Objective: To analyze epidemiological characteristics of brucellosis in Shaoxing City, Zhejiang Province from 2005 to 2023, so as to provide the basis for developing targeted control measures. Methods: Data of brucellosis cases and epidemiological investigation in Shaoxing City from 2005 to 2023 were collected from the Monitoring and Reporting Management System of the Chinese Disease Prevention and Control Information System. The epidemiological characteristics of brucellosis were descriptively analyzed, the trend in incidence of brucellosis was analyzed using average annual percent change (AAPC). Results: A total of 270 cases of brucellosis were reported in Shaoxing City from 2005 to 2023, with an average annual incidence of 0.29/105. The AAPC was 0.812%, with no significant changing trend (P>0.05). The incidence of brucellosis peaked from February to March, with 80 cases (29.63%). The reported cases were mainly distributed in Shangyu District (139 cases, 51.48%) and Shengzhou City (74 cases, 27.41%). There were 188 male cases and 82 female cases, with a male-to-female ratio of 2.29∶1. The cases were primarily concentrated in the age group of 40 to <70 years, with 205 cases accounting for 75.93%. Among these, 86 cases were reported in the 50 to <60 years of age group, accounting for 41.95%. The majority of the cases were farmers, with 187 cases accounting for 69.26%. The median interval from onset to diagnosis was 22.73 (interquartile range, 39.97) days, with a delayed diagnosis rate of 62.96%. Infections through breeding, selling and transporting cattle and sheep resulted in 164 cases (60.74%), and through buying and slaughtering resulted in 36 cases (13.33%). An outbreak of brucellosis was reported in Xinchang County in 2018, with three confirmed cases. Conclusions The incidence of brucellosis in Shaoxing City had no significant change from 2005 to 2023. The peak period was from February to March. The cases were mainly distributed in Shangyu District and Shengzhou City. People aged 50 to <60 years, males, and farmers were the key groups for prevention and control.

Objective:To compare the safety and efficacy of two-person and three-person operation of endoscopic retrograde cholangiopancreatography (ERCP) after Roux-en-Y anastomosis.Methods:A total of 31 cases of bile duct stones where endoscopic access was successful and papilla was detected after Roux-en-Y anastomosis in Hangzhou First People's Hospital from January 2021 to September 2022 were recruited. Based on the retrospective study, 17 patients with the two-person operation (an operator and an assistant completed selective intubation) were included in group A from January to December 2021, and 14 patients with the three-person operation (an operator and two assistants completed the selective intubation) from January to September 2022 were included in group B. The success rate, the time of intubation, and complication incidence of the two groups were compared.Results:The intubation success rate of all enrolled patients was 90.32% (28/31). There was no significant difference in the intubation success rate between group A and group B [82.35% (14/17) VS 100.00% (14/14), P=0.232]. The intubation time in group B was significantly less than that of group A (42.89±6.57 min VS 61.02±9.23 min) with significant difference ( t=5.77, P<0.001). The incidence of postoperative complication of ERCP in all enrolled patients was 16.13% (5/31). There was no significant difference in the postoperative complication incidence between group A and group B [17.65% (3/17) VS 14.29% (2/14), P=1.000]. Conclusion:For patients undergoing ERCP after Roux-en-Y anastomosis, the two methods were not statistically different in terms of the intubation success rate and the incidence of procedure-related complications. But three-person operation shows clear advantage in terms of operation time.

ObjectiveTo explore the predictive factors for the efficacy of Yiqi Yangxue prescription combined with western medicine in treating aplastic anemia （AA） in non-elderly adults， so as to provide a reference for predicting the prognosis of this therapy. MethodA retrospective study was conducted with the clinical data of non-elderly adult AA patients who visited 19 hospitals including Xiyuan Hospital of the China Academy of Chinese Medical Sciences from September 2018 to March 2021 and were treated with Yiqi Yangxue Prescription combined with western medicine. According to the efficacy evaluation results at the 6^th month of treatment， the patients were assigned into effective and ineffective groups. The two groups were compared in terms of the gender， age， disease classification ［non-severe aplastic anemia （NSAA）/severe aplastic anemia （SAA）］， course of disease， family history， complications， history of drug allergy， baseline blood routine examination ［hemoglobin （HGB）， white blood cell （WBC）， neutrophil （ANC）， platelet （PLT）， and reticulocyte （Ret）］， T lymphocyte subsets， degree of proliferation of nucleated cells in bone marrow， and expression of T-bet and GATA-3. ResultA total of 101 non-elderly adult AA patients were enrolled in this study， including 81 in the effective group and 20 in the ineffective group. The effective group had a higher proportion of the patients without a history of drug allergy than the ineffective group （P<0.05）. The body height， body weight， gender， age， disease classification， course of disease， family history， and complications showed no significant differences between two groups. The effective group had higher levels of ANC and PLT before treatment （P<0.05） and higher proportion of patients with ANC≥1.6×10⁹/L and PLT≥25×10⁹/L （P<0.05， P<0.01） than the ineffective group. The baseline levels of WBC， HGB， and Ret showed no significant statistical differences between two groups. The levels of CD3⁺HLA-DR⁺T cells in the effective group before treatment was higher than that in the ineffective group （P<0.05）. The levels of CD3⁺CD19^-T cells， CD4⁺T cells， CD8⁺T cells， Th1 cells， Th2 cells， and CD3⁺CD25⁺T cells showed no significant statistical differences between two groups before treatment. The proportion of patients with active bone marrow nucleated cells proliferation in the effective group before treatment were significantly higher than that in the ineffective group, while the proportion of patients with reduced or extremely reduced proliferation were significantly lower than that in the ineffective group （P<0.05）. The expression levels of T-bet and GATA-3 genes had no significant differences between two groups before treatment. The multivariate binary logistic regression analysis showed that the ANC level before treatment and history of drug allergy were independent influencing factors for efficacy （P<0.05， P<0.01）， while other indicators were not influencing factors for efficacy. The receiver operating characteristic （ROC） curve was applied to analyze the predictive value of the ANC level before treatment in the treatment of AA in non-elderly adults with Yiqi Yangxue prescription combined with western medicine. The area under the curve was 0.679 （P<0.05）， with the critical value of 1.595×10⁹/L， the sensitivity of 0.42， and the specificity of 0.95. ConclusionThe history of drug allergy， pre-treatment ANC， PLT， CD3⁺HLA-DR⁺ T cell levels， and proliferation of nucleated cells in bone marrow before treatment are predictive factors for the efficacy of Yiqi Yangxue prescription combined with western medicine in treating AA in non-elderly adults. This therapy tends to be more effective for the patients with no history of drug allergy， higher ANC and PLT levels before treatment， especially those with ANC≥1.6×10⁹/L， PLT≥25×10⁹/L， and higher CD3⁺ HLA-DR⁺T cell levels and the more active proliferation of nucleated cells in bone marrow before treatment.

Objective: To investigate the epidemiological characteristics of hemorrhagic fever with renal syndrome (HFRS) in Shaoxing City from 2006 to 2022, so as provide insights into improvements of the HFRS control strategy. Methods: Data pertaining to HFRS cases in Shaoxing City from 2006 to 2022 were captured from the Surveillance System of China Information System for Disease Control and Prevention. The temporal, population and regional distributions of HFRS were analyzed using the descriptive epidemiological method, and the trends in incidence of HFRS were evaluated using annual percent change (APC). Results: Totally 1 022 HFRS cases were reported in Shaoxing City from 2006 to 2022, with annual average incidence of 1.22/105 and three deaths. The incidence of HFRS appeared a tendency towards a decline in Shaoxing City from 2006 to 2022 (APC=-11.101%, t=-9.930, P<0.001), and the incidence of HFRS peaked from May to June and from November to January of the next year. A higher incidence of HFRS was seen in men than in women (1.76/105 vs. 0.68/105; χ2=201.361, P<0.001). There were 714 HFRS cases at ages of 30 to 59 years (69.86%), and farmers were the predominant occupation (78.18%). The three counties with the largest number of HFRS cases included Zhuji (366 cases), Xinchang (263 cases) and Shengzhou (134 cases). The incidence of HFRS was lower in urban districts (Yuecheng, Keqiao and Shangyu) than in counties (Zhuji, Shengzhou and Xinchang) (0.58/105 vs. 1.96/105; χ2=326.880, P<0.001). Conclusion The incidence of HFRS appeared a tendency towards a decline in Shaoxing City from 2006 to 2022, and the incidence was high in late spring, early summer and winter. The HFRS cases were mainly males, young and middle-aged people, and farmers, and predominantly distributed in counties. Targeted control measures are needed.

ObjectiveTo investigate the predictive indicators of early efficacy of Bushen Shengxue prescription combined with western medicine in the treatment of aplastic anemia， and provide prognosis indicators for the treatment of aplastic anemia （AA） with kidney-tonifying therapy in traditional Chinese medicine （TCM） combined with western medicine. MethodA total of 126 patients treated by Bushen Shengxue prescription combined with western medicine in 19 hospitals including Xiyuan Hospital of the China Academy of Chinese Medical Sciences from September 2018 to March 2021 were selected for a retrospective study. The therapy was proven to be effective after six months of treatment. According to the efficacy after 4 months of treatment， the patients were assigned into a 4-month effective group and a 4-month ineffective group. The age， sex， disease severity （including severe aplastic anemia and non-severe aplastic anemia）， course of disease， degree of bone marrow nucleated cell proliferation， baseline hemogram levels ［including white blood cell count （WBC）， absolute neutrophil count （ANC）， hemoglobin （HGB）， platelets （PLT）， and reticulocytes （RET）］， T lymphocytes subsets， and the expression levels of T-box transcription factor （T-bet） and GATA-binding protein-3 （GATA-3） were compared between the two groups before treatment. ResultThe proportions of patients within the age ranges of ［20， 40） and ［60， 80） were higher in the 4-month effective group （P<0.05）. The sex， disease severity， course of disease， and comorbidities had no significant differences between the two groups. The 4-month effective group had higher baseline levels of HGB， WBC， ANC， and PLT than the 4-month ineffective group （P<0.05）， and there was no significant difference in the RET level between the two groups before treatment. Binary Logistic regression analysis showed that the PLT level before treatment was an independent factor affecting the onset time， while other indicators did not affect the onset time. The receiver operating characteristic （ROC） curve was established to analyze the value of PLT level before treatment for predicting the onset time， and the area under the curve was 0.691. With the critical value of 40.5×10⁹/L， the sensitivity and specificity of the prediction that the therapy will take effect within 4 months were 0.569 and 0.893， respectively. The two groups of patients were graded according to age ｛（14， 20）， ［20， 40）， ［40， 60）， and ［60， 80）｝ and PLT level before treatment （PLT<40×10⁹/L， PLT≥40×10⁹/L）. The proportion of the patients with PLT≥40×10⁹/L before treatment in the 4-month effective group was significantly higher than that in the 4-month ineffective group （P<0.05）. The degree of bone marrow nucleated cell proliferation before treatment had no significant difference between the two groups. The level of total T lymphocytes in the 4-month effective patients was lower than that in the 4-month ineffective patients before treatment （P<0.05）. The levels of Th1 cells， Th2 cells， CD4⁺ T cells， and CD8⁺ T cells showed no significant differences between the two groups before treatment. The T-bet expression level in the 4-month effective group was higher than that in the 4-month ineffective group before treatment （P<0.05）， while the expression level of GATA-3 showed no significant difference between the two groups before treatment. ConclusionBushen Shengxue prescription combined with western medicine will achieve faster effect for the patients within the age ranges of ［20， 40） or ［40， 60）， with higher levels of HGB， WBC， ANC， and PLT （especially those with PLT≥40×10⁹/L）， lower level of total T lymphocytes， or higher T-bet expression level before treatment.

Objective: To detect the expression of serum exosomal miR⁃30d⁃5p in occupational dermatitis medicamentosa⁃like of trichloroethylene(OMDT) patients and its correlation with liver function , then perform bioinformatics analysis and verify the target gene. Methods : Serum exosomes were extracted from 6 OMDT patients and 6 healthy controls , and miRNA was extracted from exosomes which were identified by transmission electron microscopy, nanoparticle tracking analysis and western blotting. The expression of serum exosomal miR⁃30d⁃5p was detected by real⁃time fluorescence quantitative PCR , then the correlation with liver function was analyzed. The target genes of miR⁃30d⁃5p were predicted by the miRWalk and miRBD databases. Gene ontology analysis and KEGG pathways analysis were performed. Finally , RHOB was verified by Dual⁃luciferase reporter assay. Results: The expression of serum exosomal miR⁃30d⁃5p significantly decreased in 6 OMDT patients at the peak of the disease(P < 0. 05) , and it was negatively correlated with the level of AST , ALT and GGT (correlation coefficient : rs = - 0. 943 ,P = 0. 005 ;rs = - 0. 886 , P = 0. 019 ; rs = - 0. 886 , P = 0. 019 ) . Bioinformatics analysis and dual⁃luciferase reporter assay showed that RHOB was the target gene of miR⁃30d⁃5p. Conclusion The expression of serum exosomal miR⁃30d-5p decreases in OMDT patients , which is negatively correlated with the level of liver function , and the target gene RHOB may be involved in the process of liver injury induced by trichloroethylene.

OBJECTIVE To optimize th e p rocessing technology of Portulaca oleracea charcoal，and to investigate its improvement effect on the symptom of hemorrhoid model rats. METHODS The effects of roasting temperature ，dosage and roasting time on the processing technology of P. oleracea charcoal were investigated with Box-Behnken response surface methodology using comprehensive score of tannin content ，water-soluble extract content and appearance properties as the index. The optimal process parameters are selected and verified. The hemorrhoid model rats were treated with P. oleracea charcoal（0.8 g/mL）prepared by the optimal processing technology ，once a day ，for 11 days. After last medication ，the perianal pathological score of hemorrhoid model rats were performed ；serum levels of tumor necrosis factor α（TNF-α），interleukin 6（IL-6）and IL- 1β were detected. RESULTS The optimal processing technology of P. oleracea charcoal included roasting temperature of 200 ℃， dosage of 150 g and roasting time of 14 min. Results of validation test showed that the comprehensive score of P. oleracea charcoal was 92.57，and relative error of it with predicted value （96.59）was －4.13％. External use of P. oleracea charcoal 0.8 g/mL prepared by the optimal processing technology could significantly promote the wound healing of hemorrhoid model rats ，reduced the amount of exudate ，and decreased the levels of TNF-α，IL-6 and IL-β in serum. CONCLUSIONS The optimized processing technology of P. oleracea charcoal is feasible. P. oleracea charcoal prepared by the optimized processing technology has good curative effect on the symptom of hemorrhoid model rats.

ObjectiveTo investigate the efficacy of Bushen Shengxue prescription and Yiqi Yangxue prescription in the treatment of chronic aplastic anemia and the effect on T cell subsets and the expression of T-box expressed in T cells （T-bet） and GATA binding protein 3 （GATA3）. MethodA total of 585 patients with chronic aplastic anemia who were treated in 19 hospitals in China from May 2018 to June 2021 were enrolled. With the prospective， double-blind and randomized control methods， the patients were randomized into three groups： kidney deficiency group， Qi and blood deficiency group， and control group. The three groups were respectively treated with Bushen Shengxue prescription granule， Yiqi Yangxue prescription granule， and Placebo （half the dose of Bushen Shengxue formula granules）. In addition， all of them were given oral cyclosporin and androgen. The treatment lasted 6 months， with 3 months as a course. The blood routine indexes， T cell subsets， and fusion genes T-bet and GATA3 before and after treatment were analyzed， and the safety indexes were monitored. ResultDuring the observation， a total of 75 cases dropped out and 18 were rejected. Finally， 161 cases in the kidney deficiency group， 164 in the Qi and blood deficiency group， and 167 in the control group were included. After 6 months of treatment， the total effective rate was 98.8% （159/161） in the kidney deficiency group， which was higher than the 79.9% （131/164） in the Qi and blood deficiency group （χ²=30.135， P<0.01） and the 61.7% （103/167） in the control group （χ²=70.126， P<0.01）. The total effective rate was higher in the Qi and blood deficiency group than in the control group （χ²=13.232， P<0.01）. After treatment， the hemoglobin （HGB） content increased significantly in three groups （P<0.05） as compared with that before treatment， particularly the kidney deficiency group （P<0.01）. After treatment， the white blood cell （WBC） count and platelet （PLT） count in the kidney deficiency group and the control group increased compared with those in the Qi and blood deficiency group （P<0.01）. There was no specific difference in neutrophils （ANC） after treatment among the three groups. At the same time point， the level of T helper type 1 （Th1） cells， Th1/Th2 ratio （P<0.05）， level of CD4⁺， and CD4⁺/CD8⁺ ratio （P<0.05） were significantly low in the kidney deficiency group among three groups. There was no significant difference in CD19^-， HLA/DR⁺， and CD25⁺ between the kidney deficiency group and the other two groups， but the T-bet of the kidney deficiency group and the control group was lower than that of the Qi and blood deficiency group （P<0.05）. ConclusionBushen Shengxue prescription exerts therapeutic effect on the aplastic anemia by improving the immunoregulatory mechanism， inhibiting the activity of immune system， modulating T cell subsets， suppressing Th1 and CD4⁺， and promoting bone marrow hematopoiesis. Moreover， it is safe with little side effects， which is worthy of further promotion.

Pediatric neurogenic bladder (PNB) is mostly caused by the dysplasia of lumbosacral spinal cord and nerve, and there is no effective treatment available at present.Bladder fibrosis occurs frequently in PNB, and the prevention and treatment of PNB fibrosis is still a challenge worldwide.Most PNBs develop bladder fibrosis over time, which is characterized by the thickened bladder wall, decreased bladder compliance, and obstruction of the bladder outlet.According to some studies, bladder fibrosis is not only related to bladder smooth muscle cells, but also epithelial cells and mesenchymal cells of bladder.However, the mechanism of fibrosis remains unclear.It has been reported that it is associated with the changes of transforming growth factor-β 1 (TGF-β 1)/ Smad, bladder high pressure and related angiotensin Ⅱ signal pathways.Although anti-fibrotic therapies that target a variety of factors have been employed in animal models, the clinical validation is still needed.It is required to conduct a further exploration on whether early clean intermittent catheterization could prevent the fibrosis in PNB patients with increased residual urine.In this paper, the research progress in PNB fibrosis would be reviewed, in order to provide reference for clinical practice.

Objective: To understand the epidemiological characteristics of viral hepatitis B in Shaoxing from 2008 to 2018,so as to provide basis for formulating the viral hepatitis B prevention and control strategy. Methods: The data of viral hepatitis B cases in Shaoxing from 2008 to 2018 were collected from infectious diseases reporting and management system. Descriptive epidemiological method was employed to analyze the time,place and population characteristics of viral hepatitis B cases in Shaoxing. Annual percentage change（APC）was calculated to analyze the development trend of viral hepatitis B. Results : From 2008 to 2018,a total of 22 764 cases of viral hepatitis B were reported in Shaoxing,with an average annual incidence rate of 42.24/100 000 and a standardized incidence rate of 39.19/100 000. The incidence rate of viral hepatitis B decreased from 2008 to 2018,among which the APC from 2012 to 2018 was -18.00% with a significantly downward trend（P<0.05）. Six counties,cities or districts in Shaoxing reported cases of viral hepatitis B,of which Zhuji（49.40/100 000）,Yuecheng（44.17/100 000）and Xinchang（43.28/100 000）ranked top three in average annual incidence rate. The incidence rate of viral hepatitis B in men was 57.07/100 000,which was higher than 27.33/100 000 in women（P<0.05）.The age of onset was mainly 25-59 years old,with 16 941 cases（74.42%）reported. The top three occupations were farmers,workers and migrant workers,with 15 013（65.95%）,2 730（11.99%）and 1 121（4.92%）cases reported,respectively. Conclusions The incidence of viral hepatitis B in Shaoxing from 2008 to 2018 showed a downward trend. Farmers,workers and migrant workers aged 25-59 years were at high risk of hepatitis B infection.