Objective:To explore the intermedial to long term surgical management in aortic valve insufficiency(AI)after ventricular septal defect(VSD)repair.Methods:A total of 22 consecutive patients with AI after VSD repair in our hospital from January 1996 to December 2007 underwent surgical treatment were enrolled in this study. Valve perforation was mainly pathological changes. Aortic valve replacement was performed in 13 patients and aortic valvuloplasty was done in 9 patients.Results:One patient died after the operation.Post operative X-ray and echocardiogram revealed that both cardio-thoracic ratio(0.57±0.07 vs. 0.52±0.04 P<0.05)and left ventricular end diastolic diameter(54.5±10.2 mm vs. 46.7±5.8mm P<0.05)decreased markedly. 3 patients suffered from mild aortic regurgitation after valvuloplasty.Conclusion:The iatrogenic injury of aortic valve during VSD repair could be corrected satisfactorily by valve replacement or valvuloplasty.

ObjectiveTo evaluate in vivo antithrombosis property of optimized FW-Ⅱ axial blood pump and provides evidence for future clinical use.MethodsA left ventricle-pump-descending aorta bypass model was established in five healthy sheep (60-70 kg) and the circulation of these sheep was assisted by FW-Ⅱ axial blood pump for 2 weeks.In preoperative and postoperative day 1,2,3,7,10 and 14,blood was drawn from the jugular vein to examine platelet activation and leukocyte-platelet aggregation respectively quantified with Annexin V,CD41/61 and CD14-PE by flow cytometry assays.Immediately after termination of the experiment,FW-Ⅱ axial blood pumps were explanted and each part was inspected for thrombus formation.Macroscopic and histological examinations were checked on heart,brain,kidney and spleen,respectively for thrombosis.ResultsCompared with preoperative baseline,the number of platelet activation and leukocyte-platelet aggregation reached a peak at postoperative day 2,it retained a high level within 7 days,then gradually decreased,but was still higher than preoperative level at dayl4.According to rotating speed,the number of platelet activation and platelet-leukocyte aggregation were lowest at the speed of 8000 r/min Minus thrombus were found in the front and rear hub of the pump rotor,and there was no thrombus at other components (flow straighter,impeller and pump housing).There were no ischemia and infarction evidences in macroscopic and histological examination of the heart,brain,kidney and spleen.ConclusionFW-II axial blood pump can be used to assist left ventricular circulation for 2 weeks with a satisfactory antithrombosis property.The level of platelet activation and leukocyte-platelet aggregation can be reduced to a lowest level at an optimized pump rotating speed.

In this study,we analyzed the data of hemorrhagic fever with renal syndrome (HFRS) and host animals monitoring in Zhangzhou City,Fujian Province,China,2006-2015,in order to find out the epidemic situation and risk factors,and provide a scientific basis for the prevention and control strategy.A total of 171 HFRS cases,including 1 death,were reported in Zhangzhou in this decade.The incidence rate of 0.352/105 showed an upward trend (xtrend2 =58.60,P＜0.01).And 70 villages and towns in 11 counties have affected,accounting for 56.00％ of the counties in Zhangzhou City.The cases were mainly reported in some towns of Huaan,Nanjing and Zhaoan countries.The cases mainly occurred in countryside,which reported 142 cases.The cases in farmers accounted for the highest proportion (79.58 ％),and pig farming staff accounting for 23.01％ in farmer cases.Most cases were reported in municipal hospitals (86.55 ％).The common clinical manifestations of those cases were fever,nausea,vomiting,backache,headache,pain,oliguria or anuria,eyelid edema and so on,with 72.67％ of thrombocytopenia and of 83.09 ％ proteinuria positive.Compared with the proportion (80.49 ％) of mice in patients' house from 2006 to 2010,that (45.83％) from 2011 to 2015 decreased obviously;however,the proportion of mice or mice droppings in workplaces were rising from 60.98％ to 73.33％.Mean rodent density was 6.40％ and total infection rate in rats was 7.42％.The main kind of rats with virus infection was Rattus norvegicus,carrying Seoul virus Ⅱ.Results of this study indicate that Zhangzhou is one of the foci of HFRS rodent,and the epidemic is rising in recent years,the overall in the highly distributed,while some counties showed a rising trend year by year.Thus,monitoring and control efforts in prone areas should be increased,and to carry out clinics training of HFRS in primary health care institutions.

Objective: To report the medium-long term survival rates of ventricular septal myectomy for treating the patients with hypertrophic obstructive cardiomyopathy and to analyze the predictive factors affecting the outcomes. Methods: A total of 655 consecutive patients who received ventricular septal myectomy in our hospital from 1984-10 to 2014-12 were retrospectively summarized. The cohort study was conducted with questionnaires by cardiovascular nurses. Result: The operative mortality was 1.4% (9/655). The mean follow-up time was (30.8 ± 30.9, from 3 to 213) months, there were 52/646 (7.9%) patients lost contact and 583 patients having NYHA classification at I or II during that period. The overall survival rates for 1 year, 5-year and 8-year were 98.3%, 90.5% and 88.3% respectively. There were 80 patients suffered from end point events including HCM-related death, heart transplantation, repeated myectomy, permanent pacemaker implantation and re-admission for ischemic stroke, tachyarrhythmia, myocardial ischemia or infarction, congestive heart failure. The end point events free survival rates for 1 year, 5-year and 8-year were 94.2%, 76.7% and 65.9% respectively. Multivariable Cox regression analysis presented that age>50 years (HR=2.16, 95% CI 1.36-3.46,P=0.001) and pre-operative atrial ifbrillation (FA) (HR=2.31, 95% CI 1.35-3.94,P=0.002) were the independent predictors for end point events occurrence. Conclusion: Ventricular septal myectomy may achieve good medium-long term survival rate with less adverse event in patients with hypertrophic obstructive cardiomyopathy. Elder than 50 years of age and with pre-operative FA were the independent predictors for adverse events occurrence.

Objective To explore the recurrent epidemiological characteristics of hand,foot and mouth disease (HFMD) among children aged <4 years to provide evidence for HFMD prevention and control. Methods Principles on historical cohort study were followed when analyzing data related to HFMD surveillance in Fujian province. All the research objects were restricted to patients aged<4,with HFMD and who were permanent residents in Fujian province. Characteristics of the study objects were extracted as potential factors when the patients first showed symptoms of HFMD. These factors might cause the recurrence of HFMD and were filtered by the logistic stepwise regression with SAS 9.0. Results A total of 82 949 children were included. Among them,2 612 had repetitiously suffered from HFMD (occupied 3.15%),including 2 510 who had the histories of suffering twice,98 suffering three times,3 suffering four times,and 1 even suffering five times. Comparing with the objects who had the first onset at the age of 3,also with the risk increased to 4.39 (95%CI:3.80-5.07)times,when compared to those who had the first onset at the age below 2. Again, the risk among children whose first onset was at the age of 2 had increased to 2.73 (95%CI:2.35-3.18)times. According to the current residents areas,the morbidities of patients under 6 years old were below 2%when the symptoms first started,but the risk of the objects whose morbidities were higher than 4%,had increased 2.15(95%CI:1.88-2.45) times. Again,risk of the objects whose morbidities were between 3%and 4%had increased to 2.10(95%CI:1.85-2.38)times. Among those whose specific morbidities were between 2% and 3%,the risk had increased to 1.65(95%CI:1.44-1.89) times. Comparing with the objects who never visited any maternal/child care settings when started the first onset,the risk among the ones who had been to the maternal/child care settings, had increased to 1.64(95%CI:1.51-1.78)times. Boys had the risk 1.34(95%CI:1.23-1.46)times increase than girls. The preponderant pathogen causing HFMD recurrence was EV71 (33/60). Recurrence might cause more severe symptoms or signs (8/2 612). Pathogens causing the initial infection and recurrence might both belonged to the same-EV71(3/6). Conclusion Recurrence of the disease were closely related to the opportunities of contacting the pathogens. Interventions should be imposed on patients in time as soon as the disease initiated,especially at the younger age.

Objective To analyze the epidemiological characteristics and spatial distribution of human brucellosis in Fujian province during 2011-2016,and provide evidence for the prevention and control of the disease.Methods The surveillance data of human brucellosis in Fujian during 2011-2016 was analyzed with software R 3.3.1,ArcGIS 10.3.1,GeoDa 1.8.8 and SaTScan 9.4.3.Results During 2011-2016,a total of 319 human brucellosis cases were reported,the incidence increased year by year (F=11.838,P=0.026) with the annual incidence of 0.14/100 000.The male to female rate ratio of the incidence was 2.50 ∶ 1.Farmers and herdsmen accounted for 57.37％.The incidence was 0.40/100 000 in Zhangzhou and 0.32/100 000 in Nanping,which were higher than other areas.The number of affected counties (district) increased from 12 in 2011 to 28 in 2016,showing a significant increase (F=13.447,P=0.021).The Moran' s I of brucellosis in Fujian between January 2011 and December 2016 was 0.045,indicating the presence of a high value or low value clustering areas.Local spatial autocorrelation analysis showed that,high-high clustering area (hot spots) were distributed in Zhangpu,Longhai,Longwen,etc,while high-low clustering areas were distributed in Nan' an and Jiaocheng,etc.Temporal scanning showed that there were three clustering areas in areas with high incidence,the most possible clustering,occurring during January 1,2013-December 31,2015,covered 6 counties,including Yunxiao,Pinghe,Longhai,etc,and Zhangpu was the center,(RR =7.96,LLR=92.62,P＜0.001).Conclusions The epidemic of human brucellosis in Fujian is becoming serious,and has spread to general population and non-epidemic areas.It is necessary to strengthen the prevention and control of human brucellosis in areas at high risk.

OBJECTIVETo explore the recurrent epidemiological characteristics of hand, foot and mouth disease (HFMD) among children aged <4 years to provide evidence for HFMD prevention and control.

METHODSPrinciples on historical cohort study were followed when analyzing data related to HFMD surveillance in Fujian province. All the research objects were restricted to patients aged <4, with HFMD and who were permanent residents in Fujian province. Characteristics of the study objects were extracted as potential factors when the patients first showed symptoms of HFMD. These factors might cause the recurrence of HFMD and were filtered by the logistic stepwise regression with SAS 9.0.

RESULTSA total of 82 949 children were included. Among them, 2 612 had repetitiously suffered from HFMD(occupied 3.15%), including 2 510 who had the histories of suffering twice, 98 suffering three times, 3 suffering four times, and 1 even suffering five times. Comparing with the objects who had the first onset at the age of 3, also with the risk increased to 4.39 (95%CI:3.80-5.07) times, when compared to those who had the first onset at the age below 2. Again, the risk among children whose first onset was at the age of 2 had increased to 2.73 (95% CI: 2.35-3.18) times. According to the current residents areas, the morbidities of patients under 6 years old were below 2% when the symptoms first started, but the risk of the objects whose morbidities were higher than 4% , had increased 2.15(95% CI:1.88-2.45)times. Again, risk of the objects whose morbidities were between 3% and 4% had increased to 2.10 (95%CI:1.85-2.38) times. Among those whose specific morbidities were between 2% and 3% , the risk had increased to 1.65 (95% CI: 1.44-1.89) times. Comparing with the objects who never visited any maternal/child care settings when started the first onset, the risk among the ones who had been to the maternal/child care settings, had increased to 1.64 (95% CI:1.51-1.78) times. Boys had the risk 1.34 (95% CI:1.23-1.46)times increase than girls. The preponderant pathogen causing HFMD recurrence was EV71 (33/60). Recurrence might cause more severe symptoms or signs (8/2 612). Pathogens causing the initial infection and recurrence might both belonged to the same-EV71 (3/6).

CONCLUSIONRecurrence of the disease were closely related to the opportunities of contacting the pathogens. Interventions should be imposed on patients in time as soon as the disease initiated, especially at the younger age.

Child, Preschool ; China ; epidemiology ; Cohort Studies ; Epidemics ; Female ; Hand, Foot and Mouth Disease ; epidemiology ; Humans ; Infant ; Logistic Models ; Male ; Recurrence ; Risk Factors

Objective: To study the influence of meteorological factors on the incidence of hand foot and mouth disease (HFMD) in Xiamen, Fujian province, and provide scientific evidence for the early warning, prediction, prevention and control of HFMD. Methods: Correlation analysis and distribution lag nonlinear models (DLNM) analysis of meteorological factors such as daily average pressure, daily average relative humidity, daily average temperature and sunshine hours and the incidence of HFMD in Xiamen during 2013 to 2017 were conducted by using R3.4.3 software. Results: A total of 36 464 cases of HFMD were reported in Xiamen during 2013-2017, and the incidence showed an upward trend (F=40.359, P=0.008). The daily average relative humidity, daily average temperature and sunshine hours were positively correlated with the incidence of HFMD (r>0), and the daily average site pressure was negatively correlated with the incidence of HFMD (r<0). In the case of a lag of 0-5 days, when the daily average pressure of the station was higher than 1 005 hPa, the risk of HFMD gradually increased with the increase of air pressure, and the risk of disease decreased with the increase of lag days. The risk was highest when air pressure was 1 017 hPa and at the lag of 0 day (RR=1.14, 95%CI: 0.67-1.94). When the relative humidity was higher than 95%, the risk of HFMD gradually increased with the increase of relative humidity, and the lag time ranged from 0 day to 10 days, which was most obvious on the 4^th and 5^th days. The risk was highest when relative humidity was 100% and at the lag of 5 days (RR=1.32, 95%CI: 1.02-1.71). When the air temperature was >28 ℃ and <8 ℃, the risk of HFMD existed, but the lag time was inconsistent. The relative risk was highest during 15-20 days at low air temperature, and the lag time at high air temperature was mainly during 5-15 days. The risk was highest when air temperature was 28 ℃ and at the lag of 4 days (RR=1.10, 95%CI: 0.94-1.29). The sunshine time was >12 h and lag of 0-3 days was a risk factor for the incidence of HFMD. The risk was highest when sunshine time was 13 h and the lag of 0 day (RR=1.20, 95%CI: 1.05-1.36). Conclusion Meteorological factors such as daily average pressure, daily average relative humidity, daily average temperature and sunshine hours were associated with the incidence of HFMD with certain lag in Xiamen. So, it is suggested to use these data in the early warning system of HFMD.