Objective To review the experience of surgical treatment of congenital esophageal atresia. Methods From 1987 to 2001, 32 patients with congenital esophageal atresia were treated surgically, 13 patients using the traditional method, 17 using the new method and 2 using esophago gastric reconstruction. Results There was no postoperative mortality in all patients. There was one anastomosis leak and 4 anastomosis stricture. No anastomosis leak and one esophageal stricture in the patients recieved new method. Conclusion The new surgical method for congenital esophageal atresia can effectively prevent postoperative anastomosis leak and stricture. One stage esophago gastric reconstruction can be used in type I and type II esophageal atresia and instead of two stage operation.

Objective To explore the expression of p130Cas and c-erbB-2 in human breast carcinoma and the relationship between p130Cas and c-erbB-2 levels with clinical and pathological characteristics. Methods Immunohistochemistry SP staining was applied to detect the expression of p130Cas and c-erbB-2 in tumor tissues from 53 cases of human primary breast carcinoma,10 cases of breast fibroadenoma and in 10 cases of normal breast tissues. Results Breast carcinoma tissues showed higher levels of p130Cas and c-erbB-2 than normal and fibroadenoma tissues(both P＜0.01).The expression of p130Cas was related with age, menopausal status, ER, PR status and histological grades, but not related with tumor size, lymph node status and pathological stages. The expression of c-erbB-2 was related with ER status, histological grades and lymph node status, but not related with age, menopausal status, PR status, tumor size and pathological stages. There were no significant correlations between p130Cas and c-erbB-2. Conclusion p130Cas and c-erbB-2 have relations with the malignant transformation and differentiation of breast carcinoma.c-erbB-2 is associated with metastasis of breast carcinoma.p130Cas and c-erbB-2 can be served as useful indicators in the prognosis of breast carcinoma.

ObjectiveTo explore the expression of p130Cas and paxillin in breast carcinoma and investigate the relationships of p130Cas and paxillin levels with clinical and pathological characteristics.MethodsReverse transcriptase polymerase chain reaction (RT-PCR) was applied to detect the expression of p130Cas and paxillin in tumor tissues from 30 cases of primary breast carcinoma,15 cases of normal breast tissues and 10 cases of breast fibroadenoma.ResultsThe levels of p130Cas and paxillin were 0.444 ± 0.088,0.493 ± 0.073,0.739 ± 0.092,0.755 ± 0.137 in normal breast tissues and breast fibroadenoma tissues.The levels of p130Cas and paxillin were 0.914 ±0.186,0.303 ±0.043 in breast carcinoma tissues.Breast carcinoma tissues showed higher levels of p130Cas and lower levels of paxillin than normal breast tissues and breast fibroadenoma tissues(P ＜ 0.01 ).The expression of p130Cas was related with age (r =0.599,P =0.000 ),menopausal status (t =5.602,P =0.000 ),estrogen receptor ( ER ),progesterone receptor ( PR ) status (t =5.768,P =0.000; t =4.151,P =0.000 ) and histological grades (r =-0.668,P =0.000 ),but not related with tumor size (F =0.717,P =0.497 ),lymph node status (F =1.230,P =0.308 ) and pathological stages(r =0.283,P =0.137).The expression of paxillin was related with rumor size (F=4.114,P =0.028 ),pathological stages( r =-0.520,P =0.003),and lymph node status(F=12.418,P=0.000 ),but not related with age(r =0.294,P=0.115),menopausal status(t =-0.403,P =0.690),ER,PR status(t =0.749,P =0.460;t =0.006,P =0.995) and histological grades (r =-0.173,P =0.362).Conclusions p130Cas and paxillin have relations with the malignant transformation,invasion and metastasis of breast carcinoma.Measurement of p130Cas and paxillin may provide useful prognostic information for patients with primary or metastatic breast carcinoma.

Objective To analysis the correlation factors which influence the prognosis and relationship of molecular subtypes on young patients.Methods Clinical data of 108 cases young breast cancer patients (≤ 35 years old) who were treat in the Third Affiliated Hospital of Zhengzhou University from January 2007 to October 2014 were retrospective analyzed.According to immunohistochemistry such as estrogen receptor (ER),progesterone receptor(PR),human epidermal growth factor receptor-2 (Her-2/neu),Ki-67 index,patients were divided into molecular subtypes and follow up.Results LuminalA subtype,LuminalB subtype,human epidermal growth factor receptor-2 overexpression subtype and basal-like accounted for 22％ (24/108),33％ (36/108),20％ (21/108) and 25％ (27/108) respectively,and there's 5-year disease-free survival rate were74.1％,62.8％,.56.8％,58.5％ respectively.Kaplan-Meier method was used to draw the disease-free survival curves through.There was no significant difference in the 5-year disease-free survival rate of each subtype (x2 =0.318,0.802,0.876,0.277,0.239,0.074,P＞0.05).Univariate analysis of prognostic factors of Log-rank showed that there were significant differences between recurrence with tumor size,age,lymph node metastasis and surgical methods in young patients with breast cancer(x2 =9.612,12.099,51.345,5.928,P＞0.05),while no significant difference with adjuvant chemotherapy,radiotherapy,endocrine therapy and molecular typing(x2 =2.381,1.958,0.027,2.612,P＞0.05).Multivariate Cox proportional hazards regression model analysis showed that tumor size (RR =5.487,95％ CI 1.519-19.822,P =0.009) and lymph node metastasis (RR =5.655,95％ CI 2.939 -10.884,P＜0.001) were independent risk factors for disease recurrence.Conclusion Tumor size and lymph node metastasis are important factors of prognosis on young patients.Young patients need the screening and therapy in the early time.

To analyze the genetic characteristics of a polio-I highly variant vaccine recombinant virus in Shandong Province (China) in 2011 and to identify isolates from healthy contacts, two stool specimens from one patient with acute flaccid paralysis (AFP) and 40 stool specimens from his contacts were collected for virus isolation. The complete genome of poliovirus and VP1 coding region of the non-polio enterovirus were sequenced. Homologous comparison and phylogenetic analyses based on VP1 sequences were undertaken among coxsackievirus (CV) B1, CV-B3 isolates, and those in GenBank. One poliovirus (P1/11186), CV-A4 and CV-A8 were isolated from the AFP patient; one CV-A2, Echovirus 3 (E-3), E-12 and E-14, ten CV-B1, and five CV-B3 strains were isolated from his contacts. These results led us to believe that there may be a human enterovirus epidemic in this area, and that surveillance must be enhanced. P1/11186 was a type-1 vaccine-related poliovirus; it combined with type-2 and type-3 polioviruses in 2A and 3A regions, respectively. There were 25 nucleotide mutations with 9 amino-acid alterations in the entire genome. There were 8 nucleotide mutations with 5 amino-acid alterations in the VP1 region compared with the corresponding Sabin strains. Homology analyses suggested that the ten CV-B1 isolates had 97.0%-100% nucleotide and 98.9%-100% amino-acid identities with each other, as well as 92.6%-100% nucleotide and 99.2%-100% amino-acid identities among the five CV-B3 isolates. Phylogenetic analyses on the complete sequences of VP1 among CV-B1 and CV-B3 isolates showed that Shandong strains, together with strains from other provinces in China, had a close relationship and belonged to the same group.
Base Sequence ; Capsid Proteins ; genetics ; immunology ; Child, Preschool ; China ; Humans ; Male ; Molecular Sequence Data ; Phylogeny ; Poliomyelitis ; etiology ; prevention & control ; virology ; Poliovirus ; classification ; genetics ; immunology ; isolation & purification ; Poliovirus Vaccines ; adverse effects ; genetics ; immunology

Objective To analyze the genetic characterization of VP1 region of Coxsackie virus A10(CVA10)isolated from clinical specimens of hand, foot and mouth disease(HFMD) patients in Shandong Province. Methods Clinical specimens were collected from some of HFMD patients from 2008 to 2009. The virus was isolated by cell culture. Total RNA was extracted, and the VP1 genes of the isolates were amplified by reverse transcription-polymerase chain reaction (RT-PCR) and sequenced. The genotypes were identified by molecular typing method and bioinformatics analysis.Homologous comparison and phylogenetic analysis of representative CVA10 strains were performed.Homologous comparison between the Shandong isolates and strains obtained from GenBank were performed and phylogenetic analysis of some representative CVA10 strains were performed. Results Three hundred and thirty viruses strains were isolated from 760 clinical specimens collected from HFMD patients, and 17 of them were identified as CVA10. The homologies of nucleotide and amino acid of the 17 CVA10 strains were 82.3%-100.0% and 94.2%-100.0%, respectively. Compared with the prototype strain of CVA10 (Kowalik/USA/2003), the homologies of nucleotide and amino acid were 75.6%-76.8% and 90.2%-93.2%, respectively. Interestingly, Shandong CVA10 strains were clustered into two distinct subgroups in the phylogenetic tree. Conclusions CVA10 is one of the causative agents of HFMD. Two independently circulating subgroups of CVA10 exist in Shandong province.

Objective: To estimate the immune memory at 12 years after hepatitis B vaccination and its risk factors among adults. Methods: The study was conducted in 20 villages of Qudi town in Jiyang county, Shandong province, China in 2003. Hepatitis B surface antigen (HBsAg), antibody against HBsAg (anti-HBs) and antibody against hepatitis B core antigen (anti-HBc) were tested for all healthy residents aged 15-40 years in these villages. Those who had no history of hepatitis B vaccination and were negative for all three indicators were divided into two groups randomly. Hepatitis B vaccine (HepB) was administrated to them on 0-6 month schedule or 0-1-6 month schedule respectively. Blood samples were obtained at one month after the last dose for each receipt and were quantitatively detected for anti-HBs. Finally a total of 629 participants completed HepB vaccination and anti-HBs testing, including 288 of two-dose group and 341 of three-dose group respectively. In 2015, an additional dose of HepB (challenge dose) was administrated to those who were negative for anti-HBs at follow-up (anti-HBs <10 mIU/ml) to evaluate the immune memory. A total of 93 blood samples, including 50 of two-dose group and 43 of three-dose group respectively, were drawn at 14 days after the challenge dose and anti-HBs was quantitatively detected. The anti-HBs geometric mean concentrations (GMCs) after the challenge dose were compared between the two groups. Multivariate linear regression model was built to find the independent risk factors associated with immune memory response (anti-HBs GMC after the challenge dose). Results: The challenge dose of HepB and post-challenge anti-HBs detection were completed among 93 participants. Totally 92 (98.92%, 92/93) participants were found holding immune memory (anti-HBs after the challenge dose was ≥10 mIU/ml). The immune memory positive rates were 100% (50/50) and 97.67% (42/43) in the two-dose group and three-dose group respectively and the corresponding anti-HBs GMC after challenge dose were 2 684.30 (95%CI: 1 721.71-4 185.08) mIU/ml and 3 527.48 (95%CI: 2 145.15-5 800.58) mIU/ml (P=0.410). The anti-HBs GMC after the challenge dose were 1 908.33 (95%CI: 1 190.01-3 060.27) mIU/ml, 4 004.20 (95%CI: 2 257.90-7 101.12) mIU/ml and 8 682.16 (95%CI: 5 813.94-12 965.36) mIU/ml among the participants whose anti-HBs titer was<4, 4-6 and 7-9 mIU/ml at follow-up, respectively (P=0.002). There was no correlation between immune schedule and anti-HBs GMC after the challenge dose; β (95%CI) was -0.07 (-0.34-0.20), P=0.601. Conclusion The immune memory after primary hepatitis B vaccination lasted for at least 12 years among adults. The immune memory response was independently associated with ant-HBs titer at follow-up, but might be similar between 0-6 month schedule and 0-1-6 month schedule.

Objective:To explore newer enteroviruses (EVs) circulating in China and research their genetic characterization.Methods:Sewage samples were collected in Jinan in January and July of 2018, respectively. PCR amplification of the P1 coding region of EV and next-generation sequencing (NGS) were conducted. Homologous and phylogenetic analyses were performed on the newly identified newer EVs.Results:The EV-A89 (n=2) and EV-C96 (n=1) nucleic acid sequences were detected in the sewage in January and July, respectively and obtained complete P1 coding sequence. The two EV-A89 sequences had 6.1% nucleotide divergence among themselves, and had 88.2%-95.3% homologies with other strains. No close genetic relationship was obtained with the sequences from Xinjiang, China and those from other countries. The EV-C96 sequence in this study had 76.2%-89.4% nucleotide similarities with other isolates throughout the world. Phylogenetic analysis showed that global EV-C96 strains were divided into 5 branches, i. e, A to E. Except for the Shandong 1991 isolate, the other Shandong and domestic strains were all located in branch D.Conclusions:This study added the molecular epidemiologic data of newer enteroviruses EV-A89 and EV-C96, and provides basic data for future research on the epidemic trend of EV-A89 and EV-C96 as well as their association with diseases.

Objective:Investigate and analyze the etiology and serological diagnosis capabilities of pertussis in medical institutions in Shandong Province in 2018.Methods:Using the census method, a questionnaire survey was conducted among 603 second and above level medical institutions in Shandong Province. The deadline for the survey was December 2018, and a total of 543 questionnaires have been recovered, and the validity rate of the questionnaires was 90%. Surveyed the pertussis etiology and serology test items (pertussis IgM and IgG, pertussis nucleic acid and pertussis bacterial culture) and the start time of each test item by questionnaire. The reported cases (confirmed cases and clinically diagnosed cases) between January 1, 2012 and December 31, 2018 were derived from the Chinese Disease Control and Prevention Information System according to the onset date. We used indicators such as fixed-base development speed, chain development speed, and chain growth speed for analysis. The chi test was used to analyze the differences in the composition ratio of medical institutions with detection ability in different levels and regions, and analyze the changes in the number of reported cases before and after the development of pertussis etiology and serology testing.Results:A total of 543 medical institutions accounted for 90.0% (543/603) of all secondary and above level medical institutions in the province, 356 secondary medical institutions (65.6%), and 187 tertiary medical institutions (34.4%). There were 10 medical institutions that carry out pertussis IgM, IgG and nucleic acid testing, accounting for 1.8% (10/543) of the surveyed medical institutions respectively. 2 medical institutions that carried out bacterial culture, accounting for 0.4% of the surveyed medical institutions (2/543). 20 medical institutions have carried out the above tests (8 secondary medical institutions and 12 tertiary medical institutions), accounting for 3.7% (20/543). The proportion of tertiary medical institutions with pertussis IgM, IgG detection and nucleic acid detection capabilities [6.42% (12/187)] was significantly higher than that of secondary medical institutions [2.25% (8/356)] ( χ2=6.01, P=0.014). From 2012 to 2018, the fixed base ratio development speed of reported cases was 3 834.69% in Shandong Province, among which medical institutions with etiology and serological testing capabilities reached 4 533.33%. In 13 medical institutions, the average annual number of reported cases after pertussis etiology and serological testing were higher than that of reported cases before testing. Conclusion:The ability of pertussis etiology and serology diagnosis of secondary and above medical institutions in Shandong Province needs to be improved.

Objective:Investigate and analyze the etiology and serological diagnosis capabilities of pertussis in medical institutions in Shandong Province in 2018.Methods:Using the census method, a questionnaire survey was conducted among 603 second and above level medical institutions in Shandong Province. The deadline for the survey was December 2018, and a total of 543 questionnaires have been recovered, and the validity rate of the questionnaires was 90%. Surveyed the pertussis etiology and serology test items (pertussis IgM and IgG, pertussis nucleic acid and pertussis bacterial culture) and the start time of each test item by questionnaire. The reported cases (confirmed cases and clinically diagnosed cases) between January 1, 2012 and December 31, 2018 were derived from the Chinese Disease Control and Prevention Information System according to the onset date. We used indicators such as fixed-base development speed, chain development speed, and chain growth speed for analysis. The chi test was used to analyze the differences in the composition ratio of medical institutions with detection ability in different levels and regions, and analyze the changes in the number of reported cases before and after the development of pertussis etiology and serology testing.Results:A total of 543 medical institutions accounted for 90.0% (543/603) of all secondary and above level medical institutions in the province, 356 secondary medical institutions (65.6%), and 187 tertiary medical institutions (34.4%). There were 10 medical institutions that carry out pertussis IgM, IgG and nucleic acid testing, accounting for 1.8% (10/543) of the surveyed medical institutions respectively. 2 medical institutions that carried out bacterial culture, accounting for 0.4% of the surveyed medical institutions (2/543). 20 medical institutions have carried out the above tests (8 secondary medical institutions and 12 tertiary medical institutions), accounting for 3.7% (20/543). The proportion of tertiary medical institutions with pertussis IgM, IgG detection and nucleic acid detection capabilities [6.42% (12/187)] was significantly higher than that of secondary medical institutions [2.25% (8/356)] ( χ2=6.01, P=0.014). From 2012 to 2018, the fixed base ratio development speed of reported cases was 3 834.69% in Shandong Province, among which medical institutions with etiology and serological testing capabilities reached 4 533.33%. In 13 medical institutions, the average annual number of reported cases after pertussis etiology and serological testing were higher than that of reported cases before testing. Conclusion:The ability of pertussis etiology and serology diagnosis of secondary and above medical institutions in Shandong Province needs to be improved.