Objective:To understand the distribution characteristics of human brucellosis in Anyang City, Henan Province, and to provide scientific basis for control of brucellosis.Methods:The epidemic data and population data of human brucellosis in 2019 in Anyang City were collected from the Chinese Disease Control and Prevention Information System, and the epidemiological and clinical data were collected by Anyang Center for Disease Control and Prevention. Descriptive epidemiological method was used to sort out and analyze the epidemiological and clinical characteristics of brucellosis.Results:In 2019, 128 cases of brucellosis were reported in Anyang City, with an incidence rate of 3.12/100 000 (128/4 096 193). Among them, 85 cases were male and 43 cases were female, the sex ratio of male to female was 1.98∶1.00; the youngest was 1 year old, and the oldest was 83 years old, there were 100 cases between 40 and 69 years old, accounting for 78.12% (100/128); the main occupation was farmer (119 cases), accounting for 92.97% (119/128); a total of 96 cases had contact history with sheep, accounting for 75.00% (96/128). The peak of incidence was from April to August (81 cases), accounting for 63.28% (81/128). Eight counties (cities and districts) in Anyang City were all affected, and the top three counties (districts) were Yindu District (15.39/100 000, 42/272 983), Longan District (5.16/100 000, 12/232 421) and Neihuang County (4.02/100 000, 27/672 396). The median time from onset to diagnosis was 32.18 d, ranging from 3 to 350 d, 72 cases were ≥ 31 d, accounting for 56.25% (72/128).Conclusions:In 2019, the main population of brucellosis in Anyang City is male middle-aged and elderly farmers, and the main infection route is contact transmission. It is suggested to strengthen the implementation of prevention and control measures of brucellosis.

Objective To investigate the antenatal influencing factors associated with birth weight of twins and the risk factors for the occurrence of discordant twins. Methods Totally, 834 twins delivered at the Third Affiliated Hospital from January 2000 to December 2009 and the First Affiliated Hospital of SUN Yat-sen University, from January 2000 to June 2009, were recruited in the study. The diagnosis criteria of discordant twins was intrapair birth weight difference more than 25 %.Antenatal factors on birth weight were retrospectively investigated among twins and discordant twins respectively with Logistic analysis. Results (1) There were several factors associated with birth weight of twins, including maternal age, conceptive style, chorionicity, gestational diabetes mellitus and placental cord insertion ( P = 0. 021, 0. 000, 0. 000, 0. 012 and 0. 017, respectively). While hypertensive disorder in pregnancy, parity and fetal gender differences were not associated with the birth weight of twins (P＞0.05). Hypertensive disorder in pregnancy (OR=2. 600, 95% CI:1. 566-4. 316) and monochorionicity (OR= 1. 833, 95% CI: 1.010-3. 582) were risk factors of discordant twins. All 834 twin pregnancies were divided into 4 groups according to materal age, ＜25 yrs (n=69), 25-30 yrs (n=312), 30-35 yrs (n=325) and ≥35 yrs (n=128). The average birth weight of twins were (2205±483) g, (2347±406) g, (2381±439) g and (2352±455) g. Significant difference was found bewteen every two groups (P＜0. 05) except that between the 30-35 yrs and ≥35 yrs group (P＞0.05). Among twins of different gender (n=270), the average birth weight of boys and girls were (2416±-514) g and (2322±488) g, and that of female twins (n=272) and male twins (n=292) were (2301±418) g and (2381±428) g. Significant difference was shown between every two groups (P＜0.05) except that between the male twins and male fetus of twins of different gender (P＞0.05).Conclusions The fetal birth weight of twins decreases remarkably when maternal age ＜25, or monochorionicity twins, or complicated with marginal or velamentous placental cord insertion or female pairs.However, birth weight of twins would increase if the pregnancy conceived by assisted reproductive technology or complicated with gestational diabetes mellitus. Twin pregnancy complicated with hypertensive disorder in pregnancy or monochorionicity should alert the clinicians of discordance twins.

Objective To explore the short term effects of five second-generation antipsychotics on the serum pro?lactin levels of first-episode schizophrenia patients. Methods Two hundred fifty first-episode schizophrenia patients were randomly divided into five groups and were then treated with risperidone, olanzapine, paliperidone, quetiapine or ziprasidone, respectively. The serum prolactin were tested at baseline, and every week following initiation of treatment. The positive and negative symptom scale (PANSS) and the treatment emergent symptom scale (TESS) were used to evalu?ate the effect and side effect of treatment. Results Repeated measure ANOVA for serum prolactin showed that the main effects of time, the main effect of group, and the interactive effect of time and group were significant (all P<0.01). At the first week, the serum prolactin level of risperidone group was higher than all the other four groups (P<0.05). At the sec?ond, third, fourth and fifth week, the serum prolactin level of risperidone group and olanzapine group was higher than the other three groups (P<0.05). At the end of the sixth week, the serum prolactin level of risperidone group, olanzapine group and paliperidone group was higher than the quetiapine and ziprasidone groups (P<0.05). But serum prolactin level of risperidone group and olanzapine group was higher than that of paliperidone group (P<0.05). The changes of PANSS before and after treatment were significantly different among groups (P<0.05). However, the incidence of the side effects was not significantly different among groups (P>0.05). Conclusion The level of serum prolactin gradually increases in schizophrenia patients receiving treatment of antipsychotics. The short term effects of different second generation antipsy?chotics on serum prolactin vary differently. Risperidol and olanzapine result in the elevation of serum prolactin level in the early period of treatment.

Objective to evaluate the validation of atypical depression among Chinese outpatients with depressive episodes and explore the role of atypical depressive symptoms in distinguishing bipolar depression from unipolar depression.Methods Structural clinical interviews with self-compiled questionnaires were performed on 276 outpatients with current depressive episode,then comparison of clinical characteristics including age of onset,gender proportion,seasonality,comorbidity of anxiety disorder,bipolar property,psychotic features,number of depressive episodes,and maximum duration of depressive episode were conducted between atypical (defined by DSM-Ⅳ-TR) and nonatypical depression.then the rate of atypical depressive symptoms were compared between unipolar depression and bipolar depression.Results The proportion of atypical depression among all the participants was 23.9％.Compared to nonatypical depression,psychotic features were more likely seen in atypical depression (20.0％ vs 9.1％,P＜0.05),but no difference was found in other clinical features between atypical and nonatypical depression.Except mood reactivity,atypical symptoms including oversleeping(45.5％ vs 26.0％),overeating (22.7％ vs 15.4％),weight gain(24.1％ vs 14.6％),leaden paralysis (56.6％ vs 47.2％),interpersonal rejection sensitivity(66.7％ vs 34.2％) were more likely to occur in bipolar depression than in unipolar depression,the difference was statistically significant for oversleeping and interpersonal rejection sensitivity (P ＜ 0.05).Patients with mood reactivity differed little from those without mood reactivity in other clinical features.No association was found between mood reactivity,leaden paralysis and other criteria symptoms of atypical depression.Conclusion-Atypical depression might be a useful concept,but its diagnostic criteria needs further validation among Chinese population.

To understand the genetic origin and variation of porcine epidemic diarrhea virus (PEDV) prevailing in Henan province,a total of 22 PEDV positive samples from suckling piglets with severe diarrhea were collected from 16 pig farms and amplified by RT-PCR.ORF3 genes were then cloned into pMD18-T vector and sequenced.The result of sequencing showed that the length of ORF3 genes all were 675 bp which encoded 224 amino acids.The strains in this study had eight amino acid substitutions when compared with CV777 strain.The nucleotide homologies of the 22 strains were 95.9％-100％ and amino acid homologies were 96.4％-100％.By comparing with those of European strain CV777 and vaccine strain truncated CV777,the nucleotide homologies were 97.1％-97.9％ and 94.8％-95.4％,respectively.Based on the phylogenetic relationship of ORF3 genes,the PEDV field strains and PEDV reference strains could be divided into two groups,and all the field strains identified in this study belong to group 2.It suggested that prevalent PEDV strains in this study seem to be closely related to Henan isolates in previous years,domestic strains,Janpanese strains,American strains as well as Korean strains but differ genetically from European strains or vaccine strains used in China.This experiment analyzed the ORF3 gene sequence features in prevailing of Henan region in recent years,which provides a new support of epidemiology study and protein function research of PEDV ORF3 gene.

In order to develop a combined live vaccine that will be used to prevent against porcine parvovirus (PPV) and Pseudorabies virus (PRV) infection, the VP2 gene of PPV was inserted into the transfer vector plasmid pG to produce the recombinant plasmid pGVP2. The plasmid pGVP2 and the genome of PRV HB98 attenuated vaccine were transfected by using lipofectamine into swine testis cells for the homologous recombination. The recombinant virus rPRV-VP2 was purified by selection of green fluorescence plaques for five cycles. 6-week-old female Kunming mice were immunized intramuscularly with attenuated PRV parent HB98 strain, commercial inactivated vaccine against PPV, recombinant virus, DMEM culture solution. The injections were repeated with an equivalent dose after 2 weeks in all of the groups, and then challenged with the virulent PRV NY strain at 7 weeks after the first immunization. The recombinant virus rPRV-VP2 was successfully generated, and the recombinant virus could effectively elicite anti-PPV and PRV antibody and significant cellular immune response as indicated by anti-PPV ELISA and HI, PRV-neutralizing assay and flow cytometry. The challenge assay indicated that recombinant virus could protect the mice against the virulent PRV challenge. These results demonstrated that the recombinant virus can be a candidate recombinant vaccine strain for the prevention of PRV and PPV.
Animals ; Antibodies, Viral ; immunology ; Antigens, Viral ; administration & dosage ; genetics ; immunology ; Capsid Proteins ; administration & dosage ; genetics ; immunology ; Female ; Gene Expression ; Genetic Vectors ; genetics ; metabolism ; Herpesvirus 1, Suid ; genetics ; metabolism ; Mice ; Parvovirus, Porcine ; genetics ; immunology ; Swine ; Swine Diseases ; immunology ; prevention & control ; virology ; Viral Vaccines ; administration & dosage ; genetics ; immunology

Objective To investigate de-escalation of empiric broad-spectrum antibiotics treatment for patients in intensive care unit (ICU).Methods Data of the patients discharged from ICU in the Second Affiliated Hospital of Zhejiang University from July 1 to December 31 of 2012 and from July 1 to December 31 of 2013 were retrospectively reviewed.Patients with initial use of empirical broad-spectrum antibiotics within 3 d after ICU admission were included in the study.Clinical data including status of infection,the initial empiric antimicrobial therapy,pathogens culture and adjustment of antibiotics in 5 days were analyzed.Results A total of 841 patients were discharged from ICU during the study periods and antibiotics were used in 786 (93.5％) patients.Among 786 patients,389 (49.5％) were treated empirically with broad-spectrum antibiotics,but only 269 (69.2％) had evidences of bacterial infections.Of the 389 patients with empiric antibiotics use,de-escalation of antibiotics was applied only in 6 (1.54％) patients within 5 days after the initiation of treatment.In 269 patients with evidence of infection,specimen sampling and culture were performed in 248 (92.2％) patients within 3 days,among which 165 samples were positive,and the clinical isolates were mainly multi-drug resistant gram negative bacilli and colonized bacteria in oropharyngeal cavity.De-escalation was applied only in 4 (1.49％,4/269) patients with evidences of bacterial infections.Conclusion Broad-spectrum antibiotics as initial empiric therapy is common for patients in ICU,however de-escalation of empiric therapy is rarely applied even in patients with positive results in pathogen isolation and culture.

Objective To analyze the occurrence features of the active surveillance of adverse events following immu?nization (AEFI) in Tianjin, and evaluate the sensitivity of passive surveillance systems over the same period. Methods The layered eight vaccination clinics of four counties were selected as active surveillance points. The data of active surveillance AEFI were collected through telephone investigation in 2011-2013. The data of passive surveillance was collected through the national AEFI information management system. The descriptive methodology and chi square test were used. Results A total of 235 cases were collected through active surveillance in 2011-2013. The AEFI incidence rate was 718.70 per 100 000 doses,no difference in the incidence between three years(χ2=5.07). A total of 4164 cases were collected through passive sur?veillance. The incidence rate was 34.09 per 100 000 doses,the incidence increased year by year(χ2=572.02,P<0.05). In ac?tive surveillance cases, 95.32%was the common vaccine reaction, 3.83%was the rare vaccine reaction, no serious vaccinereaction. In passive surveillance cases, the common vaccine reaction, the rare vaccine reaction were 85.09%and 13.32%. The serious vaccine reaction was found in 44 cases. Conclusion The more slightly common vaccine reaction can be found by active surveillance. The sensitivity of Tianjin passive surveillance system is increasing year by year, which can meet the requirements for job. The classification and diagnostic criteria of the serious vaccine reaction need to be established.

Objective To explore the association of methyl-CpG-binding protein2 (MeCP2) polymorphisms with female schizophrenia in Chinese Han population.Methods By using the technology based on microarray Chip,gene polymorphism analysis of 4 locus located in the gene MeCP2 was performed in 126 schizophrenia patients fulfilled with DSM-Ⅳ-TR criteria for schizophrenia and in 144 healthy controls.Chi square test was used to compare the inter-group differences of genotypic and allelic distribution.Haplotype case-control association analysis based on linkage disequilibrium was conducted using SNP stats online software after the data was screened.The significance of results was corrected by permutation test.Results To the point of Locus rs1616369 which located in Gene MeCP2,the distribution of the genotype G/A between two groups(24.8％ vs 34.3％) reached significance (P＜0.05) ; rs3027933,genotype G/C(25.6％ vs 34.8％),P＜0.05 ; rs17435,genotype T/A(25.6％ vs 35.5％),P ＜ 0.05 ; rs2239464,genotype C/A (58.5％ vs 71.8％),P＜ 0.05.The distribution prevalence of Haplotype GCCA was 0.1581 in case group,and 0.2389 in control group,reached significant difference(P＜0.05).Conclusion As to female MeCP2 gene,the genotype on the four locations might associate with the onset of schizophrenia,MeCP2 might be susceptibility gene of female schizophrenia.The Haplotype GCCA maybe the protective factor.

Objective　To evaluate the therapeutic effect of rapid angulation rotation traction for lumbar intervertebral disc protrusion. Methods　A total of 88 patients (66 male and 22 female;age: 18-65), with a history of 2 days to 10 years were analyzed. Among them 20 cases were central protrusion 68 cases were lateral protrusion. Traction range: 60-65 mm, angle: 20°-25°, rotation degree: 20°-25°, traction time: 3 s-1 min. The process of treatment was computer designed. The traction was then 1 to 3 times, with a interval of 4-7 days between two treatments. Results　The effective rate was 96% for the case with history <1 month 96% and 85% for cases with history >1 month (P<0.01). The effective rate was 62% for central protrusion, and 87% for lateral protrusion respectively. χ2 test showed the difference was not significant. Conclusion　The rapid angulation rotation is an effective treatment for lumbar inter-vertebral disc protrusion and this non operative method should be used as early as possible.