Objective To analyze the epidemiological characteristics of human brucellosis in Harbin City.Methods Retrospective study was used to collect the information of brucellosis epidemic situation and monitoring data.The information of brucellosis cases was from China disease surveillance information system and from the Harbin surveillance results of brucellosis between 2004 and 2013.According to the results of epidemiological characteristics of brucellosis in Harbin,analysis of regional distribution,time distribution,population distribution and brucellosis serology positive rate were conducted in 18 counties (cities,districts) of Harbin.Data were analyzed using SPSS 13.0 software.Results From 2004 to 2013,2 602 cases of brucellosis were reported.In particular,the largest increase was in 2012,a total of 481 cases was reported,which was 2.11 times that of 2011 (228 cases).The incidence was raised from 2.20/100 000 to 5.98/100 000,and the epidemic range expanded from 15 counties (cities,districts) to 18 counties (cities,districts).Age of onset concentrated in young adults,the 20-59 years old group accounting for 86.47％ (2 250/2 602) of the total incidence.The proportion of male and female was 2.90 ∶ 1.00 (1 936 ∶ 666).The occupation of most new cases was farmers,accounting for 83.55％ (2 174/2 602) of the total incidence.In brucellosis surveillance,4 877 people was undergo serological test,the positive number was 145,and the positive rate was 2.97％.Conclusion Human brucellosis epidemic has an increasing trend in Harbin,age of onset is concentrated in young adults,males are more than females,and the epidemic range expands year by year.

Objective To analyze the survival statistics and perioperative parameters of clinical stage Ⅰ non-small cell lung cancer patients who received systemic or selective mediastinal lymphadenectomy,and explore the value of selective mediastinal lymphadenectomy for clinical stage Ⅰ non-small cell lung cancer.Methods The clinical data of 984 patients with clinical stage Ⅰ non-small cell lung cancer who underwent lobectomy and systemic/selective lymph node dissection in Zhongshan Hospital from January 2005 to December 2010 were analyzed retrospectively.There were 581 males and 403 females with an average age of(59.6 ± 10.2) (24-84) years.786 patients received systemic mediastinal lymphadenectomy,and 198 patients received selective mediastinal lymphadenectomy.Results Average operation time of selective mediastinal lymphadenectomy group was(132.3 ±30.3) minutes,and that of systemic mediastinal lymphadenectomy group was(150.7 ±41.8) minutes with significant difference(P ＜ 0.01).Average amount of intraoperative bleeding of selective mediastinal lymphadenectomy group was (96.2 ± 53.5) ml,and that of systemic mediastinal lymphadenectomy group was (124.4 ± 65.4) ml with significant difference(P ＜0.01).There was no significant difference in overall survival rate between two groups(P =0.844).Recurrence rates were 25.3 ％ and 27.5 ％,respectively (P =0.533).Subgroup analysis showed no significant difference of 5-year survival rates between the two groups.Conclusion For patients with clinical stage Ⅰ non-small cell lung cancer,selective mediastinal lymphadenectomy can reduce operation time and amount of intraoperative bleeding.Survival of patients who received selective mediastinal lymphadenectomy was no worse than that of patients who received systemic mediastinal lymphadenectomy.

Objective To investigate the gene expression change of TNF-α,IL-6 and IL-1β at different time points in brain tissues of rats with cerebral ischemia reperfusion injury.Methods A total of 24 adult male SD rats were randomly divided into four groups:sham group and 3 groups with brain ischemia reperfusion of 3h,6h and 12h.Real-Time PCR was used to analyze the gene expression ofTNF-α,IL-6 and IL-1 β at 3h,6h,and 12h after reperfusion.Results In the sham group,the mRNA expression levels of TNF-α,IL-6 and IL-1 β in were low,but increased immediately after brain ischemia injury and decreased gradually thereafter.The gene expression of TNF-α mRNA at 3h after reperfusion was significantly increased and reached the peak (P ＜0.01) then significantly decreased at 12h after reperfusion.The gene expression of IL-6 mRNA was notably increased at 3h after reperfusion and peaked at 6h (P＜0.01),and significantly decreased at 12h compared with 6h (P＜0.01).The gene expression of IL-1 β mRNA at 3h after reperfusion was significantly increased,peaked at 6h (P＜0.01) and significantly decreased at 12h (P ＜0.01).Conclusion The gene expression levels of TNF-α,IL-6 and IL-1β mRNA increased significantly in the early stage of reperfusion and decreased gradually after reaching the peak,which suggested that the gene expression change of TNF-α,IL-6 and IL-1β was involved in the mechanism of cerebral ischemia reperfusion injury.

Objective To investigate the relationship between the microsatellite polymorphism of cytotoxic T lymphocyte associated antigen-4 (CTLA-4) gene and inflammatory bowel disease(IBD) patients in Zhejiang province. Methods One hundred and eighteen IBD patients without consanguinity (99 patients with ulcerative colitis, 19 patients with Crohn's disease) and 140 healthy controls were studied. The (AT) repeats in the 3' untranslated region of exon 4 of CTLA-4 gene were amplified by allele-specific PCR. The amplified products were electrophoresed with 12% polyacrylamide gel, followed by silver staining. Results Twenty alleles were found in IBD patients and healthy controls. The frequency of 122 bp allele was higher in patients with ulcerative colitis (P=0.0001/Pc=0.0025, OR= 11.393, 95% CI:2.574-50.429) and Crohn's disease (P=0.0003/Pc=0.0050, OR=21.061, 95% CI:3.927-112.94) than that in healthy controls. Conclusion CTLA-4 gene microsatellite polymorphism was obviously associated with IBD in Zhejiang province.

Objective To investigate clinical outcomes and side effects of 103Pd seed brachytherapy for malignant tumors. Methods Twenty patients with residual or recurrent unresectable malignancies were treated with 103Pd seed implantation under the guidance of ultrasonigraphy or CT scans. Three patients were given a local anesthesia and 17 patients, general anesthesia. The match peripheral doses ranged from 97.3 Gy to 182.78 Gy (mean, 123 Gy). The activity of each seed ranged from 1.4 mCi to 1.8 mCi. The planning target volume (PTV) included a 1 cm isotropic expansion margin around the clinical target volume (CTV). The seeds were retrogradely placed with a Mick applicator. External beam radiation was required 3～4 weeks after seed implantation in 6 patients, with a total dose of 45～50 Gy and 2 Gy each fraction. All of the patients received CT scanning after implantation for quality evaluation and underwent routine chest X-ray examination at 24～48 hours for seed observation. Results A complete response was achieved in 5 patients and a partial response in 12 patients. Two patients were assessed as having stable disease. In 1 patient with prostatic cancer, the serum PSA level was decreased significantly. The local control rate was 90% (18/20). The 20 patients were followed for 2～25 months (median,11 months).Two patients were lost to follow-up at 6 and 12 months after operation, respectively. Twelve patients died and 6 patients survived.No severe complications were recorded postoperatively. Conclusions 103Pd brachytherapy for malignant tumors gives a high local control rate and satisfactory reliability.

Objective To investigate the technological feasibility and short-term efficacy of 125I seeds implantation in head and neck cancer. Methods Thirty patients with head and neck recurrent cancer were treated with 125I seeds interstitial brachytherapy. The operation was performed under local anesthesia and the 125I seeds were implanted under the guidance of ultrasonography. The seed needles were implanted parallelly to each other, at 1～1.5 cm apart. The Mick applicator was used to implant seed at 1 cm interval. The radioactive activity per seed ranged 0.40～0.70 mCi, and the matched peripheral dose (MPD) was 90～160 Gy. The number of 125I seed implanted per lesion was 3～84 (median, 24). Ten patients with a seed radioactive dose

Objective:To explore the application effect of small private online course (SPOC) teaching mode in clinical practice teaching of thoracic surgery.Methods:A total of 56 undergraduate students who were internships from May to July 2018 were selected as subjects. They were randomly divided into experimental group and control group. SPOC teaching mode and traditional teaching mode were respectively adopted in the practice teaching, and the teaching effect was evaluated by questionnaires and written examinations. SPSS 22.0 was used for statistical analysis, ttest for independent-sample test, and chi-square test for counting data. There were significant differences when P<0.05. Results:The questionnaire showed that the six teaching effect evaluation indicators of the experimental group were higher than those of the control group ( P<0.01). In terms of written test assessment, the average score of the experimental group was significantly higher than that of the control group, with significant differences ( P<0.05). Conclusion:The SPOC teaching mode can improve the teaching effect of clinical practice in thoracic surgery and improve students' self-learning ability.

Objective: To investigate the mechanism of Glytan lowering portal pressure induced by biliary liver fibrosis. Methods: SD male rats, 240-260g weight around, were randomly divided into sham-operation group, model group, propranolol group, Glytan high-dose, middle-dose and low-dose group according to the weight. Portal hypertension was induced by common bile duct ligation in rats. After two and four weeks, measured the portal pressure(PP) of each group, observed the histological changes of liver by HE staining, tested liver function and the concentration of endothelin-1 in systemic circulation and mesenteric circulation radioimmnuoassay. Results: After two and four weeks, portal pressure of model group rats increased significantly. Both Glytan and propranolol can decrease PP after two and four weeks, and the pressure-relief effect was similar between the two drugs. HE staining showed that Glytan can significantly inhibit the formation of collagen, promote the recovery of liver tissue structure; liver function indicated a significant decrease in serum AST, ALT, TBIL and Na+ concentration. In addition, Glytan decreased the concentration of endothelin -1 in systemic circulation, increased it in mesenteric circulation after two weeks. Conclusion: Glytan decrease PP by improving liver function and microcirculation, inhibiting collagen formation and water-sodium retention after long-term therapy, ameliorating hyperdynamic circulation at the early stage.

Objective To discuss the relation between level of Hs-CRP and glycometabolic disturbance in patients with acute coronary syndrom. Methods 155 patients with acute coronary syndrome were divided into 3 groups according to the WHO standard of diabetes diagnosis,normal glucose tolerance group(group A,44 cases),impaired glucose tolerance group(group B,60 cases),diabetes group(group C,51 cases). All cases were checked by the 75g glucose tolerance test, blood Glucose, insulin, HbA1c,lipid,hypersensitive C reaction protein(hs-CRP). 95 patients were checked by coronary angiography(CAG). Statistic comparison were measured among three groups including the levels of hs-CRP,insulin,HbA1c,lipid and coronary artery lesions. Results The levels of Hs-CRP,PBG, FINS, PINS,HbA1c,TC,LDL-C in both group B and C were higher than those in group A;The levels of TG,PINS were not found significant differences between group B and C. The level of Hs-CRP was correlated with the levels of PBG,PINS,HbA1c,TC,LDL-C. The coronary artery lesions showed by CAG in group B and C were more severe than those in group A,coronary multivessel changes in group B and C were more frequent than in group A,it had no significant difference between group B and C.Conclusion Compared with the patients of normal glucose tolerance, patients with glycometabolic disturbance have higher levels of hs-CRP,their coronary artery lesions are more severe.

Objective To analyze the safety, feasibility and operative technique details of non-grasping en bloc mediastinal lymph nodes dissection technique in uniportal video-assisted thoracic surgery(VATS) for lung cancer.Methods From April, 2014 to March, 2015,46 patients with lung cancer received non-grasping en bloc mediastinal lymph nodes dissection after uniportal VATS lobectomy.Clinical data of the cases were analyzed retrospectively.There were 19 males and 27 females.The age was(57.2 ± 9.0) (38-73) years.The first 6 cases were performed in the lateral decubitus position while the later 40 cases were all performed in the semiprone position.Results All cases accepted uniportal VATS non-grasping en bloc mediastinal lymph nodes dissection successfully.Arm fatigue of surgeon and assistant was obviously relieved when the patient was placed in the semiprone position.The thoracic drainage time was(3.2 ± 2.1) (1-12)days and the postoperative length of hospital-stay was(6.0 ± 4.5) (2-27) days.The number of dissected mediastinal lymph nodes stations was (4.3 ± 0.8) (3-6)and the number of dissected mediastinal lymph nodes was (11.8 ± 4.9) (4-30).There were 42 cases with stage No , lease wit stage N1, and 3 cases with stage N2 in pathological examination.Five patients developed minor postoperative complications.No perioperative death occurred.Conclusion Uniportal VATS non-grasping en bloc mediastinal lymph nodes dissection for lung cancer was safe and feasible, which could decrease the interference of the instruments and help to keep the surgical field clear.Non-grasping en bloc mediastinal lymph nodes dissection would be performed more smoothly in the semiprone position with less damage to lung and better ergonomics.