Parasitological and dissection methods were used to confirm Echinococcus infection and echinococcosis in animals,and to understand the epidemiological situation in final and intermediate animal hosts in Qinghai Province. Three Echinococcus species were found in the Province including E. granulosus,E. multilocularis and E. shiquicus. The prevalence of hydatid disease showed a tendency of increase with an average rate of over 50% in yaks and sheep. Higher prevalence in wild animals as intermediate host was found in the southern plateau,while that in final hosts such as dogs and wolves,the prevalence was higher in the area of Qilian mountain. There is a complex chain of life cycle of the parasites among animals,which poses a threat to the health of human population. Effective measures to control the disease in animals are urgently needed.

Objective To compare the speech recognition by severe - to - profound hearing - impaired children using digital hearing aids and microlink FM system.Methods Hearing - impaired children were given respectively bilateral 100% omnidirection digital hearing aids, bilateral 100% omnidirection digital hearing aids and lateral FM system, bilateral 100% omnidirection digital hearing aids and bilateral FM system in noise and quiet environment. Speech recognition of these children was tested using different intensity.Results There was significant difference between children using microlink FM system and none FM system ( P

Objective:To study the use of digital subtraction angiography (DSA) guided transnasal ileus tube placement in management of abdominal compartment syndrome (ACS) after liver transplantation.Methods:From January 2015 to December 2019, a total of 30 patients who developed ACS after liver transplantation who were admitted to the Transplantation Intensive Care Unit of Tianjin First Central Hospital were retrospectively studied. According to the way of decompression, these patients were divided into the study group and the control group. Patients in the control group were treated with conventional abdominal decompression, while patients in the study group were treated with DSA guided transnasal ileus tube placement based on management principles developed in conventional abdominal decompression. Changes in intra-abdominal pressure, treatment efficacy rates and liver functions were monitored in the two groups up to 7 days after abdominal decompression.Results:There were 23 males and 7 females, aged (53.4±11.6) years. After treatment, the IAP, portal venous blood flow velocity, bile drainage volume, ALT and AST in the study group were significantly better when compared with the findings before treatment: [IAP: (7.13±3.87) vs (22.73±2.09) mmHg, portal vein blood flow velocity: (34.76±10.31) vs (21.45±6.47) cm/s, bile drainage volume: (198.43±19.94) vs (80.72±9.52) ml/d, ALT: (158.92±67.56) vs (278.73±99.17) U/L, AST: (79.36±15.63) vs (196.71±89.05) U/L], ( P<0.05). After treatment, when compared with the control group, the IAP, portal vein blood flow velocity, bile drainage and TBil in the study group were significantly better [IAP: (7.13±3.87) vs (13.47±6.19) mmHg, portal vein blood flow velocity: (34.76±10.31) vs (24.98±8.54) cm/s, bile drainage: (198.43±19.94) vs (108.73±21.30) ml/d, TBil: (258.85±91.95) vs (343.69±89.45) μmol/L], ( P<0.05). In the control group, the IAP significantly decreased on the fourth day after treatment, ( P<0.05); compared with the significant difference in the study group on the second day after treatment ( P<0.05). After 7 days of treatment, the efficacy rate of the control group was 46.7% (7/15), compared to 86.7% (13/15) in the study group. The difference between the two groups was significant (χ 2=5.400, P<0.05). Conclusion:DSA guided transnasal ileus tube placement for treatment of abdominal compartment syndrome after liver transplantation resulted in a better treatment efficacy rate than conventional treatment.

Objective To assess the efficacy of different internal fixations of palatal fracture.Methods Seventy-four patients with palatal fracture admitted between October 2007 and October 2013 were reviewed retrospectively.Through out-patient follow-up,postoperative occlusion and palatal complications were examined and fracture healing was evaluated using CT scan.Results Palatal type Ⅰ-Vfractures involved in 8 patients (11％),14 patients (19％),26 (35％),12 patients (16％),6 patients (8％),and 8 patients (11％) respectively.Forty-three patients were available to follow-up,including 31 patients with good or acceptable occlusion.All wounds healed without palate associated infections,plate exposure or oronasal fistula.Of the 27 patients classified as type Ⅱ,Ⅲ and V sagittal palatal fractures,both nasomaxillary and zygomatico-maxillary struts fixation (n =17) and isolated zygomatico-maxillary struts fixation (n =10) had insignificant differences in success rate as to occlusion assessment (82％ vs 80％,P ＞0.05).Whereas compared with isolated vertical buttress fixation (n =15),additional immobilization of horizontal alveolar buttresses (n =12) had significantly higher success rate (100％ vs 67％,P ＜ 0.05).Conclusion Complete rigid fixation at early stage,including vertical buttress fixation,in particular the zygomatico-maxillary struts,and horizontal alveolar buttress fixation can achieve satisfactory outcome.

[Objective]To explore the possible effects of the apolipoprotein A5(APOA5)gene rs2075291 and rs3135507 poly-morphisms on plasma lipid levels and the severity of coronary stenosis in patients with coronary heart disease(CHD)in Chinese Han people.[Methods]Polymerase chain reaction-restriction fragment length polymorphism method(PCR-RFLP)was used to identify the genotypes of the rs2075291 or rs3135507 polymorphism for the 324 patients with CHD and the 152 CHD-free controls,and the lipid levels between the genotypes were compared. The severity of coronary stenosis was assessed by the Gensini scoring system ,and the associations of the rs2075291 and rs3135507 polymorphisms as well as other factors with the Gensini scores were analyzed by mul-tivariate linear regression.[Results]The CHD patients had higher prevalence of hypertension ,and higher levels of triglycerides (TG),total cholesterol(TC),apolipoprotein B100(APOB100),lipoprotein(a)[Lp(a)],TG/high-density lipoprotein cholesterol (HDL-C),TC/HDL-C,low-density lipoprotein cholesterol(LDL-C)/HDL-C and APOB100/apolipoprotein AI(APOAI),and low-er levels of HDL-C and APOAI than the controls(P < 0.05 for all). The rs2075291 or rs3135507 allele and genotype frequencies were similar between the CHD group and the control group. The subjects with the rs2075291 GT genotype had higher levels of TG and TG/HDL-C,and lower levels of HDL-C than the subjects with the GG genotype in controls(P < 0.05 for all). In CHD patients, those with the rs2075291 GT genotype had higher levels of TG/HDL-C and TC/HDL-C than the patients with the GG genotype(P<0.05 for both). Regarding the rs3135507 polymorphism,the A allele carriers had lower level of APOB100 than the patients with the GG genotype(P<0.05). No significant association between the rs2075291 or rs3135507 polymorphism and the Gensini scores were detected by multivariate linear regression(P > 0.05).[Conclusion]The APOA5 rs2075291 polymorphism had significant effects on plasma lipid levels,but no effects on the occurrence and development of CHD. Further multicenter case-control studies with large samples are needed to validate these findings.

Objective To investigate the predictive value of serum albumin level in patients with severe sepsis .Methods One hundred and twenty cases of patients with severe sepsis admitted to Qilu Hospital ,Shandong University from April 2014 to October 2014 were prospectively enrolled .The serum albumin levels were measured and the laboratory and clinical data were collected at the onset of severe sepsis .Acute Physiology and Chronic Health Evaluation (APACHE ) Ⅱ score and Sequential Organ Failure Assessment (SOFA) score were calculated .Patients were grouped according to the prognosis by day 28 or stratified by albumin level . Prognostic factors were analyzed by multivariable Logistic regression .Results A total of 120 patients were enrolled with mean age of (57 .6 ± 18 .3) years ,among which 75 were male .The mean duration of hospitalization was (20 .1 ± 17 .8) days .The 28‐day mortality was 25 .8% (31/120) .The most common infection sources were respiratory tract (56 .7% ) ,abdominal/pelvis (19 .2% ) and bloodstream (9 .2% ) .Serum albumin level in survival group was significantly higher than that in death group ([32 .1 ± 6 .4] g/L vs [27 .5 ± 5 .5] g/L ,t=3 .562 ,P=0 .001) .Compared with survival group ,the patients in death group had higher APACHE Ⅱ and SOFA scores (22 .0 ± 9 .1 vs 13 .4 ± 7 .2;7 .1 ± 3 .7 vs 4 .3 ± 3 .5 ;t= —5 .372 and —3 .690 ,both P<0 .05) .Along with the decrease of serum albumin level ,the incidence of bloodstream infection ,solid tumor ,septic shock ,acute kidney injury and liver injury significantly increased .Patients with lower albumin level had significantly higher SOFA scores and 28‐day mortality (all P<0 .05) .Multivariable regression analysis showed that albumin level lower than 28 g/L and higher APACHE Ⅱ score were independent risk factors for mortality (OR=4 .156 ,95% CI:1 .198—14 .415 ;OR=1 .121 ,95% CI:1 .039—1 .210;both P<0 .05) .Conclusions A significantly lowered serum albumin level would increase the risk of mortality in patients with severe sepsis .The combination of albumin level and APAHCE Ⅱ score might be beneficial to evaluate the prognosis .

Thyroid-associated ophthalmopathy(TAO)is a multifactorial-mediated autoimmune orbital disease with the highest incidence of orbital disease in adults.Due to the complex clinical manifestations and prolonged course,TAO seriously affect the physical and mental health of patients.The pathogenesis of TAO has not been fully elucidated and the treatment lacks specificity.Therefore,in-depth research on the pathogenesis of TAO is to find effective treatments.In recent years,studies have suggested that there is gut microbiota disorder in TAO,and the risk factors of TAO can promote gut microbiota disorder.Disordered gut microbiota can participate in the occurrence and development of TAO via influencing T cell differentiation,mimicking autoantigens,and influencing host non-coding RNA expression.Modulating the gut microbiota also has therapeutic effects on TAO and is a promising therapeutic approach.

Objective:To establish a tissue based assay and in-house cell based assay combined system to screen anti-metabotropic glutamate receptor 1 antibodies in a case of previously idiopathic encephalitis with prominent cerebellar ataxia and make the final diagnosis, and to summarize and analyze clinical characteristics and treatment response of the disease.Methods:A middle-aged woman admitted to Department of Neurology, People's Liberation Army General Hospical Accredited to the Sixth Medical Center in January 9, 2020, who presented with acute dizziness, unsteady gait and developed head titubation, repeated language and calculation impairment was reported. The patient′s serum and cerebrospinal fluid were firstly tested with commercial kits for conventional neural antibodies.Then samples were incubated with rat hippocampus, cerebellum and human embryonic kidney 293 cells transfected with metabotropic glutamate receptor 1 plasmid to screen extra antibodies by indirect immunofluorescence method. By reviewing literature, physical functions of metabotropic glutamate receptor 1 and clinical features of anti-metabotropic glutamate receptor 1 antibodies associated encephalitis were summarized.Results:The patient was neural antibodies negative with commercial kits. Further investigation showed neuropil staining pattern after her serum and cerebral spinal fluid were incubated with rat brain slices. The characteristic "Medusa head" staining pattern of Purkinje cells in cerebellum was also noticed. Along with her previous head titubation symptom, an in-house cell based assay using human embryonic kidney 293 cells transfected with metabotropic glutamate receptor 1 plasmid was developed and proved the existence of anti-metabotropic glutamate receptor 1 antibodies. The final diagnosis of anti-metabotropic glutamate receptor 1 antibodies associated encephalitis was made. One-year follow-up revealed her serum antibodies titers dramatically decreased and cerebrospinal fluid antibodies were negative after using steroids and intravenous immunoglobulin, but still left prominent cerebellum atrophy and severe ataxia.Conclusions:Anti-metabotropic glutamate receptor 1 antibodies may cause acute encephalitis. Cerebellar ataxia and head titubation are characteristic symptoms of metabotropic glutamate receptor 1 autoimmunity. The response to immunotherapies is limited and patients may have severe neurological deficits.

Primary liver cancer is one of the common tumors in China， which seriously endangers human health. With the advancement in medical science and technology， some achievements have been made in the clinical treatment of liver cancer， but there is an urgent need to find a safe and effective solution for patients with advanced liver cancer. As a unique therapy in China， traditional Chinese medicine （TCM） has the characteristics of multiple targets and multiple pathways and plays a certain role in the treatment of malignancies. The present study aimed to clarify the mechanism of action of "dispelling pathogens" in the treatment of liver cancer through literature research. In TCM etiology and pathogenesis， deficient healthy Qi and exuberance of pathogenic Qi， such as phlegm， blood stasis， and toxins， lead to the development of liver cancer. The treatment should follow the principles of reinforcing healthy Qi and eliminating pathogens. It has been generally believed that tumor cell is the "pathogenic factor" and the immune function serves as the "healthy Qi". In the treatment of malignancies and the regulation of the immune function of patients， it is often advocated to reinforce healthy Qi to eliminate the accumulation. With the continuous updating of knowledge on tumors and tumor microenvironment， it is also recognized that there are "healthy Qi" and "pathogenic Qi" in the immune microenvironment of tumors. For example， the immune cells and immune factors that inhibit tumor growth can be classified as "healthy Qi" with TCM attributes， while those promoting tumor growth can be classified as "pathogenic Qi". Additionally， as proved by clinical data and experimental research， the elimination methods represented by "activating blood， resolving phlegm， and removing toxins" in the treatment of liver cancer can combat tumor cells and also regulate the "healthy Qi" and "pathogenic Qi" in the immune microenvironment of liver cancer to achieve the balance of Yin and Yang. Based on this， the present study reviewed from the TCM theory and the mechanisms of western medicine to provide theoretical support for the TCM treatment of malignancies by elimination methods and some ideas for TCM in tumor resistance.

To improve the evaluation indicators of medical quality in TCM hospitals; To realize objective, fair, and accurate evaluation of the quality of TCM. Based on relevant literature on medical quality in traditional Chinese medicine hospitals research and thematic group discussions, 21 evaluation indicators for TCM characteristics were formed. A questionnaire survey was conducted among 40 experts, and 37 were effectively collected, with a positive coefficient of 92.50%. After two rounds of expert consultation, the evaluation indicators were determined to be: the intensity of outpatient use of TCM decoction pieces (utilization rate of TCM decoction pieces, prescription number of TCM decoction pieces, dosage of TCM decoction pieces, and service price of TCM decoction pieces), the intensity of the use of TCM technology (proportion of TCM technology, number of TCM projects, cost of TCM technology, and course of treatment). Case studies were conducted on relevant data from 10 departments using the operational decision support system (BI) platform of Yueyang Integrated Traditional Chinese and Western Medicine Hospital affiliated with Shanghai University of Traditional Chinese Medicine to verify the rationality of indicators. The 10 departments were analyzed and evaluated, and the results obtained were basically consistent with the actual medical quality situation of the hospital. The indicators used in this study can reflect the actual medical quality situation, and have a certain degree of scientificity, feasibility, and applicability, providing reference for improving the medical quality evaluation indicators of TCM hospitals.