ObjectiveTo analyze the epidemiological trends and characteristics of brucellosis in humans (hereinafter referred to as brucellosis) in Tangshan City, Hebei Province from 2016 to 2023, and to provide a scientific basis for formulating brucellosis prevention and control strategies in the region. MethodsThe incidence data of human brucellosis in Tangshan City from 2016 to 2023 were collected from the China Disease Prevention and Control Information System. The diagnosis time, infection route, and clinical characteristics of the cases were obtained from the case investigation reports. Descriptive epidemiological methods were used to analyze the temporal, spatial, demographic distributions, and clinical characteristics of human brucellosis. Brucella species were identified using agglutination tests with bacterial suspension and A/M antigen-positive serum. ResultsA total of 2 193 cases of human brucellosis were confirmed and clinically diagnosed in Tangshan City from 2016 to 2023, with the peak incidence occured from March to August, and which exhibited distinct geographic distribution patterns. The highest incidence rate was found in people aged 60‒<70 years. The occupation of cases were primarily farmers. The incidence rate in males (528/100 000) was higher than that in females (184/100 000). All cases had confirmed exposure to infected animals or contaminated animal products. ConclusionThe epidemic of human brucellosis in Tangshan exhibited an overall steady downward trend from 2016 to 2023, except for a slight increase in 2016 and 2021, with the incidence rate controlled at 289/100 000‒335/100 000. The prevention and control situation of human brucellosis still remains severe, with the highest incidence rate in the eastern region of Tangshan, which are characterized by the breeding, slaughtering, and processing of cattle and sheep. Therefore, it it is necessary to enhance the prevention and control of human brucellosis among the personnel engaged in these industries in the eastern areas.

In this study, RAW264.7 cells were employed to investigate the effects of honey-processed Astragalus on their energy metabolism and polarization, and explore the scientific connotation of the enhanced efficacy of honey-processed Astragalus on invigorating spleen-stomach and replenishing Qi. The medicated sera were prepared by intragastric administration of rats with water extracts of crude and honey-processed Astragalus, and the composition changes of medicated sera of crude and honey-processed Astragalus were analyzed by using LC-MS technology. The cell survival rates were detected and the concentrations of medicated sera were screened through CCK-8 assay. The differences of cell phagocytic rates, ATP energy metabolism, and NO secretion between crude and honey-processed Astragalus were evaluated by using neutral red phagocytosis assay, ATP detection kit, and NO detection kit. The effects of crude and honey-processed Astragalus on TNF-α secretion of RAW264.7 cells were detected by employing ELISA kit. The effects of crude and honey-processed Astragalus on polarization of RAW264.7 cells were evaluated by utilizing flow cytometry. The differential metabolites related to glycolysis in cell lysates and culture media were screened by using LC-MS technology. The experiment was approved by the experimental animal ethics committee from Shanxi University of Chinese Medicine (No. AWE202407352). The results showed that the contents of betaine, amino acids, and ononin in the prepared medicated sera of rats treated by intragastric administration with water extracts of honey-processed Astragalus increased compared to those in crude one. The results of CCK-8 experiment showed that there were no cytotoxic effects on RAW264.7 cells in the medicated sera of crude and honey-processd Astragalus at different concentration. The phagocytic index and ATP yield both increased to varying degrees after administration of the medicated sera to cells. The secretion of NO in normal and inflammatory cells increased and decreased respectively, and the effect of honey-processed Astragalus was better than that of crude one. The results of ELISA kit showed that the medicated sera of both crude and honey-processed Astragalus could promote the secretion of TNF-α in a concentration-dependent manner, and the promoting effect of honey-processed Astragalus was stronger than that of crude one. The results of flow cytometry showed that the medicated sera of both crude and honey-processed Astragalus could promote M1-type polarization and inhibit M2-type polarization of RAW264.7 cells, and the effect of honey-processed Astragalus was better than that of crude one. Compared to crude Astragalus, the metabolites related to glycolysis in the cell lysates and culture media of the medicated sera of honey-processed Astragalus were generally on the rise, indicating that the effect on promoting glycolysis of honey-processed Astragalus was better than that of crude one. In summary, honey-processed Astragalus can promote the polarization and energy metabolism of RAW264.7 cells, and participate in positive immune regulation, which is correlated with its enhanced effect of invigorating spleen-stomach and replenishing Qi.

AIM:To compare the differences of ocular biometric parameters of age-related cataract between Tibetan and Han ethnic groups, and to analyze the distribution characteristics of ocular biometric parameters in Tibetan cataract patients.METHODS:Retrospective cohort study. A total of 661 patients(1 030 eyes)with age-related cataract confirmed in the hospital between January 2019 and December 2020 were enrolled. The parameters of axial length, anterior chamber depth, keratometry, corneal astigmatism and astigmatic axis were measured by IOL Master 500 in 483 cases(739 eyes)of Tibetan age-related cataract patients and 178 cases(291 eyes)of Han patients.RESULTS:The axial length, anterior chamber depth and corneal astigmatism of the Tibetan patients with age-related cataract were 23.33(22.81, 23.86)mm, 3.04(2.79, 3.30)mm and 0.73(0.47, 1.07)D. The mean keratometry was 43.89±1.35 D. The results indicated that Tibetan cataract patients had shorter axial lengths and smaller keratometry compared to Han patients(all P<0.05). Age in Tibetan patients was negatively correlated with axial length and anterior chamber depth, and positively correlated with keratometry(all P<0.05). Tibetan male patients had longer axial lengths, deeper anterior chambers, and flatter corneas compared to female patients(all P<0.05).CONCLUSION:There were differences in ocular biometric parameters between age-related cataract patients of Tibetan and Han ethnicities. The distribution of ocular biometric parameters in Tibetan cataract patients varied across different age groups and gender groups.

Objective To investigate the genetic causes of auditory neuropathy with optic atrophy in a family.Methods The proband's medical history and family history were inquired in detail,and relevant clinical examina-tions were performed to confirm the diagnosis of auditory neuropathy with optic atrophy,and the genetic pedigree of the family was drawn.Peripheral blood of proband(Ⅲ-7)was collected for whole exome sequencing,and the patho-genicity of the detected mutations were interpreted.Blood samples of proband's wife(Ⅲ-8),eldest daughter(Ⅳ-7),second daughter(Ⅳ-9)and son(Ⅳ-10)were tested for mutation sites by Sanger sequencing.Combined with clinical manifestations and examination results,the family was studied.Results The genetic pattern of this family was autosomal dominant.The proband showed decreased visual acuity at the age of 19,bilateral sensorineural deaf-ness at the age of 30,and decreased speech recognition rate.Among 20 members of the family of 5 generations,10(2 deceased)showed similar symptoms of hearing and visual impairment.Proband(Ⅲ-7),eldest daughter(Ⅳ-7)and son(Ⅳ-10)underwent relevant examination.Pure tone audiometry showed bilateral sensorineural deafness.ABR showed no response bilaterally.The 40 Hz AERP showed no response in both ears.OAE showed responses in some or all of the frequencies.No stapedial reflex was detected.The eye movement of Ⅲ-7 and Ⅳ-10 were reasona-ble in all directions,and color vision was normal.Ocular papilla atrophy was observed in different degrees in fundus examination.OCT showed thinning of optic disc nerve fibers in both eyes,and visual evoked potential showed pro-longed P100 wave peak.They were diagnosed as hereditary auditory neuropathy with optic atrophy.A mutation of the OPA1 gene c.1334G＞A(p.Arg445His,NM_015560.2)at a pathogenic locus on chromosome 3 was detected by whole exon detection in Ⅲ-7.The results of generation sequencing analysis showed that the OPA1 gene c.1334G＞A(p.Arg445His,NM_015560.2)mutation of chromosome 3 was also found in Ⅳ-7 and Ⅳ-10.Meanwhile,the gen-otypes of Ⅲ-8 and Ⅳ-9 were wild homozygous,that is,no mutation occurred.Conclusion The OPA1 c.1334G＞A(p.Arg445His,NM_015560.2)mutation site might be the pathogenic mutation in this family.

Objective:To describe the distribution of lipoprotein (a) [Lp(a)] levels in non-arteriosclerotic cardiovascular disease (ASCVD) population in China and explore its influencing factors.Methods:This study was based on a nested case-control study in the CKB study measured plasma biomarkers. Lp(a) levels was measured using a polyclonal antibody-based turbidimetric assay certified by the reference laboratory and ≥75.0 nmol/L defined as high Lp(a). Multiple logistic regression model was used to examine the factors related to Lp(a) levels.Results:Among the 5 870 non-ASCVD population included in the analysis, Lp(a) levels showed a right-skewed distribution, with a M ( Q1, Q3) of 17.5 (8.8, 43.5) nmol/L. The multiple logistic regression analysis found that female was associated with high Lp(a) ( OR=1.23, 95% CI: 1.05-1.43). The risk of increased Lp(a) levels in subjects with abdominal obesity was significantly reduced ( OR=0.68, 95% CI: 0.52-0.89). As TC, LDL-C, apolipoprotein A1(Apo A1), and apolipoprotein B(Apo B) levels increased, the risk of high Lp(a) increased, with OR (95% CI) for each elevated group was 2.40 (1.76-3.24), 2.68 (1.36-4.93), 1.29 (1.03-1.61), and 1.65 (1.27-2.13), respectively. The risk of high Lp(a) was reduced in the HDL-C lowering group with an OR (95% CI) of 0.76 (0.61-0.94). In contrast, an increase in TG levels and the ratio of Apo A1/Apo B(Apo A1/B) was negatively correlated with the risk of high Lp(a), with OR (95% CI) of 0.73 (0.60-0.89) for elevated triglyceride group, and OR (95% CI) of 0.60 (0.50-0.72) for the Apo A1/B ratio increase group (linear trend test P≤0.001 except for Apo A1). However, no correlation was found between Lp(a) levels and lifestyle factors such as diet, smoking, and physical activity. Conclusions:Lp(a) levels were associated with sex and abdominal obesity, but less with lifestyle behaviors.

Objective To analyze the medication rules of national patented Chinese herbal compounds for the treatment of diabetic peripheral neuropathy(DPN)by data mining method,and to provide reference for clinical medication.Methods The patents of Chinese medicine compound for the treatment of DPN were retrieved from the website of the China National Intellectual Property Administration(CNIPA).Excel 2021 was used for frequency statistics.RAW Graphs 2.0 was used to make a Sankey diagram of the efficacy of high-frequency Chinese medicinals.SPSS Statistics 25.0 software was used for hierarchical cluster analysis of the medicines,and the core prescriptions were mined based on Cytoscape 3.9.1.Results A total of 101 patented prescription were included,involving 243 herbs.The top three Chinese medicines in the descending order of occurrence frequency were Salviae Miltiorrhizae Radix et Rhizoma,Astragali Radix,and Paeoniae Radix Alba.Most of the medicines of patented Chinese medicine compounds for the treatment of DPN were warm and mild in nature,sweet,bitter and pungent in flavor,and had the meridian tropism of liver,heart and spleen meridians.According to the therapeutic actions,the medicine can be divided into tonic drugs,blood-activating and stasis-removing drugs,exterior-releasing drugs,liver-calming and wind-extinguishing drugs,heat-clearing drugs,bleeding-arresting drugs,mind-calming drugs,and urination-promoting and dampness-percolating drugs.The association rule analysis revealed the drug combination of Astragali Radix and Angelicae Sinensis Radix with the highest support.After hierarchical cluster analysis,the top 31 Chinese medicinals were classified into 7 groups.The core prescription which was composed of 7 medicines,namely Astragali Radix,Chuanxiong Rhizoma,Spatholobi Caulis,Salviae Miltiorrhizae Radix et Rhizoma,Achyranthis Bidentatae Radix,Cinnamomi Ramulus and Angelicae Sinensis Radix was finally mined out.Conclusion The treatment of DPN with patented Chinese herbal compounds is based on the therapies of supplementing deficiency,activating blood and removing stasis,and warming and unblocking meridians and collaterals.Meanwhile,consolidating the acquired foundation by strengthening spleen and soothing liver is also stressed.Clinically,the herbal pairs of Astragali Radix-Angelicae Sinensis Radix,Paeoniae Radix Alba-Salviae Miltiorrhizae Radix et Rhizoma are the optional drugs,and the core prescription composed of Astragali Radix,Chuanxiong Rhizoma,Spatholobi Caulis,Salviae Miltiorrhizae Radix et Rhizoma,Achyranthis Bidentatae Radix,Cinnamomi Ramulus and Angelicae Sinensis Radix can be used for the whole course of DPN.

Objective To investigate the distribution of traditional Chinese medicine(TCM)constitution in chronic hepatitis B(CHB)patients complicated with metabolism associated fatty liver disease(MAFLD),and to explore the correlation of the complication of MAFLD with TCM constitution and body composition,thus to determine their predictive values for the complication of MAFLD in CHB patients.Methods A retrospective study was adopted.The study started from the collection of the clinical data of 235 outpatients who attended the Department of Hepatology of Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine from January 2022 to December 2023,and was diagnosed as CHB following the diagnostic criteria.According to the controlled attenuation parameter(CAP)value,134 cases of CHB patients were allocated to the non-MAFLD group(CAP＜238 dB/m)and 101 cases were allocated to the MAFLD group(CAP≥238 dB/m).And then the distribution of TCM constitution in the two groups was observed.In addition,according to the body mass index(BMI)value,the patients were divided into the non-obese group(141 cases,BMI＜24.0 kg/m2)and the overweight/obese group(94 cases,BMI≥24.0 kg/m2).And then the logistic regression was used to analyze the independent risk factors for the complication of MAFLD in CHB patients,multivariate logistic regression was used to analyze the influencing factors,and receiver operating characteristic(ROC)curve was used to analyze the predictive value of the influencing factors for the complication of MAFLD in CHB patients and to determine their optimal cut-off values.Results(1)The constitutions of CHB patients in the MAFLD group were predominated by balanced constitution(36.6%),damp-heat constitution(20.8%),and phlegm-damp constitution(14.9%),which accounted for 72.3%in total.(2)In CHB patients complicated with MAFLD,the overweight/obese group had higher levels of γ-glutamyl-transpeptidase(γ-GT),BMI,total body fat mass(TBFM),total muscle mass(TMM),total body water(TBW),interacel1ular water(ICW),extracellular water(ECW),body fat ratio(BFR),visceral fat area(VFA),basal metabolism(BM),and trunk fat mass(TFM)than the non-obese group,and the differences were statistically significant(P＜0.05 or P＜0.01).(3)The results of multivariate logistic regression analysis showed that the white blood cell(WBC)count,blood uric acid(UA),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),and VFA were the influencing factors for the complication of MAFLD in the CHB patients in clinic.(4)The results of ROC curve analysis showed that in CHB patients,the areas under the ROC curve(AUC)for age,TG,UA,and VFA were 0.532,0.680,0.738,and 0.859 respectively;the optimal cut-off values of VFA in CHB patients,non-obese CHB patients,and overweight/obese CHB patients were 74.98,66.5 and 112.2 cm2 respectively,and the optimal cut-off values of VFA in patients with balanced constitution,phlegm-damp constitution,and damp-heat constitution were 85.50,66.50,and 74.98 cm2 respectively.The AUC values of VFA in various populations were significantly higher than those of age,TG,and UA,and the combined prediction by multivariate analysis has higher predictive value than that by univariate analysis.Conclusion The AUC value of VFA for predicting the risk of MAFLD is the highest in patients with CHB,and the possibility of the complication of MAFLD increased with the increase of the cut-off point level of VFA.The optimal cut-off values of VFA varies in non-obese group and overweight/obese group of CHB patients and in CHB patients with different TCM constitution.

Objective To investigate the dynamic expression with the time change of N6-methyladenosine(m6A)methylation-related factors in the repair process of skeletal muscle injury and its mechanism in the inflammatory response of macrophage in the injure process.Methods In vivo mice models of BaCl2 injury in the gastrocnemius were established.Four mice per group in the control group and injury group.Gastrocnemius tissues were harvested at day 1,3,5,7,and 9 after injury for experiments.Primary gastrocnemius muscle tissue cells,muscle satellite cells,muscle cells,and cell line C2C12 cells were treated with dexamethasone(DEX,50 μmol/L)to mimic injury.Lipopolysaccharide(LPS,100 μg/L)induced RAW264.7 cell lines to mimic the inflammatory response after skeletal muscle injury,and STM2457(30 μmol/L)was added to inhibit the effect of methyltransferase 3(Mettl3)before LPS treatment.The expression of m6A methylation-related factors(Writers,Erasers,Readers)and inflammation factors were detected by Real-time PCR and Western blotting.Results The muscle fibers were dissolved and then gradually repaired with the extension of injury time,the number of monocytes/macrophages increased first and then decreased,and the Pax7 mRNA level increased first and then decreased with the change of injury time.Compared with the control group,the mRNA and protein levels of m6A methylation-related factors in gastrocnemius did not change significantly on the injury-1 day.However,they were significantly increased on the injury-3 days compared with the control group(P＜0.05),and then obviously decreased on the injury-5 days group compared with the injury-3 days group(P＜0.05).Compared with the control group,they were no significant differences on the injury-7 days group and-9 days group.In vitro DEX decreased the mRNA levels of m6A methyltransferase factors in primary muscle satellite cells and C2C12 cells and increased the mRNA expression level of methylation-recognition enzyme factors(P＜0.05).The mRNA levels of m6A methylation-related factors increased significantly in skeletal muscle tissue cells and myocytes after DEX treatment(P＜0.05).After LPS treatment,the mRNA and protein expression levels of m6A methylation-related factors and the mRNA expression levels of inflammatory factors interleukin(IL)-6 and IL-1β in macrophages increased significantly(P＜0.05),while the levels of IL-6 and IL-1β mRNA in macrophages decreased significantly when the Mettl3 was inhibited(P＜0.05).Conclusion m6A methylation-related factors primarily is activated in the damaged muscle cells and inflammation response of macrophages.Inhibition of m6A methyltransferase can reduce the inflammatory response of macrophages.

Objective To investigate the risk factors for the clinical outcomes of patients with bloodstream infections in emergency in-tensive care unit(EICU)and provide a basis for clinical treatment.Methods The medical records and blood culture records of 141 patients with bloodstream infections in the EICU of our hospital from January 2019 to April 2023 were retrospectively collected.The risk factors leading to patients′death were analyzed by the Logistic regression and the relationships between these factors and patients′sur-vival time and outcomes were evaluated by the Cox regression.Results Among the 141 patients with bloodstream infections in the EICU,the mixed bloodstream infections of two or more bacteria(odds ratio[OR]=5.68,95%confidence interval[CI]:1.20-26.98,P＜0.05)and bloodstream infections of multidrug-resistant bacteria(OR=6.39,95%CI:2.78-14.67,P＜0.01)were significantly cor-related with the patients′death.Whether to adjust medication in a timely manner based on drug sensitivity results(hazard ratio[HR]=0.47,95%CI:0.30-0.74)and bloodstream infections of multidrug-resistant bacteria(HR=2.02,95%CI:1.28-3.20)were the risk factors leading to the death of patients with bloodstream infections in the EICU(P＜0.01).Conclusion Early blood culture to identify the pathogenic bacteria and precise medication to control infection can effectively reduce the mortality of patients with bloodstream in-fections in the EICU.

Aim To investigate the regulatory effects of chlorogenic acid(CGA)on mitochondrial autophagy and inflammation in ox-LDL induced foam cells through PINK1/Parkin signaling pathway.Methods RAW264.7 macrophages were divided into the control group,model group,CGA-L group,CGA-M group,CGA-H group and CGA-H+Mdi group.Oil red O method was used to identify cell foam.The intervention concentration of CGA was determined by CCK-8 meth-od.The mitochondrial structure was observed by trans-mission electron microscope.The expression of IL-1 β,IL-18 and IFN-γ was detected by ELISA.The expres-sion of genes and proteins associated with PINK1/Par-kin mitochondrial autophagy pathway was detected by qRT-PCR and immunofluorescence labeling.Results Oil red O staining showed that the foam cell model was successfully prepared.Compared with the model group,mitochondrial damage was significantly reduced after CGA intervention at different concentrations,and the expressions of PINK1,Parkin,p-Parkin,PHB2 and LC3 Ⅱ were induced,while the expression of TOMM20 was inhibited.The expressions of IL-1 β,IL-18 and IFN-γ decreased(P＜0.05 or P＜0.01).Compared with the CGA-H group,the CGA-H+Mdi group significantly increased mitochondrial damage,in-hibited the expression of PINK1,Parkin,p-Parkin,PHB2,LC3 Ⅱ,induced the expression of TOMM20,and enhanced the expression of IL-1 β,IL-18,IFN-γ(P＜0.01).Conclusions CGA can induce mitochon-drial autophagy in foam cells by regulating PINK1/Par-kin pathway and inhibit the overexpression of pro-in-flammatory factors IL-1 β,IL-18 and IFN-y,which may be one of the anti-atherosclerosis mechanisms of CGA.