Objective:To explore the clinical characteristics and diagnosis and treatment of occult poisoning caused by long-acting anticoagulant rodenticides.Method:Records of 12 patients from July 2008 to April 2011 diagnosed as anticoagulant rodenticide occult poisoning,who had been misdiagnosed initially at other hospitals were analyzed retrospectively.Elements from the records included clinical symptoms and signs,laboratory findings for prothrombin time (PT) and activated partial prothrombin time (APTT),and initial misdiagnosis and treatment outcome at our hospital.Results:The clinical presentations of patients were insidious and serious,often presented as skin ecchymose,hematuria,menorrhagia and gastrointestine bleeding.Laboratory examinations showed prolonged PT and APTT; bleeding was controlled effectively by administoring vitamin K1 daily.There were statistical difference between PT and APTT before and after the treatment (P＜0.01).Conclusion:Coagulation disorders might be caused by the reduced acquisition in vitamin K dependent coagulation factors,which tends to be neglected due to a hidden medical history,delayed signs of poisoning,and various organs involved.A detailed patient history and systematic review may improve the diagnostic accuracy.Once diagnosed is made,vitamin K1 should be given as soon as possible.

Objective To make a nationwide external quality assessment of tests for isolation and identification of N.gonorrhoeae in medical and healthcare facilities at different levels,and to analyze current problems.Methods Lyophilized quality control samples were uniformly delivered to 252 medical and healthcare facilities providing sexually transmitted disease (STD) services at different levels.Test results were analyzed by the National Center for STD Control,China Center for Disease Control and Prevention,and evaluation results were fed back to participating laboratories.Results Finally,test results were received from 203 (80.56％) facilities.The comprehensive score averaged at 87.14,and facilities achieving a comprehensive score of 80 or greater amounted to 80.30％ (163/203).The coincidence rate was 53.69％ (109/203) for all of the 5 quality control samples,82.76％ (168/203) and 87.68％ (178/203) respectively for two quality control samples containing only N.gonorrhoeae,86.21％ (175/203) and 96.06％ (195/203) respectively for a sample containing Neisseria sicca and a sample containing Enterococcus faecalis,69.46％ (141/203)for a sample containing different species of Neisseria.Conclusion The external quality assessment reveals a disparity in the capability to isolate and identify Neisseria among medical and healthcare facilities providing STD services at different levels.

Objective To compare the effects of medroxyprogesterone acetate (MPA) and compound norethisterone enanthate (CNE) on the susceptibility of BABL/c mice to lower reproductive tract infection with chlamydia trachomatis (Ct). Methods A total of 60 BALB/c mice were randomly and equally divided into 6 groups:MPA-pretreated control group and CNE-pretreated control group inoculated with MyCoy cell suspensions in the vagina on the 5th day after single treatment with MPA and CNE respectively, blank control group receiving no treatment, MPA-pretreated infected group and CNE-pretreated infected group inoculated with 1 × 107 inclusion-forming units(IFU)of Ct serovar E in the vagina on the 5th day after single treatment with MPA and CNE respectively, control infected group inoculated with the same quantity of IFU of Ct serovar E in the vagina but receiving no pretreatment. On day 4, 7 and 14 after inoculation, vaginal irrigation fluid was obtained from all the mice for cell culture of Ct. Three mice were randomly selected from each of these groups at the above three time points and sacrificed, and vaginal and uterine tissue specimens were obtained for hematoxylin-eosin(HE)staining and microscopic examination. Chi-square test and Fisher's exact test were conducted to compare infection rate among different groups. Results No growth of Ct was observed in the three control groups at the above time points. The culture-positive rate of Ct was 1/10 on day 4 but 0 on day 7 and 14 in both the CNE-pretreated infected group and control infected group, 7/10 on day 4, 2/7 on day 7 but 0 on day 14 in the MPA-pretreated infected group. Fisher's exact test revealed that the culture-positive rate of Ct was significantly higher in the MPA-pretreated infected group than in the control infected group and CNE-pretreated infected group on day 4 (both P =0.03), but similar among the three infected groups on day 7 (P = 0.23). Both the MPA-pretreated control group and infected group showed an increase in endovaginal mucus, thinning of vaginal stratified squamous epithelium, mucification of vaginal epithelium, presence of secretions in vaginal lumen and submucosal infiltration of a few inflammatory cells on day 4, 7 and 14, as well as appearance of pathological changes (including the presence of large quantities of purulent secretions in lumen, mild tissue edema and submucosal infiltration of a few inflammatory cells) in the vagina on day 4. Vaginal tissues were normal in both the CNE-pretreated infected group and control group at the above three time points, but mild tissue edema, lumen expansion, secretion retention and infiltration of scattered inflammatory cells were observed in the uterus on day 4 after inoculation. Conclusions MPA can arrest the estrous cycle of mice at diestrus with the mucification of vaginal epithelium, which may increase the susceptibility to Ct vaginal infection in mice. In contrast, CNE has no obvious effect on the estrous cycle and susceptibility to Ct vaginal infection despite of the appearance of pathological changes in the uterus.

Objective To compare the pathogenicity between Ureaplasma urealyticum serotype 1 (Up1)and 8 (Uu8) in the genital tract of BALB/c mice.Methods A total of 48 BALB/c mice were randomly and equally divided into four groups:blank control group receiving no treatment,estradiol group pretreated with intramuscular injection of estradiol followed by intravaginal inoculation with sterial liquid culture media,Up1 and Uu8 groups pretreated with intramuscular injection of estradiol followed by intravaginal inoculation with suspensions of Up1 and Uu8 respectively.Three mice were randomly selected from each group to be sacrificed after the collection of vaginal lavage fluid on day 3,7,14 and 21 after the inoculation.Vaginal and uterine tissue specimens were obtained from these sacrificed mice and underwent hematoxylin and eosin (HE) staining.Vaginal lavage fluid samples were subjected to culture of Uu and measurement of tumor necrosis factor-α (TNF-α).Results No evidences were observed for Uu growth in either the blank control group or estradiol group at any of the time points after the inoculation,with the average level of TNF-α in vaginal lavage fluid being (4.17 ± 0.85) pg/ml at these time points in both groups.Uu grew in all the vaginal lavage fluid samples from the Up1 and Uu8 groups at the four time points,with the color change unit (CCU) value decreasing with time.The level of TNF-α in vaginal lavage fluid peaked on day 14 after the inoculation in the Up 1 ((14.93 ± 1.11) pg/ml) and Uu8 ((27.04 ± 24.26) pg/ml) groups.Both Up1 and Uu8 infection caused acute and chronic inflammatory responses in the mice,which were mainly located in the uterus,and Up1 might cause intrauterine adhesion.Conclusions At the same inoculation concentration,no significant difference is found in the pathogenicity between Up1 and Uu8,both of which appear to mainly cause cervicitis.Upl might be partially responsible for intrauterine adhesion in mice.

AIM:To confirm the action of the light transmission method in evaluating focal ischemic cerebral infarction on persistent focal cerebral ischemia in mice. METHODS:Persistent focal cerebral ischemia was induced by middle cerebral artery occlusion (MCAO). Bederson's neurological scores, climbing board and hanging test were performed 24 h after ischemia, and infarct volume, brain hemisphere area, neuron density of cortex and subcortex were measured with computer-assisted imaging. Pranlukast ( 0.1 mg?kg -1) or nimodipine ( 0.4 mg?kg -1) were injected ip once daily for 3 days and to 1 h before MCAO assess the neuroprotective effect. RESULTS:The infarct volumes measured by light transmission closely correlated with that measured by TTC staining and neuron densities. The infarct volumes measured by light transmission well correlated with the neurological scores measured by integrated graded approach, too. Both pranlukast and nimodipine significantly attenuated infarct volumes and the ratio of ischemic/non-ischemic hemispheres, and reduced neurological deficits and neuron death. CONCLUSION:Light transmission and integrated graded approach can be used not only for qualitative analysis of focal cerebral ischemia, but also for evaluating the neuroprotective effect of drugs.

The incidence of aduIt obesity,diabetes,hyperIipidemia and hypertention has been rising dramaticaIIy in recent years. Obesity and overweight have become a significant pubIic heaIth probIem worIdwide. Though obesity is caused by compIex interactions between genetic,behavioraI,and environ-mentaI factors,its etioIogy is stiII uncIear. There is growing evidence that exposure to bisphenoI A(BPA) during prenataI and neonataI or adoIescence periods Ieads to much body mass gain. In addition,in epi-demioIogicaI studies,the association between BPA exposure and obesity and type 2 diabetes has been found. The potentiaI mechanism may be attributed to promoted differentiation and function in adipocytes via aIteration of a number of genes. BPA may act aIso through other mechanisms. It can directIy bind to nucIear receptors acting as agonists or antagonists and indirectIy disrupt hormone IeveIs by inhibiting enzymatic activity or by activating expression of the P450 enzymes. This review is focused on the effects of estrogenic endocrine disrupting chemicaIs such as BPA on the deveIopment of obesity.

Red doctor’s culture is a precious spiritual wealth formed in the medical and health practice of the Central Soviet Area during a specific historical period. With the development of society and the changes of the times, the red doctor’s culture has been endowed with new connotation. Western Fujian was the earliest place to provide medical support for the revolutionary army, the birthplace of the Republic’s health service, and made great contributions to the victory of the Chinese revolution. The cultural resources of red doctor’s in western Fujian are abundant, and it is one of the important lineages of the red culture in western Fujian, with its unique historical value. At present, there are many problems in promoting the red doctor’s culture. Actively exploring and researching specific paths and methods to promote the red doctor’s culture is of great significance and value for giving full play to the connotation of the red doctor’s culture in the new era, promoting its value leading role at various levels of society, and passing down the spirit and culture of red doctor’s.

Objective To investigate the characteristics of blood glucose fluctuation of continuous ambulatory peritoneal dialysis (CAPD) patients with end stage diabetic nephropathy(ESDN) attaining glycated hemoglobin standard. Methods The study recruited 17 patients with type 2 diabetes attaining glycated hemoglobin standard, and used continuous glucose monitoring system (CGMS) to monitor glycemic variation for 72 h. General information was collected and biochemical indexes were determined. Results The mean amplitude glycemic excur-sions (MAGE), standard deviation ,mean blood glucose levels, maximum of blood sugar, and the proportion of greater than 13.9 mmol/L in peritoneal dialysis patients were (8.36 ± 4.44) mmol/L, (3.38±1.08) mmol/L, (9.88±1.92) mmol/L, (17.95±13.11)%, which were significantly higher than those in normal. The mean amplitude glycemic excur-sions (MAGE), standard deviation ,mean blood glucose levels, maximum of blood sugar, and the proportion of greater than 13. 9 mmol/L in daytime were (8.25± 3.71) mmol/L, (2.83±0.89) mmol/L, (11.32±2.54) mmol/L, (16.61±3.86) mmol/L, (28.45±19.56)%, which were significantly higher than those in nighttime: (4.20±2.67) mmol/L, (1.34±0.89) mmol/L, (7.02±1.92) mmol/L, (9.61±2.77) mmol/L, (5.31±1.28)%, all P<0.05. The minimum and the proportion of less than 3.9 mmol/L between the two groups had no significant difference ( P>0.05). Besides, biochemical glycosylated hemoglobin was less than the calculated from CGMS: (5.88± 0.73)%vs. (7.85±1.20)%, t=4.76, P<0.01. Conclusions Peritoneal dialysis patients with ESDN have an increased glycemic fluctuation and a unsatisfied glycemic control, which is worse in daytime. Glycosylated hemoglobin is undervalued. Glycosylated hemoglobin should not be simply used on hemodialysis patients with ESDN to evaluate whether they have a good glycemic control. CGMS can better describe their blood sugar condition.

OBJECTIVE To understand and use reasonably the strategy of prevention and management of overwhelming postsplenectomy infection(OPSI). METHODS According to intervention to patients with postsplenectomy by means of education,vaccination,antibotic prophylaxis after April 1998,clinical and follow-up data were reviewed and analyzed from 337 cases patients with traumatic splenectomy from Jan 1992 to Jan 2004,and correlative factors of four OPSI cases were further analyzed. RESULTS Incidence of OPSI descended obviously after intervention(P

Background:One effective method for detecting stomach cancer is serological screening.Aims:To improve the prognosis and better direct clinical practice,this research compares the usefulness of the new scoring system and the ABC method in the screening of high-risk lesions of gastric cancer.Methods:This study involved the consecutive enrollment of 2 306 individuals(of whom 1 232 were male and 1 074 were female)who had gastroscopy at the Physical Examination Department of Xiamen Humanity Hospital between December 2020 and December 2022 and were above the age of 40.Before endoscopy,the population was classified as low-risk,intermediate-risk,and high-risk based on the serological ABC method and the new scoring system,respectively,and based on the age,gender,serum Helicobacter pylori antibody,PGR,and G-17 test findings of the studied population.An analysis was conducted on the identification of high-risk lesions of stomach cancer using the two distinct approaches,and the usefulness of the two distinct techniques for identifying high-risk lesions associated with stomach cancer was assessed.Results:Based on the serological ABC method of 2 306 patients,there were 1 293 cases in the low-risk group,856 cases in the intermediate-risk group,and 157 cases in the high-risk group.Of the three groups,759 cases(58.7%)had high-risk lesions of gastric cancer,492 cases(57.5%)in the intermediate-risk group,and 82 cases(52.2%)in the high-risk group.There were 1 899 cases in the low-risk category,383 cases in the intermediate-risk group,and 27 cases in the high-risk group,based on the novel scoring system.Among them,1 044 patients had high-risk stomach cancer lesions found.There were 18 instances(75.0%)in the high-risk group and 271 cases(70.8%)in the intermediate-risk group.The identification rate of high-risk lesions of gastric cancer in the new scoring method increases progressively as the group grade rises(χ2=35.482,P<0.001).Conclusions:While both approaches are useful for identifying high-risk gastric cancer lesions,the novel scoring system may be more beneficial for identifying these lesions early on.