To investigate the infection of Yersinia enterocolitica in Dengfeng City ,the strains were isolated from livestock and poultry .The strains were detected with biochemiological methods ,serological methods ,and virulence genes were detected with PCR .A total of 105 strains of Yersinia enterocolitica were classified from 1 285 stool samples ,the total isolation rate was 8 .17% .Among the total isolated strains ,17 strains were classified from dogs with a rate of 17 .35% and 35 strains from pigs with 13 .62% .Twelve strains were O ∶3 serotype (13 .48% ) ,12 strains were O ∶5(13 .48% ) ,and 14 strains were O ∶8 (15 .73% ) .Ail+ ,ystA+ ,yadA+ and virF+ accounted for 12 .36% ,and ystB+ accounted for 42 .70% .In conclusion ,the pigs and dogs were important animal hosts ,which may play the major role in humans'infection .

Objective To investigate the infectious status,etiological spectrum and epidemiological characteristics of rotavirus (group A/B/C),calicivirus (novovirus Ⅰ/Ⅱ,sapovirus),astrovirus and enteric adenovirus in diarrhea cases below 5 years old from 2008 to 2015 in Henan provinces.Methods Totally 2541 stool samples were collected from cases below 5 years old in four sentinel hospitals.All stool specimens were tested for group A rotavirus by double antibody sandwich ELISA method.G/P genotyping of group A rotavirus was determined by nested multiplex PCR.Viral RNA was extracted from all samples and rotavirus (group B/C),calicivirus,astrovirus and enteric adenovirus were detected by two-step reverse transcription-polymerase chain reation (RT-PCR)/PCR.Results One thousand four hundred and twenty-one out of 2 541 samples were positive with a total positive rate of 55 .9%,among which,102 were mixed infection.The isolation rate of rotavirus was 36.0% (914 samples)(group A:785 cases,group B:36 cases,group C:93 cases),calicivirus was 12.1 % (308 samples)(novovirus Ⅰ:64 cases,novovirusⅡ:193 cases,sapovirus:51 cases),astrovirus was 5 .9% (151 samples),enteric adenovirus was 1 .9%(48 samples).The group A rotavirus gene type combinations were composed mainly of G9P[8],G2P[4], G3P[8 ],G1P [8 ]and most cases were identified from September to November and March to May. Novovirus Ⅱ was predominant in calicivirus and most cases were identifed between March and May. Rotavirus or calicivirus infection was mainly among children aged 4—12 months or 3—5 years, respectively.Clinical manifestations included fever,diarrhea,vomiting,dehydration.Gender and region distributions differed according to the types of pathogen.Conclusions Group A rotavirus and novovirus Ⅱare the major viral pathogen in diarrhea cases younger than 5 years old in Henan province.Different viral infections exhibit extinct epidemiologic and clinical characteristics.

Objective Through studying the relationship between different concentrations of arsenic in drinking water and ECG changes,to investigate the effects of arsenic on human cardiovascular system.Methods During 2008-2013,people that over 20 years old and over 10 years of drinking arsenic water were investigated in 15 villages of Shanxi Province and Inner Mongolia according to the historical data of endemic arsenic poisoning through drinking water,who were divided into control group (＜ 0.01 mg/L),low arsenic group (0.01-＜ 0.05 mg/L),medium arsenic group (0.05-＜ 0.10 mg/L) and high arsenic group (≥0.10 mg/L) according to the concentration of water arsenic.Arsenic concentrations in drinking water samples were detected by the method of hydride generation atomic fluorescence spectrometry.ECG-site inspections were finished to record 12-lead ECG.The effect of different concentrations of arsenic in drinking water on ECG was studied.Results ECG of 1341 people were surveyed,and abnormal rate was 11.56％ (155/1 341),including abnormal rate of control group,low arsenic group,medium arsenic group and high arsenic group which was 5.7％ (9/158),12.85％ (59/459),12.02％ (28/233),and 12.02％ (59/491),respectively.The abnormal rate of control group was lower than that of low arsenic group,medium arsenic group and high arsenic group (x2 =6.141,4.391,5.090,all P ＜ 0.05).ECG changes were characterized by cardiac arrhythmias and ST-T changes.A variety of arrhythmias abnormal rate of control group [0(0/158)] was lower than that of low arsenic group,medium arsenic group and high arsenic group [4.58％ (21/459),3.86％ (9/233),3.46％ (17/491); x2 =7.483,6.247,5.618,all P ＜ 0.05].In addition,there were significant differences among the four groups in the rates of right ventricular enlargement and myocardial ischemia (x2 =9.525,9.848,all P ＜ 0.05).Conclusions ECG changes of the residents in the areas of water-borne-endemic arsenic poisoning are characterized by cardiac arrhythmias and ST-T changes.Water arsenic concentration exceeding 0.01 mg/L could significantly increase the ECG abnormal rate,indicating that arsenic in drinking water has a certain effect on heart tissue.

Objective To explore the association between the C46T polymorphism of coagulation factor Ⅻ (FⅫ) gene and the involvement of FⅫ activity (FⅫ:C) in patients with unexplained recurrent spontaneous abortion (URSA), and to elucidate its role in the pathogenesis of URSA. Methods This study included 203 patients with URSA (URSA group) and 171 healthy women with at least one child and no history of infertility or miscarriage (control group) in the southern area of Zhejiang Province. The C 46T polymorphism of the FⅫ gene was analyzed with matrix-assisted laser desorption/ionization time of flight-mass spectrometry (MALDI-TOF-MS) in all subjects. The values of prothrombin time, activated partial thromboplastin time (APTT), fibrinogen, FⅫ:C and other coagulant parameters were determined. The frequency distribution of the wild-type (CC), heterozygote (CT), homozygote (TT) genotypes and C and T alleles were compared between the patients and controls. A comprehensive analysis of association was conducted between C46T genotypes and the FⅫ:C levels in URSA patients. Results The CC, CT, TT genotypes of the FⅫgene were observed in 7 (3.4%, 7/203), 83 (40.9%, 83/203) and 113 (55.7%, 113/203) patients with URSA versus 7 (4.1%, 7/171), 46 (26.9%, 46/171) and 118 (69.0%, 118/171) controls. The frequency of CT in the patients with URSA was significantly higher than that in controls, but the frequency of TT in the patients was lower than that in controls (χ2=7.939, OR=1.884, 95%CI:1.210-2.935, P<0.05). The frequencies of allele C and allele T were observed in 97 (23.9%, 97/406) and 309 (76.1%, 309/406) patients with URSA versus 60 (17.5%, 60/342) and 282 (82.5%, 282/342) controls. The distribution frequency of allele T in URSA group was lower than that in control group (χ2=4.510, OR=1.475, 95%CI:1.029-2.115, P<0.05). The FⅫ:C levels in the patients were (102±13)%in CC genotype, (78±11)%in CT genotype and (59± 9)%in TT genotype, respectively. The differences of the FⅫ:C levels between the CC and CT, CT and TT, CC and TT genotypes in the patients were significant (all P<0.05). Conclusions The low level of FⅫ:C maybe result from the T allele of the FⅫgene in URSA patients. The CT genotype might be relative to the pathogenesis of URSA in a Chinese Han female population from the southern area of Zhejiang province.

Objective To sum up the experience of decompressive surgery for the acute massive hemispheric infarction to determine its beneficial effects.MethodsRetrospectively study 6 patients receiving early decompressive craniotomy because of deterioration after infarction.Results 5 patients survived,4 of them recovered to the good level of daily activity (Barthel index ≥60) one year after rehabilitation.One senile patient died of pulmonary infection.ConclusionThe decompressive surgery is an effective method on the survival and functionary recovery for the patients with deteriorating massive cerebral infarction.

China ; Electrophoresis, Gel, Pulsed-Field ; Escherichia coli O157 ; classification ; genetics ; Genes, Bacterial ; Humans ; Molecular Typing ; Virulence

Objective:To investigate the feasibility and safety of a new method of natural orifice transluminal endoscopic surgery(NOTES) -totally transtracheal endoscopic thyroidectomy(TTET) .Methods:Three miniature swines and 6 beagle dogs were underwent TTET.Under general anesthesia,special designed endotracheal tube with 2-channel was used and endoscope and instruments were inserted through the respective channel.Incision of tracheal anterior wall was accomplished and partial or subtotal thyroidectomy was performed.Finally,the defects in the trachea were sutured with ENDO STITCH instrument.Results:Partial thyroidectomy was successfully accomplished on 3 pigs and subtotal thyroidectomy was done on 6 dogs.No serious complications such as anoxia,asphyxia,airway obstruction and death occurred during the operation.Animals were sacrificed 2h after the procedure and incision of trachea was found to be closely sutured.There were no subcutaneous emphysema and haematoma formation.Conclusion:Preliminary experimental results showed the feasibility and safety of TTET.Transtracheal access maintains the integrity of cervical tissues and achieves an optimal cosmetic outcome.TTET may open up a new field of NOTES on thyroid surgery.

Objective: To investigate the infectious status, gene type transition and epidemiological features of rotavirus A isolated from infants and children (<59 months-of-age) in sentinel hospitals from 2008 to 2015 in Henan province, China. Methods: In total, 2 541 stool samples (each 3- 5 ml) were collected from infants and children aged less than five years in two sentinel hospitals and group A rotavirus was detected by a double antibody sandwich ELISA. Viral RNA was extracted from positive samples and G/P gene typing was performed using a two-step nested multiplex RT-PCR. Epidemiological information (including demographic information such as age, sex and clinical symptoms) was also collected from the patients and analyzed. Results: Group A rotavirus was detected in 30.9% (785/2 541) of diarrhea samples from children. The detection rate was higher in October (54.8%, 345/629) and lower in July (5%, 5/101) each year from 2008 to 2015. The group A rotavirus infection rate was higher in boys (30.6%, 451/1 476) than in girls (31.4%, 334/1 065) (χ²=0.18, P=0.664). Infection mainly occurred in 4-12 months old patients (61.3%, 481/785) (χ²=196.69, P<0.001), and the infection rate was lower in cities (26%, 258/992) compared with rural areas (34.0%, 527/1 549) (χ²=18.19, P<0.001). G typing of 785 strains of group A rotavirus revealed the following types: G1 (13.5%, 106 strains), G2 (11.1%, 87 strains), G3 (29.7%, 233 strains), and G9 (57.5%, 451 strains); P typing revealed the predominance of P[4] (11.3%, 89 strains) and P[8] (84.7%, 665 strains); gene type combinations comprised mainly G9P[8], G2P[4], G3P[8], G1P[8], respectively accounted for 52.9% (415), 9.7% (76), 17.3% (136), 11.3% (89). Gene type combinations G1 [8] and G3P[8] have been decreasing in prevalence since 2008 and G9P[8] has become the dominant gene type of group A rotavirus in Henan province. Among the group A rotavirus infection samples, the male:female infection ratio was 1.4∶1 (451/334), with no significant difference in the infection rate (χ²=0.18, P=0.664); the infection rate was higher in 4- 12 months old patients (61.3%, 481/785), with a significant difference detected between age groups (χ²=196.69, P<0.001). The rate of detection was lower in cities (26.0%, 258/992) than in rural areas (34.0%, 527/1 549) (χ²=18.19, P<0.001). Clinical analysis revealed a body temperature of below 37 degrees in 75.7% of positive cases (594 patients), 37.0- 37.5 degrees in 17.2% of cases (135 patients), 37.6-38.0 degrees in 2.0% of cases (16 patients), and above 38 degrees in 5.1% of cases (40 patients), with most cases showing no fever or a mild fever. The frequency of episodes of diarrhea among the patients was 0- 3 times (21.1%, 166 cases), 4- 6 times (65.6%, 515 cases), 7- 9 times (8.0%, 63 cases), or 10- 15 times (5.2%, 41 cases), mainly showing mild and moderate diarrhea. Vomiting also varied in frequency among the patients from no vomiting (86.9%, 682 cases), 1-2 times (11.8%, 92 cases), 3 times (6.0%, 47 cases), and more than 3 times (0.4%, 3 cases). The occurrence of dehydration varied from no dehydration (86.9%, 682 cases), mild dehydration of 1%- 5% (12.1%, 95 cases), to severe dehydration of ≥5% (1.0%, 8 cases). Conclusion A higher infection rate of group A rotavirus was detected in children younger than five years of age with acute diarrhea in sentinel hospitals in Henan province, including part-mixed infection cases. A predominance of cases was detected in the autumn, and secondly the spring of each year. Gene type G9P[8] was most frequently isolated. The majority of patients displayed no fever, vomiting or dehydration. The cases with clinical symptoms of fever, diarrhea, vomiting and dehydration often showed mild disease.

Objective To investigate the antibiotic resistance and pulsed field gel electrophoresis (PFGE) patterns of clinical isolates of Salmonella (S.) typhi and S.paratyphi in Henan province during 2009-2011.Methods According to molecular typing and Salmonella K-B drug susceptibility test method published by international PulseNet bacterial infectious disease monitoring network and USA Clinical and Laboratory Standards Institute (CLSI),the drug susceptibility and PFGE molecule characteristics of 78 S.typhi and S.paratyphi strains isolated from sentinel hospitals in Henan were analyzed.Results The 78 strains orS.typhi and S.paratyphi were resistant to 13 kinds of antibiotics,in which 62 were multidrug resistant (79.5％),4 were resistant to 2-3 kinds of antibiotics (5.1％),41 were resistant to 5-8 kinds of antibiotics (52.6％),14 were resistant to 9-10 kinds of antibiotics (17.9％),3 were resistant to 11-12 kinds of antibiotics (3.8％).The resistant rate to cephalosporins,quinolones and other 3 kinds of antibiotic showed an increase trends.Seventy two strains ofS.typhi and S.paratyphi could be divided 14 molecular patterns by digestion with Xba Ⅰ and PFGE,each pattem contains 1-47 strains which shared the similarity of 66.03％-100.00％.Conclusions The drug resistance of clinical isolates of S.typhi and S.paratyphi was serious in Henan.The PFGE patterns showed diversity,but the predominant patterns could be still found.The PFGE patterns of some strains were associated with their drug resistance.

Objective :To explore influence of ticagrelor on levels of serum high sensitive C reactive protein (hsCRP) and plasma homocysteine (Hcy) in patients with acute coronary syndrome (ACS).Methods :A total of 135 ACS pa‐ tients hospitalized in our department from Jan 2016 to Feb 2017 were selected .Based on routine treatment ,Patients were randomly and equally divided into routine group ,clopidogrel group and ticagrelor group (based on routine treatment respectively received clopidogrel or ticagrelor ) for four weeks .Levels of serum hsCRP and plasma Hcy were measured and compared among all groups before and after treatment .Results :Compared with before treat‐ment ,after four‐week treatment , there were significant reductions in levels of serum hsCRP and plasma Hcy in three groups (P＜0. 05 or ＜0.01).Compared with routine group and clopidogrel group after four‐week treatment , there were significant reductions in levels of serum hsCRP [ (12.95 ± 1.99) mg／L , (8. 56 ± 1. 24) mg／L vs.(4. 47 ± 1. 92) mg／L] and plasma Hcy [ (13.48 ± 2.12) μmol／L , (9.55 ± 0. 94) μmol／L vs.(6. 61 ± 1. 15) μmol／L] in ticagrelor group ( P＜0.05 or ＜0.01).Conclusion :Ticagrelor can significantly reduce levels of serum hsCRP and plasma Hcy while effective antiplatelet therapy ,then significantly inhibit inflammatory response ,improve vascular endothelial function ,contribute to stabilizing atherosclerotic plaques ,improve prognosis in ACS patients .