Objective To investigate the seroprevalence of antibody against Toxoplasma gondii among patients with hematological malignancies, and compare it with that among health individuals, so as to provide insights into unraveling the pathogenesis of hematological malignancies. Methods A total of 225 patients with hematological malignancies in Department of Hematology, Xuzhou Central Hospital and 300 healthy individuals in the same hospital were enrolled from 2017 to 2024. Blood samples were collected from all subjects, and the serum IgG and IgM antibodies against T. gondii were detected using chemiluminescent immunoassay. Demographic and clinical features were collected from patients with hematological malignancies, including gender, age, contact with cats, consumption of raw or undercooked meat, type of malignancy, clinical symptoms, blood transfusion and treatment, and the seroprevalence of anti-T. gondii antibody was compared among patients with different characteristics. Results The age (t = 0.72, P > 0.05) and gender (χ² = 0.93, P > 0.05) were compared between patients with hematological malignancies and healthy individuals. The seroprevalence of T. gondii infection was 20.89% among patients with hematological malignancies and 4.33% among healthy individuals (χ² = 34.81, P < 0.01), and the seroprevalence of anti-T. gondii IgG antibody was 20.89% among patients with hematological malignancies and 4.33% among healthy individuals (χ² = 34.81, P < 0.01), while there was no significant difference in the seroprevalence of anti-T. gondii IgM antibody between patients with hematological malignancies and healthy individuals (1.33% vs. 0; corrected χ² = 2.02, P > 0.05). The seroprevalence of T. gondii infection was 23.08% among patients with leukemia, 16.67% among patients with lymphoma, 19.23% among patients with multiple myeloma, 24.00% among patients with myeloproliferative neoplasm, and 26.09% among patients with myelodysplastic syndrome (χ² = 1.44, P > 0.05), and was all higher than among healthy individuals (corrected χ² = 23.92, 10.74, 13.76, 12.84 and 14.54; all P values < 0.01). In addition, there were no significant differences in the detection of anti-T. gondii antibody among patients with hematological malignancies in terms of gender, age, contact with cats, consumption of raw or undercooked meat, chemotherapy or blood transfusion (χ² = 0.76, 1.97, 0, 2.81, 2.38 and 0.66; all P values > 0.05). Conclusions There is a high risk of T. gondii infection among patients with hematological malignancies, and intensified surveillance of T. gondii infection is recommended among patients with hematological malignancies.

ObjectiveTo prepare oral nanoemulsions encapsulating essential oil from Alpinia zerumbet fructus（EOFAZ） and to investigate its pro-absorption effect in vitro and distribution in vivo. MethodThe proteoglycan conjugate polysaccharides of vinegar-processed Bupleuri Radix-bovine serum albumin（VBCP-BSA） was prepared by Maillard reaction of VBCP and BSA. Taking VBCP-BSA as emulsifier， vitamin B₁₂（VB₁₂） as absorption enhancer， and medium chain triglycerides mixed with EOFAZ as oil phase， the nanoemulsions loaded with EOFAZ was prepared by high energy emulsification method. The particle size， particle size distribution， surface Zeta potential， EOFAZ content and appearance and morphology of the nanoemulsions were characterized， and fluorescein tracer method was used to investigate the absorption effect of fluorescein-labeled EOFAZ nanoemulsions in vitro and their distribution in vivo. ResultVBCP-BSA was formed by Maillard reaction for 48 h with high grafting rate. Using VBCP-BSA as emulsifier， the homogeneous pink nanoemulsions was prepared and denoted as EOFAZ@VBCP-BSA/VB₁₂. The particle size of the nanoemulsions was less than 100 nm and the particle size distribution was uniform. The surface of the nanoemulsions was a weak negative charge， and the shape was spherical. The encapsulation rate of the nanoemulsions for EOFAZ was greater than 80%， which had a good absorption effect in vitro and could enhance liver accumulation after oral administration. ConclusionThe designed proteoglycan nanoemulsions can effectively load EOFAZ， promote oral absorption and enhance liver distribution， which can provide experimental basis for the development of oral EOFAZ liver protection preparations.

Objective:To investigate the current status of endoscopic treatment for gastroesophageal varices in portal hypertension in China, and to provide supporting data and reference for the development of endoscopic treatment.Methods:In this study, initiated by the Liver Health Consortium in China (CHESS), a questionnaire was designed and distributed online to investigate the basic condition of endoscopic treatment for gastroesophageal varices in portal hypertension in 2022 in China. Questions included annual number and indication of endoscopic procedures, adherence to guideline for preventing esophagogastric variceal bleeding (EGVB), management and timing of emergent EGVB, management of gastric and isolated varices, and improvement of endoscopic treatment. Proportions of hospitals concerning therapeutic choices to all participant hospitals were calculated. Guideline adherence between secondary and tertiary hospitals were compared by using Chi-square test.Results:A total of 836 hospitals from 31 provinces (anotomous regions and municipalities) participated in the survey. According to the survey, the control of acute EGVB (49.3%, 412/836) and the prevention of recurrent bleeding (38.3%, 320/836) were major indications of endoscopic treatment. For primary [non-selective β-blocker (NSBB) or endoscopic therapies] and secondary prophylaxis (NSBB and endoscopic therapies) of EGVB, adherence to domestic guideline was 72.5% (606/836) and 39.2% (328/836), respectively. There were significant differences in the adherence between secondary and tertiary hospitals in primary prophylaxis of EGVB [71.0% (495/697) VS 79.9% (111/139), χ2=4.11, P=0.033] and secondary prophylaxis of EGVB [41.6% (290/697) VS 27.3% (38/139), χ2=9.31, P=0.002]. A total of 78.2% (654/836) hospitals preferred endoscopic therapies treating acute EGVB, and endoscopic therapy was more likely to be the first choice for treating acute EGVB in tertiary hospitals (82.6%, 576/697) than secondary hospitals [56.1% (78/139), χ2=46.33, P<0.001]. The optimal timing was usually within 12 hours (48.5%, 317/654) and 12-24 hours (36.9%, 241/654) after the bleeding. Regarding the management of gastroesophageal varices type 2 and isolated gastric varices type 1, most hospitals used cyanoacrylate injection in combination with sclerotherapy [48.2% (403/836) and 29.9% (250/836), respectively], but substantial proportions of hospitals preferred clip-assisted therapies [12.4% (104/836) and 26.4% (221/836), respectively]. Improving the skills of endoscopic doctors (84.2%, 704/836), and enhancing the precision of pre-procedure evaluation and quality of multidisciplinary team (78.9%, 660/836) were considered urgent needs in the development of endoscopic treatment. Conclusion:A variety of endoscopic treatments for gastroesophageal varices in portal hypertension are implemented nationwide. Participant hospitals are active to perform emergent endoscopy for acute EGVB, but are inadequate in following recommendations regarding primary and secondary prophylaxis of EGVB. Moreover, the selection of endoscopic procedures for gastric varices differs greatly among hospitals.

Purpose Using conventional ultrasound,3D energy Doppler and shear wave elastography to develop one multi-modal ultrasound-based prediction model for placental insufficiency of second trimester.Materials and Methods A prospective analysis was conducted by reviewing 209 pregnant women with anterior wall placenta who underwent multi-modal ultrasound examination in the Affiliated Renhe Hospital of China Three Gorges University from April 2021 to April 2022,and all participants were divided into 118 cases in the normal group and 91 cases in the placental insufficiency group based on clinical diagnosis.Their placental function was evaluated through hemodynamics[blood flow parameters of umbilical artery(UA),uterine artery(Ut A)and cerebral placental rate(CPR)],blood stream perfusion[vascular index(VI),blood flow index(FI)and vaso-blood flow index(VFI)]and mechanical tissue properties[mean of elasticity modulus(Emean)].Logistic regression analysis was performed on the indicators with statistically significant differences between groups,establishing a prediction model of placental insufficiency and evaluating its efficacy.Results There were statistically significant differences in Ut A blood flow parameters,CPR,VI,VFI and Emean between the two groups(t=-12.74,-10.28,-11.01,7.02,7.00,-11.97,all with P<0.05).In regression analysis,Ut A-RI(≥0.65),CPR(≤1.53)and Emean(≥4.14 KPa)were found to be the independent risk factors,of which Emean had the greatest diagnostic efficacy(area under the curve,AUC=0.904).The AUC of the prediction model established by combining the three parameters was 0.945,with a sensitivity of 87.91%and a specificity of 94.92%,which has significantly higher diagnostic efficacy than that of a single parameter.Conclusion The prediction model based on the multi-modal ultrasound parameters has certain predictive value and high specificity for placental insufficiency of second trimester and can guide early clinical intervention to improve perinatal outcomes.

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 clinical characteristics and genetic basis for a fetus with Joubert syndrome.Methods:A pregnant woman who had visited Suzhou Municipal Hospital on February 26, 2021 was selected as the study subject. The fetus and her parents were subjected to whole exome sequencing (WES), and candidate variants were verified by Sanger sequencing. cDNA analysis of her father and RNA sequencing of her sister were also carried out.Results:The fetus was found to harbor compound heterozygous variants of the TCTN1 gene, namely c. 624G>A and c. 96dupA (p.Glu33Argfs*49), which were inherited from her father and mother, respectively. Her sister also carried the paternal c. 624G>A variant, and mRNA transcripts with the c. 624G>A variant of the TCTN1 gene were not detected by cDNA analysis of her father and RNA sequencing of her sister. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the c. 624G>A and c. 96dupA variants were both classified as likely pathogenic (PVS1+ PM2_Supporting). Conclusion:The compound heterozygous variants of the TCTN1 gene probably underlay the pathogenesis in this fetus. Above finding has also expanded the mutational spectrum of the TCTN1 gene.

Objective Based on the incidence and mortality of gastric cancer and the correlation with helicobacter pylori (Hp) infection in Enshi Tujia and Miao Autonomous Prefecture from 2011 to 2020, the prevalence trend of gastric cancer in this decade was analyzed, providing theoretical basis for the prevention and treatment of gastric cancer in Enshi Tujia and Miao Autonomous Prefecture. Methods According to the unified national examination and evaluation standards, 15 tumor registries meeting the requirements were selected in Enshi Tujia and Miao Autonomous Prefecture. The incidence and death data of gastric cancer were collected, and the incidence and death rates were analyzed by gender and age. The normalized incidence rate and Hp positive rate of enshi city, Lichuan city and six counties including Jianshi, Badong, Xuan 'en, Xianfeng, Laifeng and Hefeng were compared. Spearman correlation analysis was used to analyze the correlation between standard incidence rate and Hp positive rate of gastric cancer in each district of Tujia and Miao Autonomous Prefecture of Enshi Prefecture. Results Both male and female had an upward trend. The average rate of standard incidence of gastric cancer in male and female was 4.07% and 4.15%, respectively, and there was no significant difference in the trend of standard incidence rate in different genders (P>0.05). The gross death rates and standardized death were decreased in both male and female. The average decreasing rate of standardized death rate of gastric cancer in males and females was -3.91% and -4.12%, respectively, and there was no significant difference in the trend of standardized death rate in different genders (P>0.05). Overall, the incidence rate in age group 50-80 from 2016 to 2020 was significantly higher than that from 2011 to 2015 (P<0.05). The mortality rate in the 60-80 age group from 2016 to 2020 was significantly lower than that from 2011 to 2015 (P<0.05). The trend of morbidity and mortality in different age groups was consistent in the two periods. There was a positive correlation between the incidence standard rate of gastric cancer and Hp positive rate (r =0.473, P<0.05). Conclusion From 2011 to 2020, the incidence and mortality of gastric cancer in Enshi Tujia and Miao Autonomous Prefecture were both at a high level, with an upward trend and a downward trend. The positive rate of Hp and the new infection rate of Hp in the high incidence area of gastric cancer were higher than those in the low incidence area.

ObjectiveTo ascertain the causes of a food poisoning incident and provide references for the prevention of similar incidents in the future. MethodsCase investigation was conducted through field epidemiological investigation methods， and suspicious meals and foods were searched by the analytical epidemiological method. A food hygiene investigation was conducted in the establishment involved and samples of suspicious food， processing steps， and cases were collected for laboratory testing. ResultsA total of 91 individuals meeting the case definition were identified， resulting in an attack rate of 14.97% （91/608）. The main clinical manifestations included abdominal pain （97.80%）， diarrhea （84.62%）， nausea （62.64%）， vomiting （72.53%）， fever （12.09%）， and increased white blood cells （90.11%）. The peak incidence occurred from 16：00 to 18：00 on June 15. The epidemic curve showed a point-source exposure pattern， with an incubation period of 1 h minimum and 10 h maximum， and an average of 5 h. Analytical epidemiological studies indicated that lunch on June 15 was the suspicious meal （χ²=38.78， P<0.001）， and those who consumed cold-dressed tofu with preserved eggs had a significantly higher risk of falling ill compared to non-consumers （χ²=105.21， P<0.001）. Laboratory testing results revealed Vibrio parahaemolyticus detected in 1 employee’s anal swab and 18 cases’ anal swabs. Staphylococcus aureus was detected in 1 food ingredient and 1 case’s anal swab. The remaining samples tested negative. ConclusionThe cause of this food poisoning incident is Vibrio parahaemolyticus. The cause is the canteen’s supply of cold-dressed tofu with preserved eggs beyond its permissible business scope， potentially leading to cross-contamination during food processing. Regulatory authorities should strengthen routine law enforcement inspections and monitoring. Food service establishments should strengthen food safety awareness， standardize operational procedures in strict accordance with relevant national laws and regulations and food safety standards， and strive to reduce the occurrence of foodborne disease incidents at their source.

Enterotoxigenic Escherichia coli（ETEC）infection can induce watery diarrhea，leading to dehydration，electrolyte disturbance，and even death in severe cases. Recombinant B subunit/inactivated whole-cell cholera（rBS/WC）vaccine is effective in preventing ETEC infectious diarrhea. On the basis of the latest evidence on etiology and epidemiology of ETEC，as well as the effectiveness，safety，and health economics of rBS/WC vaccine，National Clinical Research Center for Child Health（The Children’s Hospital，Zhejiang University School of Medicine）and Zhejiang Provincial Center for Disease Control and Prevention invited experts to develop expert consensus on rBS/WC vaccine in prevention of ETEC infectious diarrhea. It aims to provide the clinicians and vaccination professionals with guidelines on using rBS/WC vaccine to reduce the incidence of ETEC infectious diarrhea.

Objective:To analyze clinical characteristics of scabies.Methods:The clinical data of 747 patients with scabies who visited Department of Dermatology, Affiliated Hospital of Jining Medical College from January 2018 to December 2019 were retrospectively analyzed.Results:There were more males (73.09%, 546/747) than females (26.91%, 201/747); most of patients had a age of 13-24 year (55.96%, 418/747); students account for 50.33% (376/747) of all patients; there were more patients living in dormitory than those living at home (61.45% (459/747) vs. 38.55% (288/747)). The cases began to rise from October, reaching the peak in December and remaining at relatively high level in January and February, then decreasing to the lowest during March to September. The number of patients living in rural areas is higher than that in urban areas. Patients took average 30 (15, 90) days from onset of disease to seeing a doctor, and itching was the main complain for visiting. The locations of lesion were most common on the abdomen (63.19%, 472/747), fingertips and wrists (53.41%, 399/747), vulva (37.22%, 278/747), and extremities (30.25%, 226/747). The lesions were characterized by erythematous papules (71.62%, 535/747), nodules (47.12%, 352/747), papules (24.50%, 183/747), wheals (6.02%, 45/747), secondary infections (3.61%, 27/747), tunnels (3.08%, 23/747) and small pustules (2.14%, 16/747); the male scrotal nodules were common (48.17%, 263/546). More patients (471/747, 63.05%) first visited non-dermatology outpatient clinics, and less first visited dermatology outpatient clinics (276/747, 36.95%); the misdiagnosis rates were 55.41% (261/471) and 27.54% (76/276), respectively; 127 cases (17.00%) were misdiagnosed as eczema, 54 cases (7.23%) as allergic dermatitis, 41 cases (5.49%) as prurigo nodularis, and 35 cases (4.69%) as urticaria pulosa. Conclusions:There is a certain discrepancy in the incidence of scabies among different populations, regions and seasons, the lesions of scabies are polymorphic involving different parts of the body surface and it is easy to be misdiagnosed.