Objective: To investigate the incidence trend of tuberculosis in Haidong City, Qinghai Province from 2006 to 2020, and the effects of age, period, and cohort on tuberculosis incidence, so as to provide the basis for enhancing the prevention and control for tuberculosis. Methods: Data of tuberculosis cases in Haidong City from 2006 to 2020 were collected from the Chinese Disease Prevention and Control Information System. Incidence rates were calculated and standardized using data from the Sixth National Population Census in 2010. The trends in incidence of tuberculosis were analyzed by annual percent change (APC). Effects of age, period and cohort on the incidence of tuberculosis were analyzed by an age-period-cohort model. Results: The crude incidence rates of tuberculosis in Haidong City from 2006 to 2020 ranged from 37.69/105 to 100.93/105, and the standardized incidence rates ranged from 42.85/105 to 115.24/105. The standardized incidence rates from 2006 to 2015 showed a decreasing trend (APC=-7.148%, P<0.05), while there was no significant trend observed from 2015 to 2020 (all P>0.05). The age-period-cohort model analysis showed that the highest incidence risk of tuberculosis in Haidong City from 2006 to 2020 was observed in the age group of 20-<25 years (RR=2.973, 95%CI: 2.353-3.756), followed by the age group of 80-<85 years (RR=2.785, 95%CI: 2.206-3.516). The incidence risk of tuberculosis was higher in the period from 2016 to 2020 (RR=1.253, 95%CI: 1.203-1.306) compared to the period from 2011 to 2015 (RR=0.796, 95%CI: 0.770-0.823). Tuberculosis incidence risk was the highest in the birth cohort from 1936 to 1940 (RR=3.050, 95%CI: 2.356-3.949), and then gradually decreased over time thereafter. Conclusions The incidence of tuberculosis in Haidong City showed a decreasing trend from 2006 to 2015, while there was no significant trend observed from 2015 to 2020. The incidence risk of tuberculosis was higher in the age groups of 20-<25 years and 80-<85 years, and the risk decreased for those born in more recent years.

This study systematically searches for academic papers related to metabolic and bariatric surgery between 2000 and 2023 through the Web of Science database, and uses biblio-metric methods and visualization techniques to deeply analyse research trends, leading researchers, research institutions, and hotspots in this field. Through analysis, it uncovers the research dynamics and cutting-edge advancements in metabolic and bariatric surgery. Additionally, the authors explore current research hotspots, challenges, and potential future research directions. This study not only provides valuable reference information for researchers in the field of metabolic and bariatric surgery, but also offers a scientific basis for clinical practice and policy making.

Paridis Rhizoma， a traditional valuable Chinese herbal medicine， has the functions of clearing heat and removing toxin， relieving edema and pain， cooling liver and calming convulsion， which can be used to treat various diseases such as mumps， abscess， burn， bleeding， and tumor. It has been used in folk medicine for a long time and is the main raw material of various Chinese patent medicines such as Gongxuening Capsules and Yunnan Baiyao. Polyphyllin Ⅰ， an isospirostanol saponin and one of the main active components in Paridis Rhizoma， is distributed in the rhizome， pericarp， and leaves of Paris polyphylla. With high polarity， polyphyllin Ⅰ is mainly extracted by n-butanol extraction and macroporous adsorption resin chromatography， separated by silica gel column chromatography and preparative high performance liquid chromatography， and purified with the combination of methods. With anti-tumor， anti-inflammatory， antibacterial， and anti-virus effects， it is generally employed to treat liver cancer， lung cancer， gastric cancer and other cancers as well as arthritis， influenza， sore toxin， and bacterial infection. However， polyphyllin Ⅰ may cause stomach irritation， hemolysis， liver damage， kidney damage， heart damage， and other adverse reactions. Pharmacokinetic studies show that it has problems such as low bioavailability and poor intestinal absorption and permeability， which affect the clinical application of polyphyllin Ⅰ. This paper summarizes the research on the plant sources， extraction and separation methods， pharmacological effects， adverse reactions， and pharmacokinetics of polyphyllin Ⅰ in recent years， which is expected to provide a reference for the rational clinical application and other in-depth research work of polyphyllin Ⅰ.

Abstract: Objective To analyze the resistance and spatial distribution of Mycobacterium tuberculosis (MTB) to six commonly used anti-tuberculosis drugs in Qinghai Province from 2016 to 2019, so as to provide a reference for tuberculosis treatment and drug-resistant tuberculosis control. Methods A total of 1 182 identified strains of Mycobacterium tuberculosis in Qinghai Province from 2016 to 2019 were collected, and 6 anti-tuberculosis drugs were subjected to drug susceptibility tests and strain confirmed by the proportional method. By means of ArcMap10.7 and SaTScan10.1 software, map visualization, spatial autocorrelation analysis and spatial scanning of MTB drug resistance were performed to identify MTB drug resistance clusters in Qinghai Province. Results From 2016 to 2019, the total drug resistance (TDR) rate of 1 182 Mycobacterium tuberculosis strains in Qinghai Province was 23.77% (281/1 182), with a mono-resistance (MR) rate of 11.08% (131/1 182), a poly-resistance (PDR) rate of 3.89% (46/1 182), a multi-drug resistance (MDR) rate of 8.80% (104/1 182), and an extensive drug resistance (XDR) rate of 0.85% (10/1 182). The rates of MDR, XDR and TDR all showed a decreasing trend year by year (P<0.01). The drug resistance spectrum displayed 21 combinations. The TDR rate and MDR rate in the retreatment patients were higher than those of the initial treated patients, and the difference was statistically significant (χ2 TDR=22.784, χ2MDR=45.082, P<0.01). In terms of demographic characteristics, the TDR rate in males was higher than that in females, and the middle-aged group was higher than other age groups, and the differences were statistically significant (χ2=7.541, 10.825, P<0.05). The results of global spatial autocorrelation analysis showed that there was no statistical significance in the autocorrelation and obvious spatial clustering of MTB drug resistance in Qinghai Province from 2016 to 2019 (P>0.05), which indicated a random distribution. The results of spatiotemporal scanning showed that there was a kind of clustering area, but the clustering effect was not significant (P>0.05), indicating a random distribution. Conclusions The TDR of MTB in Qinghai Province from 2016 to 2019 showed a downward trend year by year. In comparison with the national average, the rate of multi-drug resistance and extensive drug resistance was still high, and most of the multi-drug resistance resulted from rifampicin and isoniazid. The drugresistant population mainly consisted of retreatment, males, and young and middle-aged pop

Objective:To analyze the ideal entry parameters and entry points for C 7 pedicle screws based on three-dimensional CT reconstruction model. Methods:A retrospective case series study was used to analyze the cervical spine CT image data of 50 adult volunteers collected from April 2021 to March 2022 at Taizhou People′s Hospital Affiliated to Nanjing Medical University, including 25 males and 25 females; aged 20-67 years [(43.8±13.5)years]. No significant structural abnormalities were seen in the cervicothorax of all volunteers. First, the 50 CT images were imported into the medical engineering software Mimics 17.0 to reconstruct the three-dimensional C 7 model, and the C 7 pedicle screw diameter (PSD), pedicle screw length (PSL), sagittal angle (SA) and lateral angle (LA) were measured. Then, the anatomical markers, namely the lateral notch and the midpoint of the inferior edge of the C 6 articular process, were used to measure the horizontal distance between the midpoint of the inferior edge of the C 6 articular process and the ideal entry point (line segment A), and the horizontal and vertical distances between the lateral notch and the ideal entry point (line segments B and C). Finally, the lateral notch and the midpoint of the inferior edge of the C 6 articular process were used as markers to observe the distribution of entry points. The values of the above measured parameters were recorded and compared with each other to analyze the differences between different sides and genders. Intra-group correlation coefficients (ICC) were also used to assess intra- and inter-observer agreement. Results:All 100 pedicles from 50 C 7 models were accessed, with the PSD being (6.5±0.7)mm, PSL being (31.8±4.5)mm, SA being (89.8±8.8)°, LA being (31.0±6.7)°, line segment A being 0.9(-0.4, 2.1) mm, line segment B being (5.8±1.7)mm, and line segment C being (3.6±1.5)mm. All ideal entry points were located medial above the lateral notch; moreover, with the midpoint of the inferior edge of the C 6 articular process as a reference, 71 (71%) of the entry points were located laterally and 29 (29%) were located medially. The 12 mm area around the midpoint of the inferior edge of the C 6 articular process was divided into 6 sections, with 47% of the entry points being located within 2 mm lateral to the midpoint, 25% within 2 mm medial to the midpoint, 19% within 2-4 mm lateral to the midpoint, and only 9% within 50% lateral to the midpoint. The measured parameters were not significantly different between the left and right sides (all P>0.05). The PSD, SA, and line segment B in males were (6.8±0.7)mm, (92.0±8.2)°, and (6.3±1.6)mm, which were significantly greater than those in females [(6.2±0.6)mm, (87.5±8.0)°, and (5.3±1.6)mm] (all P<0.01). The remaining parameters were similar between two genders (all P>0.05). All measured parameters had high intra- and inter-observer agreement (ICC: 0.84-0.91), except for line segment A that had moderate intra- and inter-observer agreement (ICC: 0.46-0.63). Conclusions:For C 7 pedicle screw implantation, when the surface of the lateral mass is used as the reference plane, SA is approximately 90°; with reference to the lateral notch, all the ideal entry points are located medially above it; with reference to the midpoint of the inferior edge of the C 6 articular process, approximately 70% of the entry points are located laterally. There are no significant differences in the parameters between the different sides of screw implantation on pedicles. The measured parameters show high intra- and inter-observer agreement, except for line segment A.

Plant fungal pathogens secrete numerous proteins into the apoplast at the plant-fungus contact sites to facilitate colonization.However,only a few secretory proteins were functionally characterized in Magnaporthe oryzae,the fungal pathogen causing rice blast disease worldwide.Asparagine-linked glycosylation 3(Alg3)is an a-l,3-mannosyltransferase functioning in the N-glycan synthesis of N-glycosylated secretory proteins.Fungal pathogenicity and cell wall integrity are impaired in Aalg3 mutants,but the secreted proteins affected in Aalg3 mutants are largely unknown.In this study,we compared the secretomes of the wild-type strain and the Aalg3 mutant and identified 51 proteins that require Alg3 for proper secretion.These proteins were predicted to be involved in metabolic processes,interspecies interactions,cell wall organization,and response to chemicals.Nine proteins were selected for further validation.We found that these proteins were localized at the apoplastic region surrounding the fungal infection hyphae.Moreover,the N-glycosylation of these proteins was significantly changed in the Aalg3 mutant,leading to the decreased protein secretion and abnormal protein localization.Furthermore,we tested the biological functions of two genes,INV1(encoding invertase 1,a secreted invertase)and AMCase(encoding acid mammalian chinitase,a secreted chitinase).The fungal virulence was significantly reduced,and the cell wall integrity was altered in the Ainv1 and Aamcase mutant strains.Moreover,the N-glycosylation was essential for the function and secretion of AMCase.Taken together,our study provides new insight into the role of N-glycosylated secretory proteins in fungal virulence and cell wall integrity.

Objective To establish the quality standard for Bushen-Tongluo granules.Methods Drynariae rhizoma, Paeoniae radix alba, Cyathulae radix, Chuanxiongin rhizome were identified by thin layer chromatography (TLC), and the content of naringin and paeoniflorin was determined by high performance liquid chromatography(HPLC) with chromatographic column Agilent C18 (4.6 mm×250 mm, 5 μm), as the mobile phase was acetonitrile-0.1% phosphoric acid and the scan wave length were 230 and 283 nm. The column temperature was 30 . The flow rate ℃ was 1.0 ml/min. Results TLC could identify Drynariae rhizoma , Paeoniae radix alba, Cyathulae radix, Chuanxiongin rhizome effectively. Under the condition, there was a good linear relationship when the content of naringin was in 6.337 0-50.695 7 μg. There is also a good linear relationship when the content of paeoniflorin was in 26.065 8-130.328 8 μg. The average recovery rate of naringin was 97.13% and RSD was 1.19%.The average recovery rate of paeoniflorin was 96.61% and RSD was 1.51%. Conclusions The established methods are simple, specific, reproducible, and sensitive, and they can be used for the quality control of Bushen-Tongluo granules.

Objective To establish an HPLC method for simultaneous determination of Quercetin , Luteolin, pigenin in Matricaria Chamomila L.. Methods HPLC analysis was performed on Agilent Zorbox SB-C18 column (4.6 mm×250 mm, 5 μm) with the methanol and phosphoric acid as mobile phase in equal degree model, and the column temperature was set at 25 ℃, and the flow rate was 1.0 ml.min-1 and the detecting wave length was at 350 nm. Results The linear response ranges were from 0.25-4.04 μg of Quercetin (r=1.000, n=6) and from 0.25-3.98 μg of Luteolin (r=1.000, n=6) and 0.25-4.02 μg of Apigenin (r=1.000, n=6);and the recoveries, the precision and the stability RSD of Quercetin, Luteolin and Apigenin meet the requirements. The average recovery rate of quercetin, luteolin and apigenin was 93.64%, 95.85% and 95.40%, respectively. Conclusions All 3 samples in Matricaria Chamomila.L were determined by HPLC. The method is simple, rapid, and reproducible. It can be used as reference for the quality control of Matricaria Chamomila L..

Objective To assess the operation results of unilateral and bilateral short-segment pedicle screw fixation combined with in-termediate screws in thoracolumbar fractures .Methods A total of 73 patients with thoracolumbar fracture were included in our study .Among the 73 patients, 48 cases were treated by bilateral short-segment pedicle screw fixation and the other 25 cases were treated by unilateral short-segment pedicle screw fixation,with a mean follow-up of 24.6 months.Surgical time,surgical blood loss,surgical draining loss,hospital stays, hospitalization cost,Cobb’s angle,kyphosis of the vertebral body ,anterior height of the fracture vertebral body ,VAS and ODI scores between the two groups were compared .Results There were significant differences in the surgical time and hospitalization cost between two groups (P<0.01).The differences in the Cobb’s angle,kyphosis of the vertebral body, and anterior height of the fracture vertebral body before and after surgery between two groups were all significant (P<0.05).There was no significant difference in the loss of the correction at the last fol-low-up between the two groups(P>0.05).Conclusion Unilateral short-segment pedicle screw fixation combined with intermediate screws can significantly correct the kyphosis and achieve the clinical effect of bilateral short -segment pedicle screw fixation technique .Meanwhile , the unilateral short-segment pedicle screw fixation technique can significantly reduce the surgical time and hospitalization cost ,which is an ef-fective method for thoracolumbar fracture .

Objective To analyze the clinical features of traumatic thoracolumbar fractures,and to improve the level of prevention and treatment of traumatic thoracolumbar fractures.Methods A review of 527 patients with traumatic thoracolumbar fractures admitted to our hospital from January 2006 to December 2015 was performed to analyze their clinical features,who were divided into different groups according to the age,fracture level and etiology.Results Of the 527 patients,238 patients aged form 40 to 59 year-old,which accounting for about 45.2％.Combined thoracolumbar and other segments fracture were presented in 76 patients,accounting for about 14.4％,among which combined thoracolumbar and lumbar spine fracture in 42 patients (8.0％),thoracolumbar and thoracic spine fracture in 22 patients (4.2％),thoracolumbar and cervical spine fracture in 7 patients and thoracolumbar(1.3％),cervical spine,thoracic spine and lumbar spine fracture in 5 patients(0.9％).The sex ratio was 136∶49 (2.8),incidence of neurological deficit was 50.3％,incidence of combined injuries was 38.9％ in the 20 to 39 year-old patients.High fall,low fall and road traffic accident were the most common etiologies,accounting for 43.1％,23.3％ and 14.6％ respectively,other etiologies accounting for 19.0％.In the patients caused by struck by object group,the sex ratio was 52∶3 (17.3),incidence of neurological deficit was 60.0％,incidence of combined injuries was 47.3％ and mean ISS score was (21.4 ± 12.7) point,the values were significantly larger than the other patients (P ＜ 0.05).According to ASIA neurologic grading system,72 patients in grade A,17 patients in grade B,37 patients in grade C,95 patients in grade D,68 patients recovered 1 or more grades during hospitalization,which accounting 12.9％ of all the patients.Conclusion The epidemiological survey of traumatic thoracolumbar fractures reveals that the age from 40 to 59 year-old and high fall was the most common age and etiology for injuries of spinal fracture.The 20 to 39 year-old patients group and struck by object group presented with the highest sex ratio,incidence of neurological deficit and combined injuries,the prevention and treatment should be designed according to the injury features of different individuals.