Objective To investigate the abnormality of fluid distribution and its effect on blood pressure (BP) in hemodialysis patients. Methods One hundred and six healthy volunteers as normal controls were divided into two groups(male group and female group).ECV%?ICV%(% means a percentage of weight) and ECV/ICV were measured by bioelectrical impedance spectroscopy and calculated in 2 groups respectively.Sixty-seven stable HD patients who had been on HD for more than 2 months in our hospital were selected. Patients were divided into 4 groups (hypotension prone group, normotensive group, hypertensive group and refractory hypertensive group). ECV%, ICV% and ECV/ICV were measured and calculated as above immediately before and after HD session. The measurement was conducted by Xitron 4200 HYDRA ECF/ICF Bio-Impedance Spectrum Analyzer. Results In patients on HD, a significant decrease of ECV% and ECV/ICV, and a significant increase of ICV% were seen post-HD. The pre-HD ECV% and ECV/ICV were significantly higher than those of normal controls but dropped close to normal level after hemodialysis. Post-HD ECV% was still higher than that of normal controls[(31.6?1.0)% vs (25.3?1.6)%, P 0.05]and post-HD ECV% of these patients was significantly lower than that of normal controlsand post-HD ECV% of these patients was significantly lower than that of normal controls[(19.3?1.6)% vs (22.6?1.4)%,P

Objective To discuss the clinical characteristics and prognosis of 15 children with hand foot and mouth disease (HFMD) and acute flaccid paralysis (AFP) who were admitted to Beijing Ditan Hospital during the outbreak of HFMD in 2008. Method The epidemiology, clinical manifestations, cerebrospinal fluid (CSF),magnetic resonance imaging and prognosis of 15 children with HFMD and AFP were retrospectively reviewed. The recovery of the patients' affected extremities were monitored for 4 weeks. Results The mean age of these patients was (22.47 ± 20.68) months (range: 5～72 months). Acute paralysis developed (3.47 ± 1.68) days after the onset of fever and progressed to maximum severity within (1～2) days. Poliomyelitis-like syndrome was observed in all cases. Of the 15 cases, 10 had monoplegia of lower limbs, two had paraplegia, one had monoplegia of upper limbs and two had quadriplegia. In these cases, the muscle power varied from level 0 to level 4, and six even showed no muscle power in their affected extremities. Thirteen cases developed neurologic complications (encephalitis, meningitis or ataxia) and three had transient urinary retention. Cerebrospinal MRI examination in eight cases showed hyperintense lesions on T2-weighted images, predominantly in the impaired anterior horn regions of the spinal cord (C2～C7 for cases with upper extremity impairments and T12～L1 for cases with lower extremity impairments), and displayed long T1 signals and long T2 signals. In addition, the midbrain, brain-stem or medulla was also involved in four cases who also contracted encephalitis or meningitis. The muscle strength in 11 patients with single lower extremity impairment showed improvements in the distal limb muscles within 4～8 days, and the other cases showed recovery 2～3 weeks later. Conclusions HFMD in combination with AFP most commonly occurs in children aged less than 2 years old. Acute paralysis develops during the early stage of infection and progresses to a maximum severity within 2 days. In most cases described here, paralysis occurred in a single lower extremity and recovered more rapidly than those with all four limbs affected or with single upper extremity impairment . MRI examination is particularly valuable for the diagnosis and prognosis of AFP because of its high sensitivity and accuracy.

Objective To understand the clinical features of patients with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) complicated by cytomegalovirus (CMV)viremia.Methods The clinical data of 249 cases of HIV/AIDS patients hospitalized in Beijing Ditan Hospital from Oct 2008 to Nov 2009 were analyzed retrospectively,in which 43 HIV/AIDS patients were diagnosed with CMV viremia.The symptoms and signs,cerebrospinal fluid (CSF)tests,and pathological detections by bronchoscope,gastroscope and fibercoloscope were collected.The database was set up using Excel software.The association between cellular immunity and CMV DNA level was determined by SPSS12.0 software.Results Forty-three patients (17.3%)were diagnosed with CMV viremia by positive results of CMV pp65 antigen and CMV DNA tests; 14 patients manifested retinal bleeding or infiltration and 4 patients displayed retinal fibrosis; 1 patient was diagnosed with CMV pneumonitis by pathological results of bronchoalveolar lavage fluid.Low level of CD4+ T lymphocytes and CMV DNA levels were positively correlated.Conclusions CMV pp65 antigen and CMV DNA should be detected in HIV/AIDS patients with CD4+ T lymphocytes less than 100 × 106/L and anti-CMV treatment should be given according to the results.Ophthalmologic examination and bronchoalveolar lavage fluid pathological detection are effective methods in diagnose of CMV retinitis and pneumonitis.

Objective: To understand the prophylaxis of population exposed to rabies, and provide a basis for prevention and control of rabies. Methods: The registration data of 1 019 cases with rabies exposure in Beijing Ditan Hospital Affiliated to Capital Medical University from Mar, 2017 to Feb, 2018 were analyzed using the descriptive epidemiologic method. Results: Among the 1 019 cases of rabies exposure, the sex ratio of men to women was 0.90∶1, with the highest proportion of them were between 26 and 46 years of age old, accounting for 46.5%. Rabies exposure reached its peak (46.9%) between June and September. In addition, 63.3% of the injuries were caused by dogs and 36.7% by cats. Most of the wounds (55.1%) occurred in hands; and the second was lower limbs (26.6%). Most of the cases (60.7%) had grade II wounds; followed by grade III wounds (39.1%); 69.3% of the cases completed immunization with rabies vaccine. In grade III exposure, 73.7% of the patients were immunized with rabies immunoglobulin. Most of the persons of grade III exposure (73.7%) received inoculation with human rabies immunoglobulin (HRIG). Conclusions Measures to control rabies should be focused on the management of dogs and cats and the standardization of rabies post-exposure prophylaxis.

Objective: To analyze the clinical response in cases of multi-victims bitten by a dog in Beijing (one of whom was HIV positive), and to explore the route and prognosis of dual exposure to rabies virus and HIV. Methods: Descriptive epidemiological methods were used to analyze the exposed cases, the post-exposure prophylaxis(PEP) of rabies and HIV and the follow-up outcomes. Results: After six months-follow up, there was no rabies case was found among those nine victims bitten by the suspected dog. In addition, six HIV-negative victims who had been exposed to HIV via dog saliva were consistently tested to be HIV negative in the follow up period. Conclusions In cases with multi-victims bitten by one dog, except exposure to rabies virus, it is necessary to be alert to the presence of HIV, HBV or HCV infection in sequential victims. Therefore, the risk of the potential spreading of other blood-borne infectious pathogens should be assessed. It is important to initiate PEP as early as possible.

Objective:To investigate the clinical features of amoebic enteritis with acquired immunodeficiency syndrome (AIDS) patients.Methods:The clinical data of patients diagnosed of amoebic enteritis in Beijing Ditan Hospital, Capital Medical University from April 2011 to October 2019 were collected. They were divided into amoebic enteritis group and amoebic enteritis with AIDS group. The laboratory indexes, pathological examination and colonoscopic appearance of the two groups were analyzed retrospectively. The clinical characteristics of amoeba enteritis with AIDS patient were summarized. Pearson chi-square test, continuous calibration chi-square test, Fisher′s exact test, independent sample t test and Mann-Whitney U test were used for statistical analysis. Results:A total of 53 patients with amoebic enteritis were included, including 31 cases in amoebic enteritis group and 22 cases in amoebic enteritis with AIDS group. The detection rate of amoebic trophozoite in cases feces in amoebic enteritis with AIDS group was lower than that in amebic enteritis group (68.2%(15/22) vs 96.8%(30/31)) with statistical significance ( χ2=6.13, P=0.013). The detection rate of amoebic trophozoite by colonoscopy in amoebic enteritis with AIDS was higher than that in amebic enteritis group (7/15 vs 1/16) with statistical significance (Fisher′s exact test, P=0.015). Amoebic enteritis with AIDS cases had lower levels of red blood cell count ((3.48±0.80)×10 12/L vs (4.11±0.81)×10 12/L), hemoglobin ((102.40±25.74) g/L vs (121.52±22.73) g/L), albumin ((29.07±5.94) g/L vs (35.48±6.92) g/L), CD4 + T-lymphocyte counts (76.00 (26.25, 228.50)/μL vs 514.50 (444.00, 752.25)/μL) than patients with amoebic enteritis, which were all statistically significant ( t=2.80, 2.86, 3.52 and Z=-5.27, respectively, all P<0.050). And amoebic enteritis with AIDS cases had higher level of alanine aminotransferase (ALT) (21.00 (12.85, 41.33) U/L vs 13.40 (9.40, 22.40) U/L, Z=-2.32, P=0.020). The results of colonoscopy showed that amoebic enteritis with AIDS cases had higher rate of intestinal mucosa ulcer than amoebic enteritis cases ((11/15 vs 5/16) Fisher′s exact test, P=0.032). Conclusions:Amoebic enteritis with AIDS cases have lower levels of red blood cells, hemoglobin, albumin and CD4 + T-lymphocyte counts and higher levels of ALT. Amoebic enteritis with AIDS cases have higher rate of intestinal mucosa ulcer detected by colonoscopy. Colonoscopy combined with biopsy play an important role in the diagnosis of amoebic enteritis with AIDS patients.

Post-traumatic tetanus is the main type of non-neonatal tetanus. To reduce the incidence and mortality rate of tetanus and guide the primary medical institutions to prevent and control tetanus after trauma, National Immunization Planning Technical Working Group of the Chinese Center for Disease Control and Prevention has compiled this document in the reference with Position Paper by World Health Organization, the latest research progress from home and abroad. The guidelines focus on the basic procedures for the prevention and disposition of post-traumatic tetanus, the application of tetanus vaccines and immune preparation, and the pre-exposure immunization in high-risk populations of trauma.