatic metastasis and/or surgical margin who required adjuvant therapy. Conclusions:YAP/TAZ positivity is an independent predictive factor for survival in CCA patients after radical resectiony.

Objective:To investigate the effect of fresh food homogenate instead of traditional liquid and semiliquid diet on the condition of nutrition and aspiration in the early stage of pulling out the na-sogastric tube in patients with moderate dysphagia.Methods:Forty patients with tube feeding were randomly divided into observation group and control group.Each group had 20 cases.After extubation,the observation group ate fresh food homogenate,and the control group were feeding liquid and semi liquid diet.The actual calories intake,protein,carbohydrate,lipid and dietary fiber were recorded on the first day and the fifteenth day of intervention.The values of serum albumin,prealbumin,hemoglobin and total lymphocyte count were measured.The rate of aspiration and constipation was observed continuously during the study.Results:After 2 weeks of intervention,the daily energy and nutrient intake,nutritional biochemical indexes of observation group were higher than those of control group (P ＜ 0.05),and the incidence of aspiration and constipation was decreased in observation group (P ＜ 0.05).Conclusion:Compared with the conventional liquid and semi liquid diet,fresh food homogenate can increase the intake of daily calorie and nutrition in patients with moderate dysphagia in the early stage after the feeding tube was pulled out,improve nutritional status,reduce the aspiration and constipation,and be well tolerated.

Objective To observe the clinical effects and adverse reactions of gamma knife combined with pemetrexed plus carboplatin in concurrent or sequential chemoradiotherapy of locally advanced non-small cell lung cancer( LANSCLC) .Methods A to-tal of 125 cases of LANSCLC were randomly divided into 3 groups, in accordance with different therapeutic methods.The concurrent group ( or group A, 30 cases) received body gamma knife combined with pemetrexed plus carboplatin.The sequential group ( or group B, 31 cases) was given 2 weeks of chemotherapy with pemetrexed and carboplatin, then sequential body gamma knife radiotherapy and finally underwent two cycles of chemotherapy with the same regimen.The radiotherapy group ( or group C, 64 cases) was given just body gamma knife radiotherapy.Clinical therapeutic effects and adverse reactions were evaluated.Results The short-term effects for group A, group B and group C were respectively 83.33%, 77.42%and 73.44%, and no statistical significance could be seen when comparisons were made between them(P<0.05).The 1-2-year survival rate and the median survival time for group A were respectively 73.33%, 43.33%and 17.5 months, those for group B were respectively 64.52%, 35.48%and 15.4 months, and those for group C were respectively 46.88%, 23.44%and 10.6 months.Analyses indicated that group A was superior to group B, and group B was su-perior to group C, with the former having a better survival rate, and no statistical significance could be noticed when comparisons were made between them(P>0.05).However, there was statistical significance when comparisons were made between group A and group C (P<0.05).With regard to toxic reactions, all the adverse reactions were from gradeⅠ-Ⅲ, with bone marrow suppression and gastro-intestinal reactions as the main manifestations.GradeⅣadverse reaction never occurred.There was no statistical significance in the in-cidence rates of radiation-induced esophagiti and pneumonitis, when comparisons were made between the 3 groups(P>0.05).With re-gard to the incidence rates of bone marrow suppression and adverse reactions of the digest system, there was no statistical significance, when comparisons were made between group A and group B(P>0.05).However, statistical significance could be noted, when compari-sons were made between group A/B and group C(P>0.05).Conclusion Body gamma knife combined with pemetrexed and carboplatin in concurrent chemoradiotherapy was more superior to body gamma knife alone, furthermore it displayed better safety and higher tolerance.

Objective To explore the characteristics of chest multi-slice spiral CT and dynamic changes in adult patients with se-vere adenovirus pneumonia.Methods Clinical and CT data of 6 patients with severe pneumonia in an epidemic of the respiratory ade-novirus infection were retrospectively analyzed.The impact of hormone therapy was also studied.Results The first chest CT exami-nations in 6 patients were performed 2.22 ± 0.75 days after fever.CT showed segmental consolidation with ground-glass opacity (GGO)in one case,patchy consolidation with GGO in 3 cases,patchy interstitial changes in one case and small nodules in one case. The duration reaching the standards of severe pneumonia was 6.1 7 ± 0.37 days from the onset.During severe phase chest CT showed a range of lobar consolidation in one case,lobar in 2 cases,segmental in 2 cases or patchy in one case,consolidation with GGO in 5 cases.In all cases the lesions were commonly seen in the lower lobes of bilateral lungs.Multiple lobes were involved in 2 cases.After methylprednisolone treatment,no new lesion was showed but the early lesion was enlarged.During the first 2 to 4 days GGO absorbed completely in 6 cases,consolidation absorbed completely in one case and mostly in 5 cases.Conclusion Chest CT findings of severe adenovirus pneumonia in adult are single or multiple lobar or segmental consolidations with or without GGO which distribute mainly at lower lobes.

Objective To observe the clinical effects of bi-level positive airway pressure ( BiPAP) combined with tiotropium bromide in the treatment of chronic obstructive pulmonary disease ( AECOPD) with acute exacerbation .Methods Sixty cases of AECO-PD with acute exacerbation were randomly divided into group A and group B , each consisting of 30 cases, and clinical analyses were made on them .The patients in both groups were given routine treatment , including oxygen breathing , spasmolysis , expectoration , anti-infection and BiPAP.At the same time, the patients in group B were administered with the above treatment couple with BiPAP inhala-tion agent, with a dosage of 18μg, once a day.Symptoms, pulmonary functions and blood-gas analysis were performed to see the effects and adverse reactions , and hospitalization days were also recorded accordingly .Results Total effective rate for group A was 73.33%, while the rate for group B was 93.33%, and statistical differences could be seen , when comparisons were made between them ( P<0.05 ) .Following treatment , symptom scores , pulmonary functions and results of blood gas analysis in the patients of both groups signif -icantly improved, as compared before treatment (P<0.05).The conditions of the patients in group B were obviously superior to those of the patients in group A, with statistical significance (P<0.05).For the average length of stay at the hospital , the patients in group B were obviously superior to those of the patients in group A (P<0.05).The incidence of adverse reactions for the patients in group B was low, with minor symptoms.Conclusion The effects of BiPAP combined with tiotropium bromide in the treatment of chronic ob-structive pulmonary disease with acute exacerbation were obviously superior to that by simple BiPAP therapy .Furthermore, the former was safer and more effective , which was worth further clinical extension .

ObjectiveTo evaluate the influence of ginkgo dipyridolum injection on blood-rheological and coagulation function in pationts with AECOPD.Methods78 cases of patients with AECOPD were divided into group A (38 cases)and group B (40 cases)by mean of digital random table method.The routine treatment including oxygen inhalation,spasmolytics and anti-infection was given to patients in both groups while ginkgo dipyridolum injection (30 ml/d)was additionally added to patients in group B for two weeks.The blood-rheological and coagulation function were evaluated.ResultsAs for blood-rheological after the treatment,whole blood high shearing viscosity(5.25 ± 1.24)mPa · S,low shearing viscosity (11.12 ±2.43) mPa · S,plasma viscosity (2.06± 0.14 ) mPa · S and hematocrit (45.52 ± 2.78) ％ in the group A indicated significant differences compared to those in group B [ (4.83 ± 1.42)mPa· S,(8.78± 3.02) mPa · S,(1.73 ±0.21) mPa · S,(39.05 ± 3.41) ％],(P＜0.05); as for coagulation function after the treatment,PT (13.14± 1.31 ) S,APTT (30.85±5.24)S,FIB (4.99±1.04)S,D-D (1.42±0.23)mg/L in the group A indicated significant differences compared to those in group B [ (14.78 ± 3.13) S,(36.67 ± 8.12)S,(3.81 ± 0.42) S,(0.84 ±0.39) mg/L],(P＜0.05).ConclusionFor the patients with AECOPD,the ginkgo dipyridolum injection can decrease hood-viscosity,and obviously improve hypercoagulabale state.

Objective To evaluate the clinical effects and immune function of shenqi 11 flavor capsule as an adjuvant treatment in advanced NSCLC patients during chemotherapy.Methods 58 cases of advanced NSCLC were divided into two groups by mean of digital random table method,with 29 patients in each group.GP scheme chemotherapy was applied to patients in group B,using gemcitabine (1000 mg/m2) on the 1st and 8th day intravenously (procedure should be finished within 30 minutes) and cisplatin (75 mg/m2) on the 1st day intravenously.Each cycle was 3 weeks,two cycles in total.Same scheme was applied to patients in group A and with an addition of shenqi 11 flavor capsule(1.65 g/time,3 times/d) throughout the whole procedure of chemothrapy.Recent curative effect,life quality,toxic reactions and changes in immune indexes of both groups were observed.Results Short-term response rate in group A was 48.27％ and 41.38％ in the group B (x2=0.279,P＞0.05),which showed no significant differences between the two groups.Toxic reactions such as leukopenia,hematochrome decrease and gastrointestinal reactions in the group B were significantly severe compared to group A after chemotherapy(x2 were 4.678,4.549 and 4.687 respectively,P＜0.05).As for immune indexes after chemotherapy,CD3+ (55.21 ± 3.28) ％,CD4+ (38.84±5.13) ％,CD8+ (29.86±4.83) ％,CD4+/CD8+( 1.29± 0.17) and NK cells (20.12± 2.11 ) ％in the group B indicated significant differences compared to those in group A[(62.96±4.12)％、(45.21±3.43)％、(25.23±2.79)％、(1.82±0.21)、(25.78±3.36)％],(P＜0.05).The life quality was 58.62％ in group A and 31.03％ in the group B,which showed significant difference (x2=4.462,P＜0.05).Conclusion Shenqi 11 flavor capsule as an adjuvant treatment in advanced NSCLC patients during chemotherapy can not only improve life quality of patients,alleviate the symptoms,but also enhance their immune function.

AIM: To evaluate whether tolerogenic dendritic cells (DC) loaded with heat shock protein 60 (HSP60) inhibit the progression of aortic atherosclerotic plaque in hypercholesterolemic apolipoprotein E (Apo-E) -null mice. METHODS: Bone marrow derived DC of the mice were loaded with HSP60 and co-cultured with rapamycin to generate tolerogenic DC. The tolerogenic DC, DC loaded only HSP60 and PBS were injected into the ApoE-null mice at 8 weeks of age for three times at a one-week interval. 8 weeks after the last injection, aorta were harvested for HE staining and anti-CD4~+T cell immunostaining. Responses of pleenic cells to HSP60 were also evaluated. RESULTS: Compared with DC, DC_ HSP60 expressed higher levels of CD86, and stimulated T lymphocytes to proliferation significantly, while the tolerogenic DC expressed lower levels of CD86, and inhibited T lymphocytes to proliferation. After immunization with different injection, the numbers of CD4~+ T cells in plaque were increased significantly in DC_ HSP60 group vs in PBS group (P