Objective To explore the clinical characteristics of liver cirrhosis patients complicated with ischemic hepatitis . Methods The clinical data were reviewed retrospectively for 30 cirrhosis patients complicated with ischemic hepatitis from January 2008 to June 2013 in the intensive care unit of Dalian Sixth People′s Hospital .Results Ischemic hepatitis was identified in 1 .6% of the patients treated at the same period in ICU .In addition to the underlying disease including cirrhosis ,the patients also showed hypovolemic shock ,severe sepsis ,acute attack of chronic heart failure and acute respiratory distress syndrome . Acute increase of serum alanine aminotransferase(ALT) and aspartate aminotransferase(AST) was also reported in association with significant decrease of albumin .The patients were treated with comprehensive measures targeting shock ,infection ,heart failure ,respiratory failure ,and relevant symptoms .The overall mortality was 66 .7% (20/30) .The mortality was significantly higher in Child‐Pugh C cirrhotic patients than Child‐Pugh A or B patients .Conclusions The ischemic hepatitis in association with liver cirrhosis is mainly induced by hypovolemic shock ,severe sepsis ,heart failure ,and respiratory failure .Typical laboratory findings are sharp elevation of serum ALT and normalization after treatment . Liver cirrhosis complicated with ischemic hepatitis features high mortality ,particularly in Child‐Pugh C cirrhosis .

OBJECTIVE:To determine ampicillin concentration in human plasma by HPLC.METHODS:The chromatographic column was Waters Sunfire C18 with mobile phase consisted of acetonitrile and 0.05 mol?L-1 potassium dihydrogen phosphate(6.5∶93.5,V∶V)at a flow rate of 1.2 mL?min-1.The UV detection wavelength was 210 nm;the column temperature was 35 ℃ and the injection volume was 20 ?L.RESULTS:The linear range of ampicillin was 0.2～16.0 ?g?mL-1(r=0.999 9).The limit of quantization was 0.2 ?g?mL-1.The average methodological recovery was 99.88%～104.45%,and the average extraction recovery was 95.69%～100.56%.Both the inter-day RSD and the intra-day RSD were all less than 10%.CONCLUSION:This method is stable,rapid and sensitive,and suitable for the pharmacokinetic study for ampicillin preparation.

Objeetive: To learn the epidemic status of COVID-19 in some high-epidemic countries, so as to provide reference for prevention and control of imported COVID-19 in China. Methods: We collected the data of all the countries who totally reported over ten thousand cases of COVID-19 by March 29, 2020, and analyzed the epidemic trend by using the incidence rate, the case fatality rate, the five-day moving average time dependent reproduction number (Rt) as well as the average daily increase rate. Results : Spain, Switzerland, Italy, Germany, France, lran, UK, USA and China were inchuded in the analysis. Spain( 15.46/100 000), Switzerland(15.44/100 000) and Italy ( 15.30/100 000)ranked top three in the incidence rate of COVID-19. Italy (10.84%), Spain (7.88%) andlan (7.11%) ranked top three in the case atality rate. By March27, the values of five-day moving average Rt in USA, UK, Iran, Spain and France were all more than one. The average daily increase rate in China had changed negative since March 6. The average daily increase rates in the other eight countries ranged from 41.58% to 18.17%, and the trend was slow down from March 20 to 29, among which Germany, Switzerland and Italy had the largest decline of 35.60%, 29.76% and 25.56%, respectively Conclusions By March 29, the epidemie situation of COVID-19 in China was under controls; the situations in ltaly, Germany and Switzerland tended to be stable; while the situations in USA, UK, Iran, Spain and France maintained an upward tmend.

Objective: To estimate the influenza-associated excess mortality (IEM) in Zhejiang Province from 2016 to 2019, so as to provide insights into estimates of mortality burden due to influenza. Methods: The data pertaining to all-cause death and influenza surveillance in Zhejiang Province from 2016 to 2019 were retrieved from Zhejiang Provincial Cause of Death Registration System and Influenza Surveillance System to create distributed lag non-linear models (DLNMs). The year-, influenza subtype- and age-specific IEM rates were estimated. Results: The overall IEM was 18.67/105 (95%CI: 15.32/105-21.97/105) in Zhejiang Province from 2016 to 2019, with the lowest in 2016 (14.19/105, 95%CI: 12.00/105-16.37/105) and the highest in 2018 (22.92/105, 95%CI: 19.23/105-26.56/105). The IEM rates of influenza A (H1N1), influenza A (H3N2) and influenza B were 9.32/105 (95%CI: 7.65/105-10.98/105), 5.68/105 (95%CI: 4.24/105-7.11/105), and 3.66/105 (95%CI: 2.13/105-5.18/105). The greatest IEM was seen among residents at ages of 65 years and older (142.91/105, 95%CI: (115.99/105-169.55/105, followed by among individuals at ages of 15 to 64 years (2.74/105, 95%CI: 1.87/105-3.61/105), and the lowest was seen among individuals under 15 years of age (0.41/105, 95%CI: -0.33/105-1.14/105). Conclusions From 2016 to 2019, the highest IEM was seen in Zhejiang Province in 2018, and the elderly residents at ages of 65 years and above presented the greatest IEM, with influenza A (H1N1) as the predominant influenza subtype. Influenza surveillance and vaccination is recommended to be reinforced.

Objective: To conduct an epidemiological investigation on the first reported case of coronavirus disease 2019 （COVID-19） in Zhejiang Province, so as to provide reference for prevention and control of the disease. Methods : According to the COVID-19 Diagnosis and Treatment Program （Trial） and the COVID-19 Prevention and Control Program （Trial） issued by National Health Commission of China, a field investigation was employed on a case of fever from Wuhan reported by Wenzhou in January 15, 2020; the real-time reverse transcription polymerase chain reaction （RT-PCR） assay was performed to detect the nucleic acid of severe acute respiratory syndrome coronavirus 2 （SARS-CoV-2） from the sputum specimens or throat swabs of the case; the close contacts of the case were tracked down; relevant prevention and control measures were implemented. Results : The case had lived in Wuhan for long. On January 4 of 2020, he felt cold and uncomfortable without obvious inducement, and drove back to Wenzhou with his wife. He had fever （up to 39 ℃）, cough and expectoration on the next day. On January 9, the chest computed tomographic （CT） scan showed bilateral high-density patchy shadowing with blurred edges. On January 16, his throat swab and sputum samples were collected and sent to Zhejiang Provincial Center for Disease Control and Prevention （CDC） for detection of SARS-CoV-2. The result turned out to be positive on January 17, then was rechecked and confirmed by Chinese CDC on January 20. Two weeks before the onset of the disease, the patient was engaged in the door-to-door persuasion of installing elevators in an old residential area of Wuhan, and he denied any connection with other COVID-19 cases,markets,（sick or dead） poultry or poultry products. Totally 26 close contacts were identified and kept in quarantine. During this period,three of them developed fever or respiratory symptoms, but were excluded from COVID-19. On the afternoon of January 16,the health system of Zhejiang Province and Wenzhou City launched an emergency plan and implemented a series of prevention and control measures such as isolation and treatment of cases,screening and isolation of close contacts,and public health education. Conclusion According to the epidemiological history,clinical features and laboratory test Results,the patient was identified as the first reported case of COVID-19 in Zhejiang Province.