目的观察苁蓉通便汤治疗老年性便秘的临床疗效。方法将 62例老年性便秘患者分为两组。治疗组(32例)内服苁蓉通便汤,对照组(30例)内服麻仁润肠丸。结果治疗组疗效优于对照组(P<0.05)。结论苁蓉通便汤对老年性便秘疗效显著。

Objective To evaluate the clinical application of multi-slice spiral CT(MSCT)for foreign body of trachea or bronchus in children.Methods Twenty cases suspected foreign body were examined with MSCT.The post-processing reconstruction included multiple planar reconstruction(MPR),CT virtual bronchoscopy(CTVB),shaded surface display(SSD),minimum intensity projection(MinIP),and volume rendering(VR).Results The foreign bodies located at trachea in 1 case and at bronchia in 19 cases.The foreign bodies included 18 fragments of peanut and melon seeds,one shrimp and one plastic-tube.All cases were confirmed by fiberoptic bronchoscopy or course of diseases.The position and form of foreign bodies,as well as the relationship between foreign bodies and bronchial muous membrane could be showed by MPR,CTVB,SSD,MinIP and VR.Conclusion MSCT scanning is a significant noninvasive and sensitive diagnostic technique in detecting the foreign body in trachea or bronchus.

ObjectiveTo identify the pathogen of an aseptic meningitis outbreak which occurred in Linyi City of Shandong Province during the summer of 2009,and to analyze the genetic variations of Coxsackicvirus B5 (CVB5) isolates.MethodsForty-two cerebrospinal fluids (CSF) specimens were collected from aseptic meningitis cases and virus isolation was performed. The viral RNA was extracted and amplified from the positive specimens using reverse transcription polymerase chain reaction (RT-PCR).The partial VP1 coding region was purified and sequenced. The phylogenetic trees based on VP1 sequences were constructed among CVB5 isolates and those in GenBank.ResultsSeventeen enteroviruse strains were isolated from 42 CSF samples with 40.5％ isolation positive rate. All these strains were identified as CVB5 using both microneutralization test and molecular typing methods. Homology comparisons indicated that the nucleotide acid identities and amino acid sequence identities were 92.3 ％- 100.0％ and 98.7 ％- 100.0％,respectively among these CVB5 isolate.s,and compared with the Faulkner prototype strain,which were 81.0％-82.4％ and 96.6％97.0％,respectively.Phylogenetic analysis on VP1 sequences showed that all CVB5 could be separated into four genogroups of A,B,C and D.Isolates of this outbreak belonged to genogroup D.Interestingly,two distinct genogroups in the phylogenetic tree were observed among the 17 isolates.Conclusions CVB5 is responsible for the outbreak of aseptic meningitis in Linyi City of Shandong Province,China. The genetic diversity is high among the isolates and all belong to genogroup D.

Objective To analyze the genetic characteristics of echovirus 6 ( E-6) strains isolated from patients with acute meningitis/encephalitis syndrome ( AMES) in 2014 and sewage samples in 2013—2014 in Shandong province and to investigate their correlations.Methods Enterovirus strains were isolated from cerebrospinal fluid, stool and throat swab samples collected from 940 cases of AMES and 96 sewage samples used for environmental surveillance.The positive isolates were identified by molecular typing meth-od.Homologous and phylogenetic analyses based on the VP1 sequences of E-6 isolates were performed.Re-sults Altogether 47 E-6 strains were isolated from patients with AMES in 2014, accounting for 29.56%of all isolated enteroviruses ( EVs) strains.No E-6 strains were isolated from AMES cases in 2013.Data of the environmental surveillance showed that E-6 virus strains had been frequently detected in sewage samples since the summer of 2013 to the end of 2014.In total, 40 E-6 virus strains were isolated (7.87% of total isolated EVs strains) in 2013 and 139 E-6 virus strains (26.18%) in 2014.Phylogenetic analysis indicated that the E-6 isolates recruited in this study belonged to clusters A and C with high intracluster sequence iden-tities between AMES and environmental isolates.The nucleotide identities were 98.3%-100% among cluster A E-6 virus strains isolated from AMES cases in 2014 and 96.6%-100% among cluster A E-6 virus environ-mental isolates during the surveillance year 2013—2014.The cluster A E-6 virus strains shared 97.1%-100% nucleotide identities between the AMES and environmental isolates.For cluster C E-6 virus strains, the nucleotide identities were 100%, 98.7%-100% and 99.1%-100%, respectively.Conclusion The epidemic of viral encephalitis in Shandong province in 2014 was associated the transmission of two lineages of E-6 virus.Environmental surveillance revealed the potential epidemic of E-6 virus even before the epidemic of viral encephalitis in Shandong province, indicating the possibility of using environmental surveillance for early warning of related diseases.

Objective To analysis the correlation factors which influence the prognosis and relationship of molecular subtypes on young patients.Methods Clinical data of 108 cases young breast cancer patients (≤ 35 years old) who were treat in the Third Affiliated Hospital of Zhengzhou University from January 2007 to October 2014 were retrospective analyzed.According to immunohistochemistry such as estrogen receptor (ER),progesterone receptor(PR),human epidermal growth factor receptor-2 (Her-2/neu),Ki-67 index,patients were divided into molecular subtypes and follow up.Results LuminalA subtype,LuminalB subtype,human epidermal growth factor receptor-2 overexpression subtype and basal-like accounted for 22％ (24/108),33％ (36/108),20％ (21/108) and 25％ (27/108) respectively,and there's 5-year disease-free survival rate were74.1％,62.8％,.56.8％,58.5％ respectively.Kaplan-Meier method was used to draw the disease-free survival curves through.There was no significant difference in the 5-year disease-free survival rate of each subtype (x2 =0.318,0.802,0.876,0.277,0.239,0.074,P＞0.05).Univariate analysis of prognostic factors of Log-rank showed that there were significant differences between recurrence with tumor size,age,lymph node metastasis and surgical methods in young patients with breast cancer(x2 =9.612,12.099,51.345,5.928,P＞0.05),while no significant difference with adjuvant chemotherapy,radiotherapy,endocrine therapy and molecular typing(x2 =2.381,1.958,0.027,2.612,P＞0.05).Multivariate Cox proportional hazards regression model analysis showed that tumor size (RR =5.487,95％ CI 1.519-19.822,P =0.009) and lymph node metastasis (RR =5.655,95％ CI 2.939 -10.884,P＜0.001) were independent risk factors for disease recurrence.Conclusion Tumor size and lymph node metastasis are important factors of prognosis on young patients.Young patients need the screening and therapy in the early time.

Objective To analyze the genetic characterization of VP1 region of Coxsackie virus A10(CVA10)isolated from clinical specimens of hand, foot and mouth disease(HFMD) patients in Shandong Province. Methods Clinical specimens were collected from some of HFMD patients from 2008 to 2009. The virus was isolated by cell culture. Total RNA was extracted, and the VP1 genes of the isolates were amplified by reverse transcription-polymerase chain reaction (RT-PCR) and sequenced. The genotypes were identified by molecular typing method and bioinformatics analysis.Homologous comparison and phylogenetic analysis of representative CVA10 strains were performed.Homologous comparison between the Shandong isolates and strains obtained from GenBank were performed and phylogenetic analysis of some representative CVA10 strains were performed. Results Three hundred and thirty viruses strains were isolated from 760 clinical specimens collected from HFMD patients, and 17 of them were identified as CVA10. The homologies of nucleotide and amino acid of the 17 CVA10 strains were 82.3%-100.0% and 94.2%-100.0%, respectively. Compared with the prototype strain of CVA10 (Kowalik/USA/2003), the homologies of nucleotide and amino acid were 75.6%-76.8% and 90.2%-93.2%, respectively. Interestingly, Shandong CVA10 strains were clustered into two distinct subgroups in the phylogenetic tree. Conclusions CVA10 is one of the causative agents of HFMD. Two independently circulating subgroups of CVA10 exist in Shandong province.

To analyze the genetic characteristics of a polio-I highly variant vaccine recombinant virus in Shandong Province (China) in 2011 and to identify isolates from healthy contacts, two stool specimens from one patient with acute flaccid paralysis (AFP) and 40 stool specimens from his contacts were collected for virus isolation. The complete genome of poliovirus and VP1 coding region of the non-polio enterovirus were sequenced. Homologous comparison and phylogenetic analyses based on VP1 sequences were undertaken among coxsackievirus (CV) B1, CV-B3 isolates, and those in GenBank. One poliovirus (P1/11186), CV-A4 and CV-A8 were isolated from the AFP patient; one CV-A2, Echovirus 3 (E-3), E-12 and E-14, ten CV-B1, and five CV-B3 strains were isolated from his contacts. These results led us to believe that there may be a human enterovirus epidemic in this area, and that surveillance must be enhanced. P1/11186 was a type-1 vaccine-related poliovirus; it combined with type-2 and type-3 polioviruses in 2A and 3A regions, respectively. There were 25 nucleotide mutations with 9 amino-acid alterations in the entire genome. There were 8 nucleotide mutations with 5 amino-acid alterations in the VP1 region compared with the corresponding Sabin strains. Homology analyses suggested that the ten CV-B1 isolates had 97.0%-100% nucleotide and 98.9%-100% amino-acid identities with each other, as well as 92.6%-100% nucleotide and 99.2%-100% amino-acid identities among the five CV-B3 isolates. Phylogenetic analyses on the complete sequences of VP1 among CV-B1 and CV-B3 isolates showed that Shandong strains, together with strains from other provinces in China, had a close relationship and belonged to the same group.
Base Sequence ; Capsid Proteins ; genetics ; immunology ; Child, Preschool ; China ; Humans ; Male ; Molecular Sequence Data ; Phylogeny ; Poliomyelitis ; etiology ; prevention & control ; virology ; Poliovirus ; classification ; genetics ; immunology ; isolation & purification ; Poliovirus Vaccines ; adverse effects ; genetics ; immunology

Objective: To evaluate the effectiveness of mumps prevention and control after implementation of two doses mumps-containing combined vaccine (MuCV) policy by analyzing epidemiological characteristics of mumps and mumps antibody levels in general population. Methods: We obtained data on cases of mumps reported during 2004-2015 from National Notifiable Diseases Reporting System (NNDRS). Descriptive analysis methods were used to describe the epidemiological characteristics of mumps during 2004-2015. MuCV immunization information from 2005 to 2015 was obtained from the immunization information management system in Shandong Province. Antibody data of mumps in healthy people were from a cross-sectional survey according to the principle of stratified random sampling from 0 to 60 years old healthy people in 2015. Commercial ELISA kits were used to detect and quantify human IgG antibodies against mumps virus in sera, and the results were analyzed statistically. Results: The average incidence of mumps from 2004 to 2015 was 11.43/100 000 in Shandong. The incidence of mumps in the central region (14.64/100 000) was higher than that in the eastern and western regions (11.14/100 000, 11.33/100 000). The incidence of mumps was still high in 2009-2013 (stage of one-dose MuCV free, 16.07/100 000) with the highest incidence of 25.33/100 000 and 24.45/100 000 occurred in 2012 and 2013 and the cases were mainly 6 to 9 years old group (172.67/100 000). Since the second dose MuCV was introduced into NIP for 6 years old children in May 2013 in Shandong, the incidence of mump decreased significantly in 2014-2015 (7.81/100 000), especially in children of 6-8 years old who were vaccinated with two doses of MuCV (2009-2013 was 114.02/100 000; 2014-2015 was 45.66/100 000) and lower than 3-5 years old vaccinated one doses of MuCV. A total of 1 785 serum samples were collected from the healthy population, the average seroprevalence was 80.62% and Geometric Mean Concentration (GMC) was 38.11 IU/ml (95%CI: 37.03-39.19 IU/ml) . There was no significant difference about seroprevalence in different regions, while the GMC in middle region was significantly higher compared to east and west region. The prevalence and GMC in children aged 19 months-2 years and 3-5 years old who received one dose of MuCV were significantly higher than those of <19 months old children. The GMC (46.88 IU/ml, 95%CI: 39.43-55.74 IU/ml) in children aged 6-9 years old who received the two doses MuCV was significantly higher than that of aged 3-5 years old children (31.71 IU/ml, 95%CI: 27.23-36.93 IU/ml). Conclusion The incidence of mumps in Shandong was still at a high level in spite of coverage one doses MuCV to children. Compared with the period of the 1 dose MuCV immunization strategy, the incidence the groups coverage two doses MuCV was significantly reduced and lower the groups coverage one dose MuCV, but the prevalence and GMC were higher than that of the groups coverage one dose MuCV.

OBJECTIVETo analyze the prevalence states of hypertension and prehypertension and to explore relevant influencing factors among adult residents in Shandong province.

METHODS15 600 residents aged between 18 and 69 from 20 counties in Shandong province were selected by multiple stratified and clustered sampling method from July to September, in 2011, to acquire related information by questionnaire survey and physical measurement. The prevalence of hypertension and prehypertension was estimated by special statistic method used to deal with complex sampling data, and the relevant influencing factors were also analyzed.

RESULTSA total of 15 350 subjects were actually completed the survey, with age at (41.4 ± 14.1) years old. The average systolic blood pressure and diastolic blood pressure were 121.1(95%CI: 119.7-122.4) and 78.8(95%CI: 77.8-79.9) mmHg (1 mmHg = 0.133 kPa) respectively. And also 3776 hypertension patients and 5721 subjects with prehypertension were detected, and the weighting prevalence of hypertension and prehypertension were 23.4% (95%CI: 20.9%-26.0%) and 37.1% (95%CI: 34.7%-39.5%) with adjustive prevalence at 20.7% and 36.5% respectively. The multiple SURVEYLOGISTIC analysis showed that age above 40 years old (OR = 3.24, 95%CI: 2.56-4.10), overweight(OR = 2.22, 95%CI: 1.70-2.89) and obesity(OR = 5.84, 95%CI: 3.54-9.66), smoking history(OR = 1.82, 95%CI: 1.03-3.23), constantly drinking (OR = 1.71, 95%CI: 1.08-2.70), diabetes (OR = 1.99, 95%CI: 1.29-3.07), abnormal TC(OR = 1.64, 95%CI: 1.24-2.17), abnormal TG(OR = 1.75, 95%CI: 1.24-2.48) and high 24 h urine Na/K ratio (OR = 1.05, 95%CI: 1.02-1.08) were risk factors of hypertension, while education equal to or above junior middle school (OR = 0.68, 95%CI: 0.52-0.89) was protective factor of hypertension; age above 40 years old (OR = 1.49, 95%CI: 1.15-1.91), overweight(OR = 1.76, 95%CI: 1.25-2.48) and obesity (OR = 3.50, 95%CI: 2.05-5.97), abnormal TC (OR = 1.54, 95%CI: 1.10-2.14), abnormal TG (OR = 1.79, 95%CI:1.25-2.56) and high 24 h urine Na/K ratio (OR = 1.02, 95%CI: 1.01-1.04) were risk factors of prehypertension, while female (OR = 0.41, 95%CI: 0.31-0.56) and education level equal to or above junior middle school (OR = 0.67, 95%CI: 0.52-0.87) were protective factors.

CONCLUSIONThe hypertension, especially prehypertension tends to be at high prevalence states currently, which may be affected by many factors.

Adolescent ; Adult ; Aged ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Hypertension ; epidemiology ; Male ; Middle Aged ; Prehypertension ; epidemiology ; Risk Factors ; Young Adult

Objective To observe the effect of transcranial direct current stimulation (tDCS) with mirror neuronal rehabilitation training system (MNST-V1.0) in post-traumatic unconscious patients after severe craniocerebral injury. Methods A prospective, self controlled and open-label method was used. Thirty-six post-traumatic unconscious patients with severe craniocerebral injury from January 2016 to July 2017 were selected. Four cases of the patients did not complete the treatment and the last 32 cases completed the study. All patients were given routine wake-up therapy, and tDCS combined with MNST-V1.0 (20 min/time, 1 time/d, 6 times/week, a total of 8 weeks) was given at the same time. The Glasgow coma scale (GCS), JFK coma recovery scale and Four coma rating scale before treatment and 2, 4, 8 weeks after treatment were recorded. Results The scores of open reaction, language and motor response score of GCS 2, 4, 8 weeks after treatment were significantly higher than those before treatment:(1.56 ± 0.82), (2.06 ± 1.01) and (3.11 ± 1.45) scores vs. (1.00 ± 0.45) scores, (2.23 ± 1.06), (2.56 ± 1.08) and (3.02 ± 1.04) scores vs. (1.00 ± 0.61) scores, (2.79 ± 1.12), (3.22 ± 1.33) and (4.44 ± 1.07) scores vs. (1.00 ± 0.54) scores, and there were statistical differences (P ＜ 0.01 or ＜0.05). The scores of hearing, vision, movement, speech response, communication and arousal of JFK coma recovery scale 2, 4, 8 weeks after treatment were significantly higher than those before treatment, and there were statistical differences (P＜0.01). The scores of open reaction, sport reaction, brainstem response of Four coma rating scale 2, 4, 8 weeks after treatment were significantly higher than those before treatment, and there were statistical differences (P＜0.05); there was no statistical difference in respiratory score of Four coma rating scale before and after treatment (P＞0.05). Conclusions The tDCS combined with MNST-V1.0 can improve the consciousness level in post-traumatic unconscious patients with severe craniocerebral injury, and have the effect of promoting awakening.