Double-hit lymphoma (DHL) is a kind of disease with features intermediated between diffuse large B-cell lymphoma (DLBCL) and Burkitt lymphoma (BL),usually accompanied by myc gene breakpoint with other recurrent chromosomal breakpoint and mainly involving myc and bcl-2 translocation.The presentation of this disease is characterized by elevated serum lactate dehydrogenase levels,B symptoms,bone marrow involvement,advanced stage disease,extranodal involvement,and central nervous system involvement.Because its features are similar with DLBCL and BL,it's difficult to distinguish them by pathological diagnosis.At present,the differential diagnosis is mainly by chromosomal analysis (G-banding),FISH and immunohistochemistry.This subtype received a poor response to conventional chemotherapy for DLBCL,and has a poor prognosis.The median survival time is only 0.2-1.5 years.Currently,the main regimens include RCHOP,RICE,RCVD,methotrexate prophylaxis for central nervous system involvement,high-dose chemotherapy and bone marrow transplantation.

Objective To evaluate the reasons for intrathecal administration of vincristine,the characteristics of patients with nerve damage,and the effective rescue measures and outcome prognosis.Methods Electronic literature databases,English and Chinese Paper Documents databases,and Network Engine were searched for Case Reports of inadvertent intrathecal injection of vincristine.SPSS 15.0 was used for statistical analysis.Results Analysis of 32 cases report showed that the intrathecal injection of vincristine in patients had adverse outcome.Of these cases 25 led to death,and survival of cases was associated with lower limb paralysis or quadriplegia.Fatalities appeared due to a progressively ascending myeloencephalopathy.Early recognition and immediate treatment with CSF drainage appeared to be the only intervention that had improved patients' survival.The survival curves of different surgical treatments,whether or not to use folic acid treatment,whether or not to use glutamate treatment,whether or not to use pyridoxinetreatment,was a significant difference.Conclusions Timely ventriculo-lumbar washout,using folic acid treatment and glutamate treatment appear critical.It is difficult to obtain satisfactory clinical outcome,so the key lies in the implementation of effective preventive measures.

Objective To understand the current status,type,and effect of training programs conducted by Health Bureau and CDC in China.Methods One person of each province was selected from China field epidemiology training network and designated as contact person who was responsible for collecting information of field practical training lasting for at least 6 months for staff of public health emergency and infectious disease control in each province from October 2001 to October 2010.Questionnaire including basic condition,organization and management,training design,faculty condition,trainee condition and training outputs was designed and filled in by contact person.Results There were 35 training programs covering over 9 provinces in China.The first province and city FETP started in 2004,including Guangdong FETP,Zhejiang FETP,Hangzhou FETP,Ningbo FETP and Guizhou FETP.Thirty-five training programs had 355 mentors,22(6％)were CFETP graduates and 57 (16％)were local FETP graduates.All program funds were paid by local governments.The training programs included two parts,theoretical lectures and field practice,which occupying 10％-20％ and 80％-90％ of the whole training time,respectively.Among 6 evaluative items including emergency investigation,surveillance analysis,surveillance evaluation,planned investigation,investigation report and paper publication,most programs(50％-94％) had less than average one person per time.Conclusions Field epidemiology training program after several years of development in china achieves the certain scale.Some provincial programs are successful,but the effect and quality of training programs in different areas are uneven.We suggest optimizing of field epidemiology training resources and further expanding China field epidemiology training network.

Objective: To study the relationship between the expressions of Bel -2, Ki -67, C -myc and prognosis in patients given chemotherapy for malignant lymphoma (ML). Methods: The expressions of Bel-2, Ki-67 and C-myc were measured by immunohistochemistry (IHC) in paraffin-embedded samples of 65 ML cases who received chemotherapy. The survival analysis was done by the Kaplan -Meier method and Log -rank test. Results: For patients with non -Hodgkin lymphoma (NHL) who received chemotherapy, the 3-year disease free survival (DFS) was 22.22% in Bcl-2(+) group compared with that of 55.56% in Bcl-2 (-) group. The difference of DFS was significant between the two groups. Meanwhile, for ML patients, the 3-year DFS was 37.50% in Ki-67(+) group, and 61.54% in Ki-67(-) group respectively(P < 0.05). Conclusion: The expressions of Bcl-2 and Ki-67 were closely related with relapse after chemotherapy in patients with ML. They were useful molecular makers for predicting the prognosis in patients with ML after chemotherapy.

Objective:To evaluate the implementation of national continuing medical education (CME) base programme about infectious disease control and prevention during 2013-2020, so as to improve the quality management of CME.Methods:According to data from national CME system, Excel and SPSS 27.0 were used to analyze project hosting days, places, teachers, students, project directors and training effect. The counting data were expressed by frequency and percentage [cases (%)], chi-square test was used to make comparison between groups, Mantel-Haenszel chi-square test was used for trend test, and the significance test level of the difference was α = 0.05. Results:A total of 116 projects were conducted from 2013 to 2020, with execution rate of 87.9%(116/132). Most hosting days were 2 to 3 days [57.8% (67/116)]. The majority [65.2% (5 785/8 871)] of trainees had junior and intermediate technical titles. As for trainers, trainers with senior technical titles accounted for 87.6% (758/865), and those with intermediate titles accounted for 12.4% (107/865). Mantel-Haenszel chi-square test showed that there was a linear relationship between the proportion of technical titles and the year ( χ2趋势 = 4.97, P趋势 = 0.026). Project directors almost had senior professional title, and nearly one third of them had the experience of undertaking three or more base projects within 8 years. The top three training modules were parasitic diseases prevention and control, AIDS prevention and control, and viral diseases prevention and control. Trainees were highly satisfied with the training contents. Conclusion:The implementation of the infectious disease prevention and control base programme went well in general from 2013 to 2020. In the future, it’s needed to be demand-oriented, rationally design training programs, enhance the evaluation of training effects, strengthen the construction of public health core capacity, and adopt a strategy of brand development in the process of the infectious disease prevention and control base programme.

China ; Humans ; Meningococcal Infections ; Serogroup

Caliciviridae Infections ; prevention & control ; therapy ; Disease Outbreaks ; prevention & control ; Humans ; Norovirus ; Practice Guidelines as Topic

Objective: To assess the vaccine loss related to the Expanded Program on Immunization (EPI) in Xinjiang Uygur Autonomous Region so as to improve the management of vaccines. Methods: A total of 135 vaccination clinics were randomly selected, using a stratified cluster sampling method. In each clinic, data on vaccination was collected between 2016 and 2017, including the number of doses in routine immunization program and supplementary immunization activities (i.e., vaccine doses in vials that were opened for use) on polio vaccine, number of doses administered to children and the number of doses discarded (e.g., expired vaccine or broken vials that had not been opened for use), etc. Coefficient on vaccine loss was calculated with the following equation: vaccine loss coefficient=(number of vaccine doses used)/(number of vaccine doses administered). The vaccine discard rate appeared as: number of vaccine doses discarded)/number of vaccine doses used. Results: For vaccines in single-dose vials [diphtheria-tetanus-pertussis vaccine (DTaP) and trivalent oral polio virus vaccine (tOPV)], the loss coefficients appeared as 1.00 and 1.02, respectively. For vaccines in multi-dose vials [bivalent oral polio vaccine (bOPV), group A meningococcal polysaccharide vaccine (MPV-A), diphtheria-tetanus combined vaccine (DT) and bacilli Calmette-Guérin (BCG) vaccine], the loss coefficients were 1.58, 1.67, 1.68, and 3.02, respectively. The coefficients of EPI vaccine loss in urban, rural, and pastoral area vaccination clinics ranged between 1.00-2.84, 1.00-3.71, and 1.00-2.27, respectively. Loss coefficients ranged between 1.00-3.00, 1.00- 4.41, and 1.00-1.94, respectively, were seen in township clinics, village clinics, and decentralized vaccination clinics. Coefficients on larger vaccine loss were associated with longer intervals between clinic sessions and with fewer vaccinations administrations per day. Conclusions In Xinjiang, coefficients on the loss of multi-dose EPI vaccines were high. The coefficients on loss were different from the levels of region and types of clinics, and time interval between clinic sessions. Programs on refining the management and distribution of EPI vaccines, to minimize the vaccine loss were recommended.

OBJECTIVETo analyze causes of growing hepatitis E (HE) cases reported in Guizhou province, and probe into existing problems faced by medical institutions in diagnosis of clinical and laboratory-confirmed cases, for the purpose of improving the quality of HE surveillance system.

METHODSSix hospitals reporting greater HE cases from 2007 to 2011 were pinpointed, whose reported cases rose suddenly in 2011. Such cases were investigated by means of impatient medical record review, results of laboratory test and clinician interview.

RESULTS136 of the 354 reported HE cases investigated were found compliant with the diagnostic criteria of HE with an accordance rate of 38.42%. Difference of the HE diagnostic accordance rate among individual years, hospitals and reporting departments was statistically significant. Such rate of hospital reports was found to be the lowest in 2011, ranging from 0 to 18.18% respectively; HE cases reported by non-infectious departments accounted for 61.30% of total cases reported, with its accordance rate considerably below the infectious departments (8.29%). HE positive cases and HE positive rate in 2011 were significantly higher than that of preceding years.

CONCLUSIONSuch increase of reported HE cases in 2011 in the province was mostly attributable to more HE laboratory tests made by the hospitals, yet the accordance rates were lower than satisfactory. In this regard, the medical institutions in question were advised to enhance their competency training for HE diagnosis and case report quality.

China ; epidemiology ; Hepatitis E ; diagnosis ; epidemiology ; Hospitals ; Humans ; Laboratories ; Research Design