Objective The main purpose is to investigate the status of brucellosis infection in high-risk areas of Urumqi and population characteristics,and to provide a basis for prevention of brucellosis.Methods In Urumqi City,Dabancheng District,Gaoxin District,Midong,Zone and Urumqi County were selected as survey sites;according to pastoral,agro-pastoral and agricultural,all towns in each survey site were classified into three categories;150 to 200 residents in each township were selected as subjects.Basic demographic information was collected,and blood samples were collected for serological detection.rose bengal plate agglutination test (RBPT) was used for preliminary screening,RBPT positive persons were further confirmed by standard tube agglutination test (SAT).Different regions,gender,age,occupation,exposure difference and brucellosis infection rates were studied.x2 test was used to compare rates.Results The infection rate was 5.42％ (29/535).Furthermore,the infection rate ofthe Dabancheng District [10.34％ (12/116)] was higher than those of Gaoxin District [2.94％ (3/102)] and Urumqi County [2.58％ (4/155),x2 =4.643,7.199,all P ＜ 0.05],the differences were statistically significant (x2 =9.327,P ＜0.05).Besides,infection rate of the average exposure occupation [8.33％ (24/288)] was higher than those of low exposure occupation [0(0/61)] and high exposure occupation [2.72％ (5/184),x2 =5.459,6.140,all P ＜ 0.05].The differences were statistically significant (x2 =10.846,P ＜ 0.05).The differences of infection rates in ages and nations showed no statistical significance (x2 =2.396,4.639,all P ＞ 0.05).Conclusions High risk areas of brucellosis are still exist in Urumqi.Health education should be strengthened in the future,in order to enhance residents' seff-protection awareness in exposed population.

Objective: To establish an HPLC method for the determination of codonoposide in Codonopsis lanceolata Benth. et Hook.F..Methods:The HPLC analysis was performed on a Kromasil C18column (250 mm×4.6 mm,5 μm). The mobile phase was 0. 1% phosphoric acid-acetonitrile (70∶ 30) and the flow rate was 1. 0 ml·min-1 . The detection wavelength was 203 nm and the column temperature was 30℃. Results:Codonoposide in Codonopsis lanceolata Benth. et Hook. F. had a good separation from the oth-er components, and a good linear relationship was obtained within the range of 1. 09-17. 41 μg( r=0. 999 9). The average recovery was 98. 46%(RSD=1. 64%, n=6). Conclusion: The method is practicable with promising repeatability, which can be applied in the content determination of codonoposide in Codonopsis lanceolata Benth. et Hook. F. .

Objective:To explore the clinical effect of Huayu-Ningkun liquid enema and external application of dreg for treating chronic pelvic inflammatory disease. Methods:A total of 106 patients with chronic pelvic inflammatory disease who met the inclusion criteria in the gynecological outpatient department of Beijing Hospital of Integrated Chinese and Western Medicine from January 2018 to December 2019 were divided into 2 groups by random number table method, with 53 patients in each group. The control group was treated with conventional western medicine therapy, and the observation group was combined with Huayu-Ningkun liquid enema and external application of drug residue on the basis of the control group. TCM symptom scores were performed before and after treatment, and the Quality of Life of patients was evaluated by Generic Quality of Life Inventory-74 (GQOLI-74). Serum CRP and TNF-α levels were detected by ELISA, and adverse reactions during treatment were recorded. Results:The total effective rate was 96.2% (51/53) in the observation group and 83.0% (44/53) in the control group, and the difference between the two groups was statistically significant ( χ2=4.970, P=0.026). After treatment, the TCM symptom scores of the observation group was significantly lower than that of the control group ( t=8.205, P<0.01). The scores of physical function, mental function, material life and social function were significantly higher than those in the control group ( t value were 7.503, 8.786, 7.798, 9.353, all Ps<0.001). After treatment, the levels of serum CRP (4.52 ± 3.46 g/L vs. 8.23 ± 3.35 g/L, t=5.608) and TNF-α (1.00 ± 0.35 μg/L vs. 1.52 ± 0.28 μg/L, t=14.551) in the observation group were significantly lower than those in the control group ( P<0.01). Conclusion:The Huayu-Ningkun liquid enema and drug residue external application combined with western medicine can relieve the symptoms, reduce the level of inflammatory cytokines, improve clinical efficacy of the patients with chronic pelvic inflammatory disease.

Whether there was crossing between Astragalus major split constituents was explored, and the methodology of cross validation for split constituents was studied to determine Astragalus sweet and warm property. The Astragalus was extracted by boiling water or other different solvents, and detected by HPLC-DAD or HPLC-ELSD. Finally, the similarity of each constituent was calculated by fingerprint software. Similarities of flavonoids and saponin constituents were all less than 0.31 and 0.34, respectively, compared to other constituents. The cross situation of nature-taste split components which was extracted by solvents was not serious. This method was proven to be feasible, and provided a theoretical and substantial basis for the Chinese taste pharmacological experiments and would be conductive to determine Astragalus sweet and warm property.

Objective To investigate the effect of laparoscopic salpingotomy with suturing on prognosis of patients.Methods One hundred and thirty two cases patients of laparoscopic salpingotomy and embryo extraction in our hospital from October 2015 to Febrary 2017 were were divided into observation group (68 cases) with suturing and control group (64 cases) without suturing according to the operation procedure.The patency of fallopian tube was observed at 3 months after operation and the intrauterine gestation rate and recurrent ectopic pregnancy rate were observed 1 years after operation in two groups.Results The fallopian tube patency in the observation group and the control group was 58 cases (85.3％) and 39 cases (60.9％) respectively at 3 months after operation.7 cases (10.3％) and 12 cases(18.8％) of the fallopian tube were not smooth in the observation group and the control group respectively at 3 months after operation.The fallopian tube obstruction in the observation group and the control group was 3 cases (4.4％) and 13 cases (20.3％) respectively at 3 months after operation.The patency rate of fallopian tube in the observation group was higher than that in the control group (Z =6.215,P ＜ 0.05).The intrauterine gestation rate (69.1％ (47/68)) in the observation group was significantly higher than that in the control group (37.5％(24/64)) 1 years after operation and the difference between the two groups was statistically significant (x2 =5.41,P ＜0.05).The rate of recurrent ectopic pregnancy in the observation group (10.3％(7/68)) was significantly lower than that in the control group (26.6％(17/64)) and the difference between the two groups was statistically significant (x2 =4.826,P ＜ 0.05).Conclusion The laparoscopic salpingotomy with suturing can improve the patency rate of the fallopian tube and the rate of intrauterine gestation and reduce the rate of recurrent ectopic pregnancy in the patients after the operation.

OBJECTIVETo investigate the accuracy and consistency of the detection of BCR-ABL tyrosine kinase domain point mutation among different laboratories.

METHODSEvery one of 6 laboratories prepared 10 cDNA samples from tyrosine kinase inhibitors resistant BCR-ABL (P210 or P190) positive patients'bone marrow or peripheral blood. Each cDNA sample was divided into 6 aliquots and delivered to the laboratories. All 6 laboratories tested BCR-ABL point mutations of 60 samples according to their own protocols. Peking University People's Hospital analyzed the comparison results based on both the reports and sequencing chromatogram from all laboratories.

RESULTSAll laboratories reported the same nucleotide and corresponding amino acid mutations in 37 samples (61.7%）. Of 60 samples, 53 had confirmed mutation types, and a total of 23 types were included; 1 had no mutation; mutation types of 6 samples could not be determined because of the big differences among chromatograms from different laboratories. Low percentages of mutants were significantly related to results inconsistency (P=0.008). Inconsistent result of one sample was caused by the unique chromatogram of the mutant L248V, and one by the non-coverage amplification of PCR product from different laboratories. Amplification was failed in 3 samples. Testing or sequencing mistakes occurred in 7 samples. The differences in the mutant percentages among laboratories were less than 20% in the 80.6% of samples with confirmed results. Low internal control gene copies (ABL<10 000) were significantly related to both failed amplification and big differences among chromatograms from different laboratories (P=0.005 and <0.001, respectively).

CONCLUSIONProblems in the clinical routine detection of BCR-ABL point mutation could be exposed and improvement could be achieved by sample exchange and comparison. Low percentage of mutant is the main reason which causes the discrepancy of BCR-ABL point mutation results among different laboratories.

Objective To investigate the clinicopathologic features of Chinese patients with early gastric cancer (EGC) according to the World Health Organization(WHO) diagnostic criteria,and to explore the risk factors of lymph node metastasis (LNM) in EGC.Methods From 2002 to 2017,at the Second Affiliated Hospital of Nantong University,and from 2014 to 2017,at the People's Hospital of Qidong City,the People's Hospital of Haimen City and the People's Hospital of Rugao City,315 EGC patients with complete clinicopathological data were enrolled.The clinicopathologic features were analyzed including gender,age,tumor location,tumor size,macroscopic type,histological type (WHO),differentiation degree,depth of tumor invasion,Lauren subtype,infiltration pattern,ulceration,lymphoid follicles,lymphovascular invasion and perineural invasion.Chi-square test and Fisher's exact test were performed for univariate analysis and the logistic regression was used for multivariate analysis.Results The ratio of EGC was 10.0％ (315/3 140) of patients with gastric cancer and received surgery during the same period.Among the 315 EGC,the ratio of well-differentiated tubular adenocarcinoma was 11.7％ (37/315),which was lower than 24.8％(2 752/11 104) in Japan and 19.9％(41/206) in South Korea,and the differences were statistically significant (x2 =28.208,P＜0.01;x2 =6.51 0,P =0.011),however there was no statistically significant difference when compared with Western countries (11.9 ％,8/67;x2 =0.002,P=0.964).Among the 276 patients who underwent radical gastrectomy,49 (17.8 ％) patients had with LNM.The results of univariate analysis showed that tumor size,macroscopic type,differentiation degree,depth of invasion,infiltration pattern,ulceration and lymphovascular invasion were related with LNM(x2=9.327,6.038,6.381,34.983,19.309,52.297 and 5.058;all P＜0.05).The results of multivariate analysis revealed that lymphovascular invasion and ulceration were the independent risk factors of LNM (odd ratio (OR)=7.028 and 2.566,both P＜0.05).Conclusions There is obvious difference in pathological diagnostic standard of well-differentiated tubular adenocarcinoma between China,Japan and South Korea,which may influence the therapeutic strategy of EGC.Lymphovascular invasion and ulceration are independent risk factors of LNM in EGC.

Objective:To explore the application effect of problem-based learning (PBL) combined with mind mapping and situational teaching in cardiology teaching of rural doctors.Methods:Twenty rural doctors of Batch 2017 and 24 rural doctors of Batch 2018 were selected as study subjects, and they were divided into the experimental group (Batch 2018) taught by PBL combined with mind mapping and situational teaching and the control group (Batch 2017) taught by traditional teaching. Classroom tests and questionnaires were used to compare the students' mastery of the teaching content, and the teaching effect and student feedback were evaluated. SPSS 18.0 was performed for t test, rank-sum test and χ2 test. Results:The theoretical results of the experimental group were significantly higher than those of the control group ( P<0.05). The scores of learning interest and initiative ( Z=-3.606, P<0.001), classroom attraction ( Z=-3.455, P=0.001), understanding ( Z=-3.757, P<0.001) and mastering ( Z=-4.259, P<0.001) in the study effect evaluation of the experimental group were significantly higher than those of the control group. The satisfaction to teachers about active classroom atmosphere ( χ2=4.556, P<0.05), flexible methods ( χ2=12.813, P<0.05), satisfaction ( P<0.05), theory with practice ( P<0.05), and thinking inspiration ( χ2=21.042, P<0.05) of the experimental group were significantly greater than those of the control group. Conclusion:PBL combined with mind mapping and situational teaching has a good effect on the teaching of cardiology of rural doctors, and it is worthy of promotion in the grassroots.

Objective:To investigate the correlation between triglyceride-glucose (TyG) index on admission and unfavorable outcomes of patients with moderate-to-severe traumatic brain injury (msTBI) at 6 months postinjury.Methods:A retrospective cohort study was conducted to analyze the clinical data of 277 patients with msTBI admitted to Affiliated Jiangyin Hospital of Nantong University from January 2019 to December 2022, including 208 males and 69 females, aged 18-88 years [(57.0±15.1)years]. Glasgow Coma Scale (GCS) scores on admission were 3-8 points in 168 patients and 9-12 points in 109. According to the Glasgow Outcome Scale-Extended (GOSE) assessment at 6 months after injury, there were 121 patients with unfavorable outcomes (GOSE≤4 points) and 156 with favorable outcomes (GOSE≥5 points). The following indicators of the patients were recorded, including gender, age, history of diabetes, cause of injury, admission GCS, GCS motor score (GCSM), pupillary light reflex, worst Marshall CT classification within the first 24 hours after admission, admission TyG index, Mean Amplitude of Glycemic Excursions (MAGE) within 24 hours after admission, GCSM decline≥2 points within 72 hours after admission, craniotomy or not after admission, and prognosis, etc. TyG index served as the exposure variable focused in this study, which was calculated with fasting triglycerides and fasting blood glucose within 24 hours after admission. The 6-month prognosis of the patients was designated as the outcome variable of the study. After the patients were divided into different groups according to the three quantiles of the TyG index and unfavorable or favorable outcomes, the univariate analysis was conducted on watch variables, and variables with statistically significant differences were included in directed acyclic graphs (DAGs) for further identification of confounding variables. Factors which were found with no statistical significance in the univariate analysis but might affect insulin resistance after injury according to the authors′ previous researches were also included in the DAGs analysis. Three Logistic regression models were designed (Model 1 without correction, Model 2 with core variables of International Mission for Prognosis and Analysis of Clinical Trials in Traumatic Brain Injury (IMPACT) corrected, and Model 3 with confounding variables screened by DAGs corrected) to analyze whether the TyG index was an independent risk factor for the prognosis of msTBI patients. The optimal Logistic regression model was selected and then restricted cubic spline (RCS) was employed to investigate the relationship between the TyG index and the unfavorable outcomes.Results:The univariate analysis suggested that there were significant differences in gender, history of diabetes, MAGE, GCSM decline, and prognosis among the three quantiles of the TyG index ( P<0.05 or 0.01). Significant differences in age, history of diabetes, GCSM, pupillary light reflex, Marshall CT classification, TyG index, MAGE and GCSM decline were observed between unfavorable and favorable outcome groups ( P<0.05 or 0.01). The results of Logistic regression analysis that identified the confounding variables that influenced the correlation between the TyG index and unfavorable prognosis with DAGs suggested that a high TyG index level was significantly correlated with unfavorable outcomes in msTBI patients. Moreover, Model 3 that was corrected with confounding variables screened by DAGs had an optimal goodness-of-fit and adaptability. Model 3-based further RCS analysis indicated that the risk of unfavorable outcomes following msTBI may increase approximately linearly with the increase in TyG index within a certain range (TyG index<9.79). Conclusions:A high TyG index level on admission is the identified as an independent risk factor for unfavorable outcomes of patients with msTBI at 6 months postinjury. As the TyG index level increases, the risk of unfavorable outcomes also rises and may show a linear increasing trend within a certain range (TyG index<9.79).

Objective To understand the epidemiological characteristics of influenza outbreaks in China from 2005 to 2013. Methods The data of influenza-like illness outbreaks involving 10 or more cases were collected through Public Health Emergency Management Information System and National Influenza Surveillance Information System in China,and the influenza outbreaks were identified according to the laboratory detection results. Descriptive epidemiological analysis was conducted to understand the type/subtype of influenza virus and outbreak time,area,place and extent. Results From 2005 to 2013,a total of 3 252 influenza-like illness outbreaks were reported in the mainland of China,in which 2 915 influenza outbreaks were laboratory confirmed,and influenza A(H1N1) pdm09 virus and influenza B virus were predominant. More influenza outbreaks were reported in the influenza A(H1N1)pandemic during 2009-2010. Influenza outbreaks mainly occurred during winter-spring,and less influenza outbreaks occurred in winter and summer vocations of schools. More influenza outbreaks were reported in southern provinces,accounting for 79% of the total. Influenza outbreaks mainly occurred in primary and middle schools,where 2 763 outbreaks were reported,accounting for 85% of the total. Averagely 30-99 people were involved in an outbreak. Conclusion A large number of influenza outbreaks occur during influenza season every year in China,the predominant virus type or subtype varies with season. Primary and middle schools are mainly affected by influenza outbreaks.