We analyzed epidemiologic characteristics and distribution of 1,067 human plague cases and 5,958 Yersinia pestis isolates collected from humans, host animals, and insect vectors during 1950–2019 in 4 Marmota plague foci in China. The case-fatality rate for plague in humans was 68.88%; the overall trend slowly decreased over time but fluctuated greatly. Most human cases (98.31%) and isolates (82.06%) identified from any source were from the Marmota himalayana plague focus. The tendency among human cases could be divided into 3 stages: 1950–1969, 1970–2003, and 2004–2019. The Marmota sibirica plague focus has not had identified human cases nor isolates since 1926. However, in the other 3 foci, Y. pestis continues to circulate among animal hosts; ecologic factors might affect local Y. pestis activity. Marmota plague foci are active in China, and the epidemic boundary is constantly expanding, posing a potential threat to domestic and global public health.

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Background. Scrophularia dentata is an important medicinal plant and used for the treatment of exanthema and fever in Traditional Tibetan Medicine. Scrodentoids H and I (SHI), a pair of epimerides of C19-norditerpenoids isolated from Scrophularia dentata, could transfer to each other in room temperature and were firstly reported in our previous work. Here, we first reported the anti-inflammatory effects of SHI on LPS-induced inflammation. Purpose. To evaluate the anti-inflammatory property of SHI, we investigated the effects of SHI on LPS-activated THP-1 cells. Methods. THP-1 human macrophages were pretreated with SHI and stimulated with LPS. Proinflammatory cytokines IL-1β and IL-6 were measured by RT-PCR and enzyme-linked immunosorbent assays (ELISA). The mechanism of action involving phosphorylation of ERK, JNK, P38, and STAT3 was measured by western Blot. The NF-κB promoter activity was evaluated by Dual-Luciferase Reporter Assay System in TNF-α stimulated 293T cells. Results. SHI dose-dependently reduced the production of proinflammatory cytokines IL-1β and IL-6. The ability of SHI to reduce production of cytokines is associated with phosphorylation depress of JNK and STAT3 rather than p38, ERK, and NF-κB promoter. Conclusions. Our experimental results indicated that anti-inflammatory effects of SHI exhibit attenuation of LPS-induced inflammation and inhibit activation through JNK/STAT3 pathway in macrophages. These results suggest that SHI might have a potential in treating inflammatory disease.

Background: Although video-assisted thoracoscopic surgery (VATS) plays an increasingly significant part in treating thoracic disease, the role of thoracotomy is not replaced in cystic echinococcosis. The aim of this study was to demonstrate the application of VATS and traditional thoracotomy in the treatment of pulmonary hydatid disease in Shigatse of the Tibet Plateau and to compare the clinical safety and efficacy of these two surgical approaches.Methods: A total of 53 patients with pulmonary hydatid who received thoracoscopic cystectomy with needle aspiration from January 2015 to December 2020 were enrolled in the study, and 126 patients who received thoracotomy during the same period were matched as the control group. The clinical characteristics, operative time, incidence of perioperative complications, length of stay, and hospitalization cost of the VATS and thoracotomy groups were analyzed to compare the safety and efficacy. Patients were followed up through telephone and outpatient service. In order to balance potential confounding baseline factors, propensityscore matching (PSM) was applied to establish a 1:1 VATS to thoracotomy group ratio.Results: There were statistically significant differences between the VATS group and the thoracotomy group in operative time, blood loss, drainage volume, and postoperative hospital stay (P<0.05), with the VATS group being superior to the thoracotomy group. There were no significant differences in postoperative complications, adverse imaging outcomes, or recurrence rates between the 2 groups. In terms of complications, there was no significant difference in the incidence of postoperative air leakage, atelectasis, or other common complications between the 2 groups, while the frequency of postoperative fever and incision infection in the thoracotomy group was significantly higher than that in the VATS group (P<0.05).Moreover, the postoperative recurrence rate between the 2 groups showed no significant difference after a 3-year follow-up.Conclusions: Compared to traditional thoracotomy, VATS had acceptable efficacy and safety and it could further accelerate postoperative recovery and reduce the cost in the treatment of pulmonary hydatid disease in the Tibetan Plateau. Thus, VATS should be promoted more widely to other Tibetan regions.