Objective To explore the correlation between clinical distribution characteristics of streptococcal pharyngitis in children and seasonal variations in Ziyang area, so as to provide basis for disease prevention and control. Methods A multistage and stratified random sampling technique was used to investigate 583 children with streptococcal pharyngitis attending Ziyang first people's Hospital from January 2022 to January 2023. The clinical data were recorded. The pharyngeal specimens were cultured for streptococci test. The number of streptococcal pharyngitis cases per season was counted. The metereological conditions (average barometric pressure, temperature, rainfall, and wind speed) were recorded. Pearson method was used to discuss the correlation between metereological factors and streptococcal pharyngitis onset. Results A total of the 583 children, 329 were male and 254 were female. The main age of onset was 7-12 years old, with a total of 227 cases (38.94%), followed by 199 cases (34.13%) aged 3-6 years old, 126 cases (21.61%) aged 1-2 years old, and 31 cases (5.32%) under 1 year old. A total of 614 strains of pathogenic bacteria were detected, of which 479 strains of Streptococcus hemolyticus were dominant, accounting for 78.01%, followed by 175 strains of Streptococcus pyogenes, accounting for 28.50%. Seasonally, 192 cases of streptococcal pharyngitis occurred in spring, 51 in summer, 72 in autumn and 268 in winter. In Ziyang, spring and winter were characterized by high mean wind speeds and barometric pressure, while summer and autumn were characterized by high mean temperatures and heavy rainfall. Pearson correlation analysis revealed that the prevalence rate streptococcal pharyngitis was positively correlated with average wind speed and barometric pressure (P<0.05), and negatively correlated with mean temperature and rainfall (P<0.05). Conclusion In Ziyang, streptococcal pharyngitis occurs mostly in children over 5 years old, and the main pathogen is Streptococcus hemolyticus. The onset of the disease is mostly in spring and winter, which is closely related to the seasonal variations of the region.

BACKGROUND:Previous animal studies have shown that riluzole can inhibit neuroinflammatory response after spinal cord injury and promote functional recovery in injured rats,but the study on whether it can regulate the expression of nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)inflammasome in the acute stage is lacking. OBJECTIVE:To observe whether riluzole can reduce microglial pyroptosis and promote functional recovery after spinal cord injury by modulating NLRP3 inflammasome through animal experiments,histological experiments and molecular biology experiments. METHODS:Female SD rats were divided into sham operation,model and riluzole groups,with 12 rats in each group.In addition to the sham operation group,T10 spinal cord injury was conducted in rats.The model group was treated with intraperitoneal administration of riluzole with solvent cyclodextrin.The riluzole group was treated with a 4 mg/kg dose of riluzole injection.The effect of riluzole on motor function recovery was assessed using the BBB score and inclined plane test.The recovery of sensory-evoked potential and motor-evoked potential was measured by electrophysiology.Hematoxylin-eosin staining was used to evaluate spinal cord tissue repair.The regulatory effects of riluzole on NLRP3,Caspase-1 and gasdermin D protein expression in spinal cord tissues were detected by western blot assay.ELISA was utilized to detect the expression levels of inflammatory factors interleukin-1β and interleukin-18.The effects of riluzole on the expression of NLRP3,Caspase-1,gasdermin D and interleukin-1β in microglial cells of the injured spinal cord were determined by immunofluorescence staining. RESULTS AND CONCLUSION:(1)At 35 days after spinal cord injury,BBB score and inclined plane test score in the riluzole group were higher than those in the model group(P<0.05).(2)At 3 days after spinal cord injury,the protein expressions of NLRP3,cleaved Caspase-1,gasdermin D-N(N-terminal domain),interleukin-1β,and interleukin-18 in the spinal cord homogenate of the riluzole group were significantly lower than those of the model group(P<0.05).(3)At 3 days after spinal cord injury,the fluorescence intensity of NLRP3,Caspase-1,gasdermin D and interleukin-1β in the riluzole group was significantly lower than that in the model group(P<0.05).(4)At day 35 after spinal cord injury,hematoxylin-eosin staining showed that the area of spinal cord injury in the riluzole group was smaller than that in the model group.Electrophysiological tests showed that the latency periods of sensory-evoked potential and motor-evoked potential in the riluzole group were shorter than those in the model group,and the latency period of wave amplitude in the riluzole group was higher than that in the model group.(5)These results suggest that riluzole can promote the repair of injured spinal cord tissue,promote the repair of nerve conduction function,and further promote the recovery of motor function in rats with spinal cord injury,which may be achieved through the regulation of NLRP3 inflammasome and the reduction of microglial pyroptosis.

BACKGROUND:Neuroinflammation is an important factor leading to secondary spinal cord injury,and microglia/macrophage pyroptosis is a significant part of post-spinal cord injury neuroinflammation.Studies have shown that microglia/macrophage undergoes pyroptosis after spinal cord injury,but the regulatory mechanism of circular RNA(circRNA)in microglia/macrophage pyroptosis after spinal cord injury remains unclear. OBJECTIVE:To investigate the role and mechanism of circRNA0005512 in regulating microglia/macrophage pyroptosis after spinal cord injury. METHODS:Female Wistar rats were divided into sham group and spinal cord injury group.Motor function was evaluated using the Basso,Beattie,and Bresnahan(BBB)scale.Cavity volume was assessed by hematoxylin-eosin staining.Differential expression of circRNA in spinal cord tissue was screened using RNA-sequencing and circ0005512 was validated by real-time PCR.Immunofluorescence,western blot assay,ELISA,and real-time PCR were performed to detect cell pyroptosis in the rats and lipopolysaccharide-induced microglial cell line HAPI cell models.Gene knockdown was used to confirm the regulatory role of circRNA0005512 in microglia/macrophage pyroptosis. RESULTS AND CONCLUSION:(1)Seven days after spinal cord injury,evident cavities were observed at the injury site.Immediately after spinal cord injury,the motor function of rats was completely lost.Over time,the motor function of rats in the spinal cord injury group gradually partially recovered,and there was a significant difference in BBB scores compared to the sham group.(2)Circ0005512 was significantly upregulated according to the results of the RNA-sequencing and confirmed in both the animal and cell models.(3)Immunofluorescence,western blot assay,real-time PCR,and ELISA confirmed the significant upregulation of cell pyroptosis markers(NLRP3,GSDMD,and caspase-1)in spinal cord injury tissue and lipopolysaccharide-induced HAPI cells.(4)In the cell model,knockdown of circ0005512 resulted in significantly decreased levels of cell pyroptosis marker-NLRP3.(5)The results above indicate that circ0005512 promotes pyroptosis in microglia/macrophages after spinal cord injury.

Objective:To compare the clinicopathological features between patients with gallbladder adenosquamous carcinoma and gallbladder adenocarcinoma, and analyze the prognostic factors for overall survival.Methods:The clinical data of 135 patients with gallbladder cancer, confirmed by postoperative pathology, treated in Department of Hepatobiliary and Pancreatic Surgery of Ningbo Medical Center Lihuili Hospital within 5 years (from January 2018 to December 2022) were retrospectively analyzed. A total of 122 patients were enrolled in this study, including 55 males and 67 females, aged (68.0±9.8) years. Patients were divided into the adenosquamous carcinoma group ( n=14) and adenocarcinoma group ( n=108). The clinicopathological features (tumor size, differentiation of tumor, tumor TNM stage) and survivals of patients were compared. The survival rates were analyzed using the Kaplan-Meier method and log-rank test. Multivariate Cox regression analysis was performed to identify prognostic factors for overall survival. Results:Compared with the adenocarcinoma group, patients with adenosquamous carcinoma had a larger tumor size, higher incidence of liver invasion, higher proportion of poor differentiation of tumor, higher proportion of TNM stage Ⅲ-Ⅳ (all P<0.05). There was also a statistically significant difference in the extent of liver resection between the two groups ( χ2=9.22, P=0.016). The 1- and 2-year cumulative survival rates after surgery in adenosquamous carcinoma group were 28.6% and 9.5%, respectively, lower than those in adenocarcinoma group (78.7% and 60.5%, respectively; χ2=27.88, P<0.001). For patients with gallbladder adenosquamous carcinoma, the cumulative survival rate of patients who received postoperative adjuvant chemotherapy ( n=11) was significantly better than that of patients without postoperative adjuvant chemotherapy ( n=3) ( χ2=5.82, P=0.016). For patients with gallbladder adenocarcinoma, multivariate Cox regression analysis identified that the N stage (N 1/N 0HR=4.521, 95% CI: 1.399-14.612, P=0.012; N 2/N 0HR=8.644, 95% CI: 2.407-31.039, P=0.001) and M stage (M 1/M 0HR=4.699, 95% CI: 1.540-14.340, P=0.007) were associated with a poor survival. Conclusions:Compared to gallbladder adenocarcinoma, adenosquamous carcinoma had more aggressive features and a worse prognosis. For patients with gallbladder adenosquamous carcinoma, postoperative adjuvant chemotherapy was associated with an improved overall survival. For patients with gallbladder adenocarcinoma, N stage and M stage were independent risk factors for overall survival.

Objective:To summarise and analyse the experience in the diagnosis and management of abdominal aortic endograft infection in recent years.Methods:Retrospectively summarised and analysed the general data, clinical presentation, laboratory and imaging findings, causative organisms and treatment choices of 14 patients with abdominal aortic endograft infection treated in Beijing Friendship Hospital, Capital Medical University, from January 2018 to June 2024, and analysed the prognosis of the patients and the risk factors associated with prognosis.Results:Positive bacterial cultures were 10 out of 14 patients. One non-operatively treated patient died of infectious toxic shock. Thirteen surgically treated patients underwent axillary-bifemoral artery bypass, removal of the infected stent, and closure of the aortic stump. Four of the 13 cases had combined aortoenteric fistula, 3 cases underwent one-stage enterocutaneous fistula repair, 1 case only fistula drainage, 3 cases of gastrojejunal anastomosis, all of them underwent gastric or jejunal nutrient tube implantation. Two of the 13 patients had combined the infection foci spread to the renal artery openings. To save the kidney, intraoperative left kidney autologous renal transplantation was performed in 1 case, and autologous saphenous vein reconstruction from celiac trunk artery-left renal artery and superior mesenteric artery-right renal artery was performed in the other case. All 14 patients were retrospectively summarised and followed up in August 2024, with 5 deaths in the early postoperative period (< 3 months), 3 deaths in the mid- to long-term period (≥3 months), and 5 survivors, with a median follow-up time of 2 years (1-5 years) for surviving patients. Among the 13 operated patients, 4 cases were combined with aortoenteric fistula, and 3 cases died in the early postoperative period; 4 cases of abdominal aortic infection foci involving renal artery openings, 2 cases of early postoperative death; 4 cases with pleural effusion, 4 cases died in the early postoperative period; 2 cases of combined creatinine elevation, 2 cases of early postoperative death; 2 cases of postoperative infection of artificial blood vessels.Conclusions:Abdominal aortic endograft infection are aggressive. The risk of early death is increased in patients who are elderly, in poor general condition, with aortoenteric fistula or with pre-existing cardiac, pulmonary, hepatic and renal insufficiency, but surgery based on adequate anti-infective therapy remains an effective means of saving the patient′s life.

Objective:To analyze the correlation between the modified Glasgow prognostic score (mGPS) and the prognosis of patients undergoing surgery for gallbladder cancer.Methods:Clinical data of 137 patients undergoing surgery for gallbladder cancer in the Department of Hepatobiliary and Pancreatic Surgery at Ningbo Medical Center Lihuili Hospital from January 2017 to December 2022 were retrospectively analyzed, including 58 males and 79 females, aged (67.7±10.1) years old. According to mGPS, patients were divided into the mGPS 0 group ( n=78), mGPS 1 group ( n=39) and mGPS 2 group ( n=20). Clinicopathological data, such as maximum tumor diameter, vascular invasion, perineural invasion, tumor differentiation and TNM stage, were compared between the groups. Survivals of patients were followed-up via outpatient follow-ups and telephone reviews, analyzed using the Kaplan-Meier method, and compared between the groups using the log-rank test. Univariate and multivariate Cox regression analysis were performed to identify prognostic factors for recurrence-free survival. Based on the results of multivariate analysis, a nomogram model of recurrence-free survival of gallbladder cancer patients was established and validated respectively. Results:The maximum tumor diameter, tumor differentiation, TNM stage, preoperative CA19-9 level and R 0 resection rate differed statistically among the mGPS 0, mGPS 1 and mGPS 2 groups (all P<0.05). Postoperative cumulative survival rate ( χ2=28.13) and recurrence-free survival rate ( χ2=25.39) of gallbladder cancer patients also differed among the mGPS groups (all P<0.001). Multivariate Cox regression analysis showed that the poor differentiation of tumor ( HR=2.433, 95% CI: 1.396-4.242, P=0.002), vascular invasion ( HR=2.809, 95% CI: 1.598-4.941, P<0.001), perineural invasion ( HR=1.980, 95% CI: 1.188-3.300, P=0.009), TNM stage Ⅲ-Ⅳ ( HR=2.689, 95% CI: 1.069-6.762, P=0.036) and mGPS 2 ( HR=2.496, 95% CI: 1.372-4.541, P=0.003) were independent risk factors for poor recurrence-free survival in gallbladder cancer. Based on the above risk factors, a nomogram of prediction model for recurrence-free survival in patients with gallbladder cancer was established, with a C-index value of 0.810 (95% CI: 0.769-0.851). The decision curve analysis findings demonstrated that the nomogram model had a significant positive net benefit, and the calibration curve demonstrated that the predicted results of the nomogram model correlates well with the actual results. Conclusions:The preoperative mGPS is associated with the overall prognosis of patients undergoing surgery for gallbladder cancer, and a high mGPS is a risk factor for poor prognosis. The mGPS-based nomogram of prediction model showed a good predictive value of the recurrence-free survival of patients undergoing surgery for gallbladder cancer.

Objective To screen the distribution frequency of Mur blood group among voluntary blood donors in Hezhou,Guangxi,and further analyze the molecular basis of of Mur antigen positive samples.Methods The Mur pheno-type of voluntary blood donors in Hezhou was serologically screened using microplate method,and the distribution frequency of Mur antigens in different ethnic groups was analyzed.Genetic typing was performed on these positive samples with PCR-SSP method to verify the accuracy of the serological method,and the genetic background was sequenced and analyzed.Re-sults Among 3 298 samples from voluntary blood donors in Hezhou,432(13.10%,432/3 298)were screened positive for Mur antigen,and PCR-SSP genotyping validation showed that all 432 samples were electrophoretic positive.Among them,the proportion of Han blood donors with positive Mur antigen was12.79%(331/2 587),Yao ethnic group was13.25%(64/483),Zhuang ethnic group was 16.51%(36/218),and no statistically significant difference was found in the three groups(P＞0.05).Further sequencing results showed that 428 samples were GYP(B-A-B)Mur,also known as GYP.Mur type(12.98%,428/3 298),the other 4 samples were GYP(B-A-B)Bun,also known as GYP.Bun type(0.12%,4/3 298).Conclusion The Mur blood type frequency is high in the voluntary blood donors in Hezhou,Guangxi,and is predominant characterized by GYP.Mur genotype.Due to ethnic integration,no significant difference was noticed in the frequency of Mur blood type distribution between Han,Zhuang and Yao population.Therefore,conducting extensive Mur blood group antigen and antibody testing in Hezhou is of great significance for ensuring clinical blood transfusion safety.

Objective:To investigate the therapeutic effect of anterolateral thigh Flow-through flap transfer surgery combined with Masquelet technique in reconstruction of Gustilo IIIC open fractures of distal tibia.Methods:Between July 2017 and May 2021, 7 patients who had Gustilo IIIC injuries in the lower limb were treated in the Department of Orthopaedics Surgery, Wuxi 9th People's Hospital by emergency surgery with transfer of anterolateral thigh Flow-through flap combined with Masquelet technique. The patients were 5 males and 2 females, aged 36 to 63 (50.0±10.4) years old. Size of soft tissue defects was 11 cm × 4 cm to 23 cm × 7 cm, the length of bone defects was 3.5-7.5 (5.34±1.52) cm and the bridging length for vascular defects was 7-12 (9.21 ± 2.34) cm. The size of the flaps was 12 cm × 5 cm - 24 cm × 8 cm. All patients received postoperative follow-up at the outpatient clinic and complications of wound, fracture healing and the recovery of limb function were observed.Results:All flaps survived uneventfully and successful limb salvage were achieved in all 7 patients, together with all bone grafts healed without infection. The follow-up lasted for 12-38 (26.69±10.73) months. At the last follow-up, the appearance and functional recovery of the lower limbs were satisfactorily. The function of ankle was evaluated according to American Orthopedic Foot and Ankle Society (AOFAS) : 3 patients in excellent, 3 in good and 1 in fair.Conclusion:Emergency anterolateral thigh Flow-through flap transfer surgery with Masquelet technique is a safe, effective and feasible surgical procedure for Gustilo IIIC open fractures of distal tibia. It allows to close the wound and rebuild the blood supply in distal limb in the primary or emergency surgery, and allows to perform bone grafting and internal fixation in stage-II surgery. The patients benefit from high rate of success in limb salvage and good function recovery of the affected limb.

Objective:To investigate the clinical effect of minimally invasive-locking block modified Krackow (MI-LBMK) and open giftbox technique in the treatment of Achilles tendon rupture.Methods:Fifty-six patients with Achilles tendon rupture from January 2016 to December 2018 were collected, including 54 males and 2 females, aged 40.7±9.4 years (range 26 to 65 years). The MI group (30 patients) used two minimally invasive incisions without exposing the rupture site, and the LBMK technique was used to repair the Achilles tendon. The open group (26 patients) used a posteromedial longitudinal incision and the giftbox technique was used to repair the rupture tendon. The Achilles tendon was repaired with 6-strand sutures in both groups. Early rehabilitation programs were adopted for postoperative rehabilitation, and regular follow-up (6 weeks, 3, 6, 12 and 24 months after operation) was performed to record the Achilles tendon resting angle (ATRA), American Orthopaedic Foot and Ankle Society ankle-hindfoot score (AOFAS), Achilles tendon total rupture score (ATRS). The rupture gap and cross-sectional area (CSA) were measured by MRI at 6 weeks and 3 months after surgery.Results:A total of 30 patients in the MI group and 26 in the open group were enrolled. The differences between the two groups in age, body mass index, interval from injury to operation, and tendon rupture site were not statistically significant ( P>0.05). All patients were followed up to 24 months after surgery. There were no wound complications in MI group, and 2 cases of superficial infection and 1 case of wound skin necrosis occurred in open group. There was no re-rupture in both groups. The relative ATRA of MI group was -6.32°±0.99°, -3.90°±1.05°, -2.38°±0.84°, -0.25°±1.37° at 3, 6, 12 and 24 months after operation, respectively. The relative ATRA of open group was -7.88°±3.71°, -6.16°±1.10°, -4.53°±0.95°, -3.01°±0.95° at 3, 6, 12 and 24 months after operation, respectively. The differences between the two groups were statistically significant ( P<0.05). The ATRS of minimally invasive group at 6 months and 12 months were 72.70±7.41 and 92.97±3.35 respectively, and the ATRS of open group at 6 months and 12 months were 68.08±6.64 and 90.85±4.27 respectively, and the differences were statistically significant ( P<0.05). The AOFAS of minimally invasive group at 6 months and 12 months were 88.60±2.76 and 93.83±1.98 respectively, and the AOFAS of open group at 6 months and 12 months were 85.77±3.20 and 92.08±2.64 respectively, and the differences were statistically significant ( P<0.05). The difference in the gap between the tendon rupture ends measured by MRI sagittal plane T2WI between the two groups was not statistically significant ( P>0.05). The cross-sectional area of Achilles tendon in the MI group was higher than that of the open group at 12 weeks ( P<0.05). Conclusion:The MI-LBMK technique may protect the peritendon tissue and has fewer complications, and can enable the patient to return to daily life faster, with lower postoperative Achilles tendon elongation and better recovery of Achilles tendon function.

Objective To analyze the epidemiological characteristics of pathogenic bacteria for respiratory tract infection in children with asthma to facilitate the prevention, diagnosis, and treatment. Methods Among 206 hospitalized children with asthma and respiratory tract infection from January 2019 to December 2021 were selected for analysis in this study, including 131 cases with upper respiratory tract infection and 75 cases with lower respiratory tract infection. The potential correlation between the distribution of pathogenic bacteria and drug resistance was analyzed and compared between the two groups. Results A total of 167 strains of pathogenic bacteria were detected in 131 children with upper respiratory tract infection, and 262 strains were detected in 75 children with lower respiratory tract infection. The distribution characteristics of pathogenic bacteria in children with asthma and acute upper respiratory tract infection were consistent with the total distribution characteristics. Among children with asthma and acute lower respiratory tract infection, the infection of Gram-positive bacteria was higher than that of Gram-negative bacteria in female children younger than 5 years old, and the proportion of staphylococcus epidermidis was the highest (P<0.05), The distribution characteristics of pathogenic bacteria in children of other ages and sexes were consistent with the total distribution characteristics. The resistance rate of Gram-positive bacteria to penicillin, erythromycin and clarithromycin was high, while the resistance rate of Gram-negative bacteria to ampicillin, cefazolin and cefuroxime was high. The distribution characteristics of pathogenic bacteria in children with upper respiratory tract infection and lower respiratory tract infection were consistent. Conclusion In children with pediatric asthma and respiratory tract infection, the main pathogens are Gram-negative bacteria, and the drug resistance rate is high. However, the infection of Gram-positive bacteria (mainly Staphylococcus epidermidis) in young female children under 5 years old is higher than that of Gram-negative bacteria in other children, which deserves special attention.