Objective　To investigate the level of pertussis antibody in 344 healthy population in Hebei Province in 2023, and to understand the infection status and estimate the potential infection of pertussis. Methods　A total of 344 healthy people of all ages from 7 cities (counties) in Hebei Province in 2023 were stratified by random sampling method. The demographic characteristics, vaccination history and pertussis history of the subjects were collected. Serum IgG antibody against pertussis toxin (PT-IgG) were determined by enzyme-linked immunosorbent assay (ELISA). Results　The geometric mean concentration (GMC) of PT-IgG in 344 healthy people was 5.28 IU/mL, and the antibody positive rate (PT-IgG concentration ≥ 40 IU/mL) was 6.10% (21/344). There was no significant difference in proportion of antibody levels and antibody concentration ≥40 IU/mL between males and females. The top three regions with the highest antibody positive rate were Xinhe County in Xingtai (20.00%), Lianchi District in Baoding (11.43%), and Shijiazhuang (9.37%). There was a significant difference in pertussis antibody levels among different regions (P=0.007), but no significant difference in pertussis antibody concentration ≥40 IU/mL among different regions (P=0.100). The GMC of antibody was the highest in the 1~<3 years old group (11.45 IU/mL), followed by the <1 year old group (8.15 IU/mL). There was a significant difference in the pertussis antibody levels among different age groups (P=0.001). The proportion of antibody concentration ≥40 IU/mL was the highest in the 1~<3 years old group (20.83%), followed by the <1 year old group (12.77%). There was a significant difference in the proportion of antibody concentration ≥40 IU/mL among different age groups (P=0.028). And 303 (88.08%) cases of the 344 healthy people had a history of DTaP , 4.62%, 46.86% and 48.52% of healthy people had completed 1-2 , 3 and 4 doses of DTaP, respectively. Among the healthy people who had completed 1-2 doses of DTaP, there was no significant difference in the level of pertussis antibody among different age groups (P=0.47). Among the healthy people who had completed 3 doses of basic immunization and 4 doses of complete immunization, there was a significant difference in the level of pertussis antibody among different age groups (P=0.04, P=0.01). There was no significant difference in the proportion of PT-IgG concentration ≥40 IU/mL among different age groups and different immunization doses (P=0.72). Conclusion　The overall antibody level and proportion of PT-IgG concentration ≥40 IU/mL in the healthy population of Hebei Province in 2023 were both low, indicating the inadequacy of the protective effect of the current immunization program for children, although vaccinated people could still infect with pertussis disease, we need to further monitoring and optimization of immune strategies indicating.

Objective:To investigate the carriage status of Neisseria meningitidis ( Nm) among the healthy population in Hebei Province for the prevention and control of meningitis. Methods:From 2015 to 2022, throat swabs were collected from health people, which were selected by cluster random sampling in 11 cities of Hebei.The positive rate of Nm was detected by bacterial culture. The serogroups of isolated strains were identified.The laboratory detection results of Nm strains, combined with epidemiological survey data, were synthetically analyzed. Results:A total of 20 245 people were investigated; 249 strains of Nm were isolated; the overall Nm carriage rate was 1.23%. The carriage rate was significantly higher in men than in women(χ 2=28.831, P<0.05). The positive rates of Nm in different age groups were significantly different(χ 2=428.018, P<0.05), with the highest rates in the 15-19 year-old group(4.90%, 149/3 042). The positive rates of Nm were significantly different in different regions(χ 2=177.512, P<0.05), with the highest positive rate of Nm in Xingtai, Shijiazhuang, Chengde and Baoding city in sequence. Among the isolated Nm strains, ungroupable serogroups, serogroup B, serogroup C, and serogroup W accounted for 71.49%(178/249), 13.65%(34/249), 6.83%(17/249) and 4.42%(11/249), respectively. Conclusions:The carriage rate of Nm among healthy population is generally low in Hebei Province. It is recommended to continue to strengthen monitoring, pay attention to the changes and distribution characteristics of Nm, and formulate scientific and targeted prevention and control measures of meningococcal disease.

Abstract: Objective To evaluate the impact of meningococcal vaccine immunization on the incidence of meningococcal meningitis, aiming to refine the local immunization strategies and programs. Methods Data on the reported incidence of meningococcal meningitis in Hebei province for 1970-2023 were collected, and interrupted time-series( ITS) analysis was used to quantitatively analyze the levels and slope change of the incidence of meningococcal meningitis before and after vaccine immunization and before and after inclusion in the Expanded Program on Immunization (EPI). Results The annual average reported incidences of meningococcal meningitis in Hebei province before vaccination (1970-1979), before (1980-2007) and after (2008-2023) the inclusion of the vaccine in the EPI were respectively 20.79 per 100 000, 1.66 per 100 000, and 0.018 per 100 000. The interrupted time-series analysis from 1970 to 2023 showed an initial meningitis incidence rate of 24.12 per 100 000 (t=9.86, P<0.05), with an average annual decrease of 1.07 per 100 000 (t=-2.42, P<0.05). After the introduction of the meningococcal vaccine in 1980, the incidence of meningococcal meningitis decreased quickly with an annual average decline of 18.39 per 100 000, showing a significant short-term intervention effect (t=-2.70, P<0.05); however, the rate of decrease slowed over the long term to 0.13 per 100 000, with the long-term intervention effect not being significant (P>0.05). And the incidence was significantly increased due to the outbreak (t=7.80, P<0.05). From 1980 to 2023, the initial level of incidence was 5.13 per 100 000 (t=8.70, P<0.05), and decreased by 0.23/100 000 per year on average (t=-6.42, P<0.05). After the inclusion of the vaccine in the EPI in 2008, the rate of decrease further slowed down to an average of 0.008 per 100,000 per year, with the long-term intervention effect being significant (t=2.50, P<0.05); the impact of epidemic outbreaks on incidence during this period was not statistically significant (P>0.05). Conclusions Meningococcal meningitis vaccination has led to a general downward trend in the incidence of meningitis in Hebei Province, and has flattened the trend of increased incidence caused by outbreaks. Therefore, long-term maintenance in immunization programs on the meningococcal meningitis is necessary. In addition, it is important to strengthen the monitoring of the distribution of epidemic serogroups in patients and healthy carriers, and to adjust immunization strategies timely based on changes in bacterial populations, selecting and promoting vaccines accordingly for the prevalent strains.

Background: and Purpose X-linked Charcot-Marie-Tooth disease type 1 (CMTX1) is characterized by peripheral neuropathy with or without episodic neurological dysfunction. We performed clinical, neuropathological, and genetic investigations of a series of patients with mutations of the gap-junction beta-1 gene (GJB1) to extend the phenotypic and genetic description of CMTX1. Methods: Detailed clinical evaluations, sural nerve biopsy, and genetic analysis were applied to patients with CMTX1. Results: We collected 27 patients with CMTX1 with GJB1 mutations from 14 unrelated families. The age at onset (AAO) was 20.9±12.2 years (mean±standard deviation; range, 2–45 years). Walking difficulties, weakness in the legs, and pes cavus were common initial symptoms. Compared with female patients, males tended to have a younger AAO (males vs. females=15.4±9.6 vs. 32.0±8.8 years, p=0.002), a longer disease course (16.8±16.1 vs. 5.5±3.8 years, p=0.034), and more-severe electrophysiological results. Besides peripheral neuropathy, six of the patients had special episodic central nervous system (CNS) evidence from symptoms, signs, and/or reversible white-matter lesions. Neuropathology revealed the loss of large myelinated fibers, increased number of regenerated axon clusters with abnormally thin myelin sheaths, and excessively folded myelin. Genetic analysis identified 14 GJB1 variants, 6 of which were novel. Conclusions These findings expand the phenotypic and genetic spectrum of CMTX1. Although CMTX1 was found to have high phenotypic and CNS involvement variabilities, detailed neurological examinations and nerve conduction studies will provide critical clues for accurate diagnoses. Further exploration of the underlying mechanisms of connexin 32 involvement in neuropathy or CNS dysfunction is warranted to develop promising therapies.

Abstract: Objective To analyze the epidemiological characteristics of human brucellosis in Hebei Province, and to explore strategies and measures for its prevention and control. Methods Data on brucellosis cases reported in Hebei Province were collected from the National Notifiable Infectious Disease Reporting Information System. The total situation of brucellosis was described, and the epidemiological characteristics of brucellosis in Hebei Province were analyzed. The spatial autocorrelation analysis method was used to explore the spatial distribution characteristics of brucellosis incidence at the county level in Hebei Province. Results From 2018 to 2023, a total of 21 718 cases of brucellosis were reported in Hebei Province, with 1 death (in 2021). The annual incidence rate fluctuated between 3.91/100 000 to 6.26/100 000, with an average annual reported incidence rate of 4.84/100 000. The epidemic peak was from April to July, showing obvious seasonal characteristics. The incidence in males was higher than in females, with a male-to-female ratio of 2.81∶1. The incidence age was concentrated 30-<70 years, accounting for 85.33% of the total cases. The primary occupational group affected was farmers, accounting for 88.59%. The top three cities with the highest average annual incidence rate were Zhangjiakou, Chengde, and Hengshui, which reported a total of 7 801 cases, representing 35.92% of the total cases in the province. From the perspective of spatial distribution: the global spatial autocorrelation analysis showed clustering distribution in Hebei Province from 2018 to 2023, and there were hot spots in local spatial autocorrelation analysis. The high-incidence areas of brucellosis were mainly concentrated in Zhangjiakou (13.651 3/100 000) and Chengde (13.116 7/100 000) in the north of Hebei Province during the past six years. The "low-low" clustering areas were mainly distributed in Tangshan, Shijiazhuang, and Handan. The "low-high" clustering areas were mainly located around the "high-high" cluster areas, in some counties of Zhangjiakou and Chengde. Conclusions The situation of human brucellosis prevention and control in Hebei Province remains challenging. It is recommended to strengthen the management of infection sources, enhance the surveillance of human brucellosis, focus on health education and behavior intervention in high-risk groups, and intensify prevention and control efforts in the hotspot areas.

Objective:To evaluate the value of conventional ultrasound, shear wave elastic parameters and immunohistochemistry in predicting axillary lymph node metastasis of breast cancer.Methods:The ultrasonographic features and pathological results of 172 masses in 152 breast cancer patients who underwent surgery in the First Affiliated Hospital of Shihezi University Medical College from May to October 2020 were analyzed retrospectively. The patients were divided into metastatic group and non-metastatic group according to the status of axillary lymph nodes. The conventional ultrasound characteristics, shear wave velocity (SWV) and immunohistochemical indexes (ER, PR, HER-2, Ki-67) of 2 groups of breast cancer masses were analyzed. Finally, the parameters with statistically significant difference between groups were selected and the Logistic regression model was established.Results:There were significant differences in the aspect ratio, calcification, SWVmean and HER-2 expression between metastatic group and non-metastatic group (all P<0.05). A prediction model was constructed with aspect ratio >1, calcification, high SWVmean and HER-2(+ ). The area under receiver operating characteristic curve (AUC) of the subjects was 0.891, which was larger than the single parameter (all P<0.05), and was in good agreement with pathological results (Kappa=0.731). Conclusions:The joint prediction model can be used to predict the status of lymph nodes, and the axillary lymph node metastasis is more likely to occur in breast cancer with the aspect ratio >1, calcification, high SWVmean and HER-2(+ ).

Objective:To analyze the radiological protection situation in the workplace of medical X-ray diagnostic equipment in primary medical institutions in south Xinjiang Uygur Autonomous Region, and then put forward necessary measures and suggestions.Methods:In accordance with the national medical radiation protection monitoring program and the requirements of relevant standards for radiological health, medical X-ray diagnostic equipment in radialogical diagnosis and treatment institutions was tested selectively for workplace radiological protection, with the result statistically analyzed.Results:From 2018 to 2021, radiological protection test was conducted for 84 workplaces in 15 radiological diagnosis and treatment institutions in 4 districts of south Xinjiang, with a pass rate of 98.8%, which was consistent with the mainland including the eastern and central regions in the country.Conclusions:Based on the current situation in radiological diagnosis and treatment institutions on medical radiation protection in south Xinjiang, it is recommended to strengthen the supervision and management of radiological diagnosis and treatment equipment, improve the testing and technical capabilities of the local medical radiation monitoring technical teams and raise the level of radiological health work in the south Xinjiang.

Objective:To report 8 cases of hereditary spastic paraplegia type 35 (SPG35) in Chinese mainland, summarize the clinical and genetic features of this disease.Methods:Eight probands with SPG35, admitted in Shanghai Jiao Tong University Affiliated Sixth People′s Hospital and Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from September 2006 to June 2021, were collected in detail. Physical examination, cranial imaging examination and whole exome sequencing were conducted, followed by Sanger sequencing and family co-segregation. In addition, the recent advances in clinical, genetic and pathogenesis studies of the disease were also reviewed.Results:Among all of the 8 patients, 7 had juvenile-onset and 1 was adult-onset. The clinical phenotype of 2 cases was pure spastic paraplegia. The other 6 cases presented with complicated form, which was characterized by not only motor dysfunction, but also cognitive impairment and dysphagia, etc. Genetic testing revealed a total of 13 fatty acid 2-hydroxylase (FA2H) gene (NM_024306) mutations, of which 6 were reported and 7 were newly reported in this study.Conclusions:SPG35 is an autosomal recessive neurodegenerative disease with highly phenotypic heterogeneity, with the causative gene as FA2H. The genotype-phenotype correlations in SPG35 are not clear.

The skin is the largest organ comprised of three main layers: epidermis, dermis and subcutaneous tissue. Characteristic microscopic and ultrastructural alterations are present in certain skin structures, such as nerve fibers, blood vessels and sweat glands, not only in vasculitis, but in several other metabolic neurologic diseases. In recent years, advances in immunohistochemistry and electron microscopy have made these dermatopathological changes identifiable and clear-cut. It was then recognized that such pathological feature could be present in many tissues in addition to those nerve systems clinically affected. Skin biopsy has become a recognized diagnostic procedure for peripheral neuropathy and central nervous system diseases. This article reviews the dermatopathology in neurological disorders under light and electron microscope to promote application of skin biopsy in clinical diagnosis for neurologist.

Objective To investigate clinical effects differences of ropivacaine combined with two doses of sufentanil on labor analgesia.Methods300 lying-in women with painless childbirth in the period from January 2016 to December 2016 in department of obstetrics in Deqing hospital of traditional Chinese medicine were chosen and randomly divided into two groups including A group (150 cases) with ropivacaine combined with conventional doses of sufentanil for 7.5μg and B group (150 cases) with ropivacaine combined with low doses of sufentanil for 2.5μg;the block onset time of sensory and motor, arrival time at the maximum block level, modified Bromage score, Apgar score, VAS score at different time points and adverse reaction rate of both groups were compared.ResultsTwo groups of maternal sensory and motor block work time and reach the highest block plane comparative differences had no statistical significance.The modified Bromage score of B group were significant better than A group(P<0.05).The adverse reaction rate of B group were significant lower than A group(P<0.05).ConclusionCompared with conventional dosage sufentanil, luo pp paid in combination with low dose used in epidural sufentanil analgesia can obviously reduce the working time, improve the quality of anesthesia and reduce the incidence of adverse reactions, is suitable for clinicians to choose application.