To investigate tick species and prevalence of Anaplasmataceae and spotted fever group Rickettsia(SFGR)in ticks collected from sheep and goats in Leibo county,Sichuan Province.Ticks were preliminary identified by morphological characters and the genomic DNAs of ticks were ex-tracted.Molecular detection was performed by PCR targeting gene fragment of tick ITS-2,gltA and ompA genes of Rickettsia spp.,16S rRNA and rpoB genes of Anaplasma spp.and Ehrlichia spp.Positive PCR products were sequenced and phylogenetic trees were built based on these genes.The results showed that a total of 353 adult ticks collected from sheep and goats were identified as H.longicornis.The total prevalence of SFGR in H.longicornis was 22.66％(80/353)with only R.raoultii detected,which was closely related to R.raoultii(JQ792163)isolated from Dermacentor niveus in Tibet.The total prevalence of Anaplasmataceae was 87.82％(310/353)with six Ana-plasma species(A.bovis,A.capra,A.marginale,Anaplasma cf.marginale,Anaplasma sp.,Can-didatus A.mediterraneum)and two Ehrlichia species(E.chaffeensis and Ehrlichia sp.)detec-ted.Go-infection was found in some H.longicornis as high as 7.37％(26/353).The results indica-ted that H.longicornis may be the dominant tick species in Leibo county with high infections rates of Anaplasmataceae and SFGR.The close monitoring of the tick-borne pathogens should be strengthened in the future research work.

Objective To explore the value of machine learning(ML)models based on non-contrast CT(NCCT)radiomics features for predicting the severity of acute phase traumatic brain injury(TBI).Methods Totally 600 TBI patients were retrospectively collected as observation group,other 65 TBI patients were taken as external validation set,while 50 TBI patients were prospectively enrolled as prospective validation set.Patients in observation group were divided into high-risk subgroup(n=240)and low-risk subgroup(n=360)according to Glasgow outcome scale(GOS)at discharge.The severity of acute phase TBI in observation group was assessed by doctor A and B with the same criteria,then an artificial model was established based on clinical and NCCT data at the time of first diagnosis using logistic regression(LR)method for predicting the severity of acute phase TBI.Patients in observation group were divided into training set(n=420,including 168 in high-risk subgroup and 252 in low-risk subgroup)and test set(n=180,including 72 in high-risk subgroup and 108 in low-risk subgroup)at the ratio of 7∶3.Based on NCCT of training set,radiomics features were extracted and selected,and LR,support vector machine(SVM),random forest(RF)and K-nearest neighbor(KNN)were used to establish 4 ML models.The efficacies of the above models were validated in test set,external validation set(including 34 cases of high-risk and 31 cases of low-risk TBI)and prospective validation set(including 21 cases of high-risk and 29 cases of low-risk TBI),respectively.Results The area under the curve(AUC)of doctor A and B for evaluating the severity of acute phase TBI in observation group was 0.606 and 0.771,respectively,of artificial model was 0.824.Based on NCCT in training set,6 optimal radiomics features were selected to construct LR,SVM,RF and KNN ML models,with AUC of 0.983,0.971,0.970 and 0.984 in test set,respectively,while the AUC of artificial model was 0.708.The AUC of LR,SVM,RF,KNN ML models and artificial model in external validation set was 0.879,0.881,0.984,0.863 and 0.733,while in prospective validation set was 0.984,0.873,0.982,0.897 and 0.704,respectively.Conclusion ML models based on CT radiomics could effectively predict the severity of acute phase TBI.

Objective:To explore the correlation of serum albumin level at admission with clinical prognoses in patients with acute traumatic brain injury (TBI).Methods:One hundred and fifty-four patients with acute moderate-extreme severe TBI (Glasgow Coma Scale [GCS] scores of 3-12 at admission) in Department of Neurosurgery, General Hospital of Western Theater Command from January 1, 2019 to December 31, 2020 were chosen. The comprehensive clinical data of these patients were collected, including age, gender, GCS scores, serum albumin level (hypoalbuminemia defined as<35 g/L), hemoglobin level, comorbidities, treatment measures, and prognoses 6 months after discharge (poor prognosis defined as Glasgow outcome Scale [GOS] scores of 1-2, and good prognosis defined as GOS scores of 3-5). Univariate and multivariate Logistic regressions were used to identify the independent factors for clinical prognoses of these patients, and differences in poor prognosis rate, length of ICU stay, and total hospital cost were compared between different groups.Results:Among the 154 patients, 43 had poor prognosis and 111 had good prognosis. Serum albumin level at admission ( OR=0.916, 95% CI: 0.843-0.996, P=0.001) and GCS scores at admission ( OR=0.701, 95% CI: 0.594-0.828, P<0.001) were independent factors for prognosis. Patients with hypoalbuminemia ( n=70) displayed significantly higher poor prognosis rate, longer ICU stays, and increased total hospitalization cost compared with those without hypoalbuminemia ( n=84, P<0.05); specifically, in patients with GCS scores of 9-12 at admission ( n=58), those with hypoalbuminemia ( n=27) exhibited significantly higher poor prognosis rate, longer ICU stays, and higher total hospitalization cost than their non-hypoalbuminemia counterparts ( n=31, P<0.05); similarly, in patients with GCS scores of 3-8 at admission ( n=96), those with hypoalbuminemia ( n=74) had significantly higher poor prognosis rate than their non-hypoalbuminemia counterparts ( n=22, P<0.05). In patients with good prognosis, those with hypoalbuminemia ( n=56) showed significantly longer total hospital stays, prolonged ICU stays, and increased total hospitalization cost compared with those without hypoalbuminemia ( n=55, P<0.05). Conclusion:Low serum albumin level at admission is likely to lead to poor prognosis, prolonged ICU stays and increased total hospitalization cost in patients with acute TBI.

China has a heavy burden of hepatocellular carcinoma, which is a serious threat to people′s life and health. However, the available drugs for advanced hepatocellular carcinoma in the past are limited and the efficacy is not satisfactory. In recent years, immunotherapy has a significant effects in some tumors. The authors introduce the efficacy of restart immunotherapy on an advanced hepatocellular carcinoma patient undergoing interruption of treatment due to corona virus disease 2019, in order to provide references for the diagnosis and treatment of this kind of patients.

Objective To investigate the clinical outcomes derived from Ningmitai combined with tamsulosin to prevent double-J stent syndrome after laser lithotripsy with ureteroscope. Methods 117 patients underwent laser lithotripsy with ureteroscope and then placed a double-J stent for draining were collected from January 2010 to January 2013. Patients with double-J stent placement were divided into four groups determined by dosage regimen. Tamsulosin group (30 cases) was treated with tamsulosin (0.4 mg once daily) lonely, Ningmitai group (29 cases) was treated with Ningmitai (1.52 g, trice time a day) lonely, tamsulosin combined Ningmitai group (30 cases) was treated with tamsulosin and Ningmitai at the same time, operation control group (28 cases) was neither tamsulosin nor Ningmitai. The catheter was removed on the 3rd day post-lithotripsy and then remained double-J stent for 1 month. The scores of urinary tract, pain and the incidence of gross hematuria were assessed. Results The significant differences in the improvement of symptom score (χ2=22.038, P=0.000), pain score (χ2=9.876, P=0.020) and hematuria (χ2=8.000, P=0.046) were found among tamsulosin group, Ningmitai group, and tamsulosin combined Ningmitai group. The number of patients with symptomless, slight symptom in tamsulosin combined Ningmitai group were higher than those of tamsulosin group, Ningmitai group, operation control group (symptomeless:14 vs. 6, 3 and 2 cases;slight symptom:13 vs. 9, 5, 4 cases). The number of patients with>Ⅱpain score (7 vs. 9, 14, 17 cases) and incidence of hematuriag [26.6%(8/30) vs. 56.7%(17/30), 58.6% (17/29), 53.6% (15/28)] were lower in tamsulosin combined Ningmitai group than those of tamsulosin group, Ningmitai group, operation control group. The drug combination of Ningmitai with tamsulosin had the synergism to relived symptom and pain, and showed the more obviousthan lonely use. Conclusion The drug combination of Ningmitai with tamsulosin can be used in clinic for prophylactic purpose to prevent double-J syndrome.

Objective:To observe therapeutic effect of maleic acid levamlodipine (amlodipine) on inflammatory fac‐tor levels in patients with essential hypertension (EH) .Methods :According to random number table method ,a to‐tal of 84 EH patients were randomly and equally divided into nifedipine group (received nifedipine treatment ) and amlodipine group (received maleic acid levamlodipine treatment ) ,both groups were treated for 12 weeks .Blood pressure ,serum levels of tumor necrosis factor α(TNF‐α) ,interleukin‐6 (IL‐6) and high sensitive C reactive protein (hsCRP) were measured and compared between two groups before and after treatment .Results:Before treatment , there were no significant difference in blood pressure ,serum levels of TNF‐α,IL‐6 and hsCRP between two groups , P>0.05;after treatment ,all above indexes significantly reduced in both groups compared with before treatment ,P<0. 01 all .Compared with nifedipine group ,there were significant reductions in systolic blood pressure [ (136. 9 ± 13.4) mmHg vs . (128.3 ± 12.5) mmHg] ,diastolic blood pressure [ (88.4 ± 7.1) mmHg vs . (82.7 ± 6.8) mm‐Hg] ,serum levels of TNF‐α [ (10.85 ± 2.56) ng/L vs . (8.61 ± 2.37) ng/L] ,IL‐6 [ (18.92 ± 4.61) ng/L vs . (13.73 ± 4.18) ng/L] and hsCRP [ (7.95 ± 2.38) mg/L vs . (5.89 ± 2.24) mg/L] in amlodipine group , P<0.01 all .Conclusion:Amlodipine can more significantly reduce levels of TNF‐α,IL‐6 and hsCRP ,inhibit inflammatory reaction than those of nifedipine and contribute to blood pressure control in patients with essential hypertension .

Objective To investigate the feasibility of glycogen synthase kinase (GSK) 3βinhibitor CHIR99021 induces human embryonic stem cells to differentiate into definitive endoderm cells. Methods Human embryonic stem cells H1 cells were cultured in feeder-free medium (Essential 8). The expression of human embryonic stem cell pluripotency markers Oct4, Nanog were detected by immunolfuorescence. Human embryonic stem cells were treated with CHIR99021 of different concentrations (0.33, 1.00, 3.00, 9.00, 27.00μmol/L) and cultured for 3 d respectively. The untreated cells were taken as control. The expression levels of pluripotency related genes OCT4, SOX2 and deifnitive endoderm related genes GATA4, SOX17 were detected by lfuorescent quantitative polymerase chain reaction (PCR). The experimental data were compared using one-way analysis of variance and LSD-t test. Results The expression of human embryonic stem cell pluripotency markers Oct4, Nanog could be detected by immunofluorescence. The human embryonic stem cells were observed in good growth when treated with CHIR99021 of different concentrations (0.33, 1.00, 3.00μmol/L) . The human embryonic stem cells were observed in poor growth or dead when treated with the higher concentrations of CHIR99021. The expression of pluripotency related gene OCT4 decreased after treated with CHIR99021 of 1.00, 3.00μmol/L concentration (LSD-t=-40.54,-59.12;P<0.05). The expression of SOX2 also decreased significantly (LSD-t=-20.46,-3.87;P<0.05). The expression of definitive endoderm related genes GATA4 increased after treated with CHIR99021 of 1.00, 3.00μmol/L concentration (LSD-t=137.21, 65.29;P<0.05). The expression of SOX17 also increased significantly (LSD-t=50.93, 6.56;P<0.05). Conclusions Human embryonic stem cells can maintain a good pluripotent state in the feeder-free culturing system. CHIR99021 can effectively induce the human embryonic stem cells to differentiate into deifnitive endoderm cells.

Objective To investigate management strategy of minimally invasive surgery for common bile duct stones. Methods Three hundred and four cases of common bile duct stones were divided into 3 groups receiving respectively endoscopic papillary balloon delation plus laparoscopic cholecystectomy ( EPBD group, 35 cases ), endoscopic sphincterotomy plus LC ( EST group, 138 cases), and Laparoscopic common bile duct exploration plus LC (LCBDE group, 131 cases). Results There was no significant difference in treatment success rate, short-term complications and bile duct retained stones among these three group ( x2 = 1. 930, 0. 038, and 0. 427 respectively, P > 0. 05 ). There was significant difference among these three groups in operation time ( F = 17.941, P = 0. 000 ), and the operation time in LCBDE group was shorter than that in other two groups( EPBD-EST: P = 0. 122, EST-LCBDE:P = 0. 000, EPBD-LCBDE:P = 0. 020 ). There was significant difference among these three groups in postoperative hospital stay (F =24. 016,P =0. 000) ,and the postoperative hospital stay in EPBD group was shorter than that in other two groups ( EPBD-EST: P = 0. 000, EST-LCBDE : P = 0. 198, EPBD-LCBDE : P = 0. 000 ). In EPBD group,bile duct recurrent stones was found in 2 cases(6. 7% ) and cholangitis in 1 case(33% ) and no duodenal papilla stenosis was encountered; In LCBDE group, bile duct recurrent stones were found in 7 cases (6. 0% ), cholangitis in 3 cases ( 2. 6% ), and there was no duodenal papilla stenosis; In EST group, bile duct recurrent stones were complicated in 18 cases ( 15.8% ), duodenal papilla stenosis in 9 cases (7.9%), and cholangitis in 14 cases( 12. 3% ). There were significant differences among these three groups for these three complications( x2 = 6. 482, 9. 160, and 12. 020 respectively,P < 0. 05 ), and the rate of complications in EST group was higher than that in other two groups. Conclusion For common bile duct stones, EPBD is the first choice followed by LCBDE while EST is only indicated for very few cases.

Aim To investigate the effects of breviscapine(Bre)on Na+,K+-ATPase activity of proximal tubule(PT) and its renal protection in early diabetic rats. Methods The rats were divided into three groups: diabetic model (DM group), Bre treatment (Bre group) and normal control (NC group). Rats were administrated with Bre(20 mg?kg-1?d-1, ip) in Bre group, with normal saline(ip) in DM and NC groups for four weeks after diabetes induction with streptozotocin (STZ 65 mg?kg-1, ip) in Bre and DM groups. The urine and blood samples were collected from two intra-ureteral cannulas and the heart, respectively, under anesthesia four weeks after diabetes induction. After one of the renal arteries being perfused, the renal cortex was incubated and PT segments were microdissected freehand under microscope before the Na+,K+-ATPase activity in the segments were assessed by liquid scintillation counter. The blood glucose, levels of creatinine in serum and in urine were assayed. The microalbumin , ?2-microglobulin(?2-MG) of urine and endogenous digitalis-like substance (EDLS) of serum were measured respectively by radioimmunoassay. Results The PT Na+,K+-ATPase activity in NC group was(959.11?117.35) pmolPi?mm-1?h-1, and that in DM group was significant higher for (1893.53?383.90) pmolPi?mm-1?h-1 than it(P

Objective To improve the level of diagnosis and treatment of the sharp injury in the back. Methods 47 cases which were treated from Jan 1991 to May 2000 were reviewed. ResultsAmong 37 cases who underwent the exploration, 5 cases died. Among 10 cases who underwent conservative treatment, 2 cases died. ConclusionThe condition of sharp injury in the back is very complicated,it is easy to be misdiagnosed, the mortality is high. Saving should be equalled with the diagnosis and treatment. The application of wound exploration, abdominal puncture, ultrasound examination and X-ray checking is valuable to the diagnosis. The patients with operation indications should be operated at once,while the others should be observed for some time to prevent the delayed clinical manifestation.