Objective To investigate the current situation of management of institutions of schistosomiasis prevention and control in Hubei Province so as to explore the probable competency building standards for these institutions at the county and township levels. Methods By using a combination of quantitative and qualitative methods the institutions of schistosomiasis prevention and control at county and township levels were investigated for the institutional setup staffing and fulfillment func-tions since the reform of 2004. Results Among 63 schistosomiasis endemic counties cities districts of Hubei Province there were 26 independent schistosomiasis control institutions 41.27% there were 24 institutions which were incorporated in-to CDC 38.10% and there were no institutions in 13 counties 20.63% . Among 518 endemic towns there were 299 institu-tions 57.72% . The total staffing size were 1 932 but there were 1 586 82.09% people actually working in the post and therefore there were 346 17.91% empty positions. The average rates of carrying out the six functions were 91.48%-71.19%but only 19.23%of the institutions participated in the comprehensive schistosomiasis control management project and its effect assessment. Conclusion According to the management model for schistosomiasis control institutions under the current institu-tional mechanisms we need a rigorous industry standard to constrain guide and standardize the management and capacity-building of the institutions in different historical periods.

Objective To understand the human resources of the grassroots institutions of schistosomiasis control and pre?vention so as to provide the evidence for formulating the standards of institutional capacity?building. Methods By using the combination of quantitative and qualitative methods the hierarchy of schistosomiasis control institution workers structural fea?tures of workers and benefits of workers were investigated and the results were analyzed statistically after the 2004 reform. Re?sults The constituent ratios of personnel≤30 years old 30 to 45 years old and≥45 years old were 6.8% 64.0%and 29.2%respectively with an average age of 43.1 years. For education levels 61.35%of the personnel had secondary or high school lev?els. At the city level the structural proportion of the senior professional medium professional and primary professional titles was 1.4∶5.6∶3.0 and at the county level the proportion was 0.5∶6.1∶3.4. There was 14 200 yuan per capita at the township schistosomiasis control institutions. Conclusion The technology of the personnel in schistosomiasis institutions of Hubei Prov?ince is weak the average age of personnel is old and the salary is low.

Objective To investigate the correlation between urinary 8-iso-prostaglandin F2α (8-iso-PGF2α) level and carotid atherosclerotic plaque stability in patients with acute ischemic stroke.Methods The patients with acute ischemic stroke were enrolled consecutively.According to the findings of carotid artery ultrasound,they were divided into either a non-plaque group or a plaque group,and then the plaque group was redivided into a stable plaque subgroup and an unstable plaque subgroup.Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of urinary 8-iso-PGF2α.Multivariate logistic regression analysis and Spearman correlation analysis were used to investigate the relationship between 8-iso-PGF2α and carotid artery plaques.Results A total of 150 patients with acute ischemic stroke were enrolled,including 104 had carotid artery plaque (30 were stable plaques and 74 were unstable plaques) and 46 had no carotid artery plaque.The urinary 8-iso-PGF2α level (86.45 ± 6.20 ng/mmol creatinine vs.45.70 ±6.19 ng/mmol creatinine; t =37.136,P=0.001) and intima-media thickness (IMT) (2.89 ± 1.03 mm vs.0.86 ±0.53 mm; t =3.518,P =0.002) in the plaque group were significantly higher than those in the nonplaque group.Multivariate logistic regression analysis showed that urinary 8-iso-PGF2α level (odds ratio [OR] 1.183,95％ confidence interval [CI] 1.087-1.276; P=0.001) and IMT (OR 28.642,95％ CI 8.276-137.231; P =0.001) were the independent risk factors for carotid artery plaque.Pearson correlation analysis showed that there was no significant correlation between urinary 8-iso-PGF2α level and carotid artery IMT (r =0.075,P =0.264).The urinary 8-iso-PGF2α level of the unstable plaque subgroup was significantly higher than that of the stable plaque subgroup (97.30 ± 7.20 ng/mmol creatinine vs.69.17 ±9.25 ng/mmol creatinine; t =16.506,P =0.001).Multivariate logistic regression analysis showed that urinary 8-iso-PGF2α level (OR 4.652,95％ CI 1.732-12.643; P =0.001) was an independent risk factor for unstable plaque.Conelusions The urinary 8-iso-PGF2α level is associated with the existence of carotid atherosclerotie plaque and instability,its increased level is an independent risk factor for carotid plaque instability in patients with ischemic stroke.

Objective To compare HER-2 state in breast cancer tissue deteced by fluorescent in situ hybridization (FISH) and immunohistochemistry (IHC) and analyze their correlation. Methods HER-2/neu protein expression and gene amplification were detected by FISH and IHC in 56 newly-diagnosed cases of female breast cancer from July 2008 to July 2009. Results Of the 56 patients, HER-2 protein expression (-), (+), (++), (+++) was 9 cases (16.1%), 29 cases (51.8%), 11 cases (19.6%) and 7cases (12.5%) respectively; 26 cases (46.4%) had HER-2 gene amplification while 30 cases (53.6%) didnt have. Type of HER-2 gene amplification was mainly HER-2(++) and HER-2(+++), and according gene amplification rate was 72 7% and 100%. HER-2 (+) gene amplification rate was 37.9 %(11cases) and no gene amplification was found in HER-2(-) tissue. The HER-2 positive rate using two methods had significant difference(χ2=19.778,P<0.01). HER-2(-) and HER-2(+++) had good consistency with the FISH results(Kappa=0.969),but HER-2(+) and HER-2(+ +) were poorly consistent with the FISH results(Kappa=0.271). Conclusions IHC is the preliminary screening method for detection of HER-2 expression. HER-2(-) and HER-2(+++) have good consistency with the gene amplification, and can guide clinical treatment. Some patients with HER-2(+) and HER-2(++) have HER-2 gene amplification. FISH is needed for targeted therapy.

Objective To investigate the pathogen distribution and risk factors of pulmonary infection after acute cervical spinal cord injury (ACSCI) in an attempt to offer reference for early antiinfection therapy.Methods The study comprised 223 cases who were admitted from October 2011 to October 2014.There were 149 males and 74 females,at (43.3 ± 13.5) years of age.Species of pathogens identified were gram-positive,gram-negative and mixed.Effects of age,gender,injury types and tracheotomy on pathogen distribution were analyzed.Results Gram-negative infection was found in 114 cases (51.1％),with tracheotomy accounting for 7.0％ of the cases and death accounting for 1.8％ of the cases,and the main causative pathogens were Klebsiella pneumonia,Escherichia coli,Pseudomonas aeruginosa and Acinetobacter baumannii.Gram-positive infection was found in 41 cases (18.4％),with tracheotomy accounting for 12.2％ of the cases and death accounting for 7.3％ of the cases,and the main causative pathogens were Staphylococcus aureus and Streptococcus pneumonia.Mixed infection was found in 68 cases (30.5％),with tracheotomy accounting for 22.1％ of the cases and death accounting for 13.2％ of the cases.Gender had no significant correlation with pathogen distribution.For the cases of complete spinal cord injury and tracheotomy,the ratio of mixed infection increased significantly (P ＜ 0.05).For the cases younger than 30 years,the pathogens were mainly gram-positive bacteria (P ＜ 0.05).Conclusions Main pathogens of pulmonary infection after ACSCI are gram-negative bacteria.The cases younger than 30 years are associated with higher risk of grampositive infection,while the cases with complete injury or tracheotomy are associated with higher risk of mixed infection.

Objective To analyze the effect of mesporous calcium silicate (m-CS)/calcium sulfate cement (CSC),m-CSC for short,in bone defect repair.Methods Setting time and compressive strength of the m-CSC (15 m-CSC as group Ⅰ and 30 m-CSC as group Ⅱ) were tested.CSC was used as the control.Cement samples were immersed in Tris-HCl solution,andin vitro degradation of the m-CSC was measured.Cell morphology and cell proliferation as well as differentiation on the samples were assessed.The cements were implanted into the traumatic femoral defects in rabbits,and the in vivo degradability and osteogenesis of the cements were investigated by histological evaluation after implantation for 4,8 and 12 weeks.Results Addition of m-CS into CSC prolonged the setting time (7.8 min in group Ⅰ and 10.5 min in group Ⅱ),obviously longer than 3.7 min in control group and did not have obvious effect on compressive strength of the cements.Weight loss of m-CSC solution was obviously lower (61.8 wt％ in group Ⅰ and50.3 wt％ in group Ⅱ),compared to70.4 wt％ in control group,pH value in group Ⅱ decreased from 7.40 to 7.26,while decreased from 7.40 to 6.86 in control group,m-CSC could promote cell proliferation and differentiation compared to CSC.At postoperative 12 weeks,histological sections showed massive new bony tissue (55.2％) in group Ⅱ,obviously higher than 25.6％ in control group.Conclusion m-CSC exhibits good biocompatibility,degradability and osteogenesis,and can promote bone regeneration in bone defect repair.

Objective To observe the clinical effect of multimodal analgesia for painless artificial abortion . Methods 150 cases of ASA Ⅰ-Ⅱ pregnancy received painless artificial abortion operation ,no contraindication for all patients,were randomly divided into the five groups ,30 cases in each group,the blank control group (group S):do not use any analgesia measure ,intravenous injection of 0.9% sodium chloride 2mL preoperation;the fentanyl group ( F group ) :intravenous injection of fentanyl 1μg/kg preoperation ;the parecoxib group ( group P ) :intravenous injection of parecoxib sodium 40mg preoperation.The patients were given painless artificial abortion after injection the above drugs.Nerve block group ( N group):the implementation of painless induced abortion operation after sleep in patients with the cervical nerve block ,injection of 1%lidocaine 2 mL.Multimodal analgesia group (group M):intra-venous injection of parecoxib sodium 40mg,fentanyl 1μg/kg,then the implementation method the same as N group . The operation time,anesthesia onset time,recovery time,time of accurate orientation and additional dosage of propo-fol;incidence rate of artificial abortion syndrome ,the incidence rate of uterine contraction pain ,10min,30min,1h,6h pain scores after operation; adverse reaction;satisfaction score of analgesic effect postoperative 24h were observed. Results The additional dosage of propofol in the group S ,group F,group P,group N and group M were (78.45 ± 20.36)mg,(15.55 ±12.33)mg,(16.75 ±13.13)mg,(14.55 ±10.25)mg,(9.35 ±8.27)mg.The incidence rates of uterine contraction pain in the group S ,group F,group P,group N and group M were 30%,10%,10%,10%,0. Compared with group M ,the additional dosage of propofol and incidence rate of uterine contraction pain in the other four groups were significantly increased (t=3.05,1.82,1.84,1.78,χ2 =72.1,68.2,68.2,68.2,all P<0.05). Pain scores after operation 10min,30min,1h,6h in the group S were (6.6 ±1.5)points,(5.6 ±1.4)points,(4.6 ± 1.1)points,(3.6 ±1.4)points.Those in group F were (5.1 ±1.5)points,(4.3 ±1.1)points,(3.1 ±0.9)points, (2.8 ±0.8).Pain scores after operation 10min,30min,1h,6h in the group P were (4.6 ±1.5) points,(4.2 ± 0.9)points,(2.9 ±0.8) points,(2.7 ±0.6) points.Those in the group N were (4.5 ±1.5) points,(4.1 ± 0.8)points,(2.9 ±0.8)points,(2.6 ±0.5).Pain scores after operation 10min,30min,1h,6h in the group M were (2.2 ±0.8)points,(1.9 ±0.7)points,(1.5 ±0.5)points,(1.2 ±0.3)points.Compared with the group M,pain scores after operation 10min,30min,1h,6h in the other four groups were significantly elevated ( t=2.03,1.96,1.86, 1.84,1.98,1.82,1.80,1.76,2.05,1.99,1.95,1.86,2.06,1.88,1.82,1.76,all P<0.05).Compared with S group,postoperative 24h satisfaction score of analgesia in the group M was improved significantly ( t =1.98,P<0.05).Compared with group M,the incidence rate of nausea in the other four groups was increased significantly (χ2 =72.2,68.9,68.1,68.1,all P<0.05).Conclusion Multimodal analgesia method can greatly reduce artificial abor-tion postoperative pain ,reduce the adverse reactions ,improve patients'satisfaction score ,ensure the safety of operation .

ObjectiveTo investigate the changes of serum concentration of parathyroid hormone (PTH) and calcium after thyroid surgery and compare the changes among different modes of operation. MethodsFrom Aug. 2006 to Dec. 2009, 470 patients accepted thyroid surgery. The serum concentration of PTH and calcium in different groups was measured and compared before and 1 day after surgery. According to the extent and similarity of the surgery, patients were classified into 7 groups and they were compared in terms of postoperative changes of PTH and serum calcium. Statistical analysis was performed. ResultsThe serum concentration of PTH and calciurn decreased significantly after surgery in all patients except for those receiving unilateral and bilateral partial thyroidectomy. Compared with unilateral lobectomy, surgeries such as bilateral subtotal thyroidectomy, unilateral thyroidectomy with contralateral subtotal thyroidectomy, bilateral near-total thyroidectomy and total thyroidectomy resulted in more dramatic decreases of serum concentration of PTH and calcium and higher incidence of hypocalcemia ( P ＜ 0.05 ). The comparison between patients receiving CLND or not had the same result. Conclusions Almost all kinds of thyroid surgery affect the parathyroid function. The wider the surgery, the higher the possibility of postoperative hypoparathyroidism. The indications and criteria of different types of thyroid surgery are essential for hypoparathyroidism prevention. In some cases, vitamin D and calcium are recommended for preventive purpose.

OBJECTIVETo observe the preventive effects of multi-glycoside of Tripterygium wilfordii (GTW) on glomerular lesions in experimental diabetic nephropathy (DN).

METHODThe DN model of rats was established with streptozotocin (STZ) and intervened with GTW. In the same time, normal, benazepril, and vehicle control groups were set up. After 8 weeks of oral treatment with GTW (50 mg x kg(-1) BW), benazepril (6 mg x kg(-1) BW), and vehicle (physiological saline), the changes of body weight, urine albumin (UA1b), blood glucose (BG), serum creatinine (Scr), blood urea nitrogen (BUN) and glomerular morphology were examined. In addition, the level of protein expression of alpha-smooth muscle actin (alpha-SMA) and collagen type I in glomeruli was determined by immunofluorescence.

RESULTBoth GTW and benazepril reduced UA1b. GTW ameliorated glomerular injury, such as mesangial cell proliferation, alpha-SMA and collagen type I over-expression, in DN model. Compared with benazepril, beneficial effects of GTW on glomerulusclerosis were more significant (total cell number: GTW group 54.44 +/- 2.41, benazepril group microg/67.83 +/- 4.41, P < 0.05; alpha-SMA score: GTW group 1.98 +/- 0.52, benazepril group 2.27 +/- 0.46, P < 0.05; collagen type I score: GTW group 2.11 +/- 0.37, benazepril group 2.88 +/- 0.58, P < 0.05).

CONCLUSIONPreventive effects of GTW on glomerular lesion in DN model are related to decreasing UA1b and ameliorating glomerulusclerosis.

Animals ; Diabetic Nephropathies ; drug therapy ; metabolism ; prevention & control ; Disease Models, Animal ; Glycosides ; administration & dosage ; Humans ; Kidney Glomerulus ; drug effects ; injuries ; metabolism ; Male ; Plant Extracts ; administration & dosage ; Random Allocation ; Rats ; Tripterygium ; chemistry

A significant proportion of patients with chorea-acanthocytosis (ChAc) fail to respond to standard therapies. Recent evidence suggests that globus pallidus internus (GPi) deep brain stimulation (DBS) is a promising treatment option; however, reports are few and limited by sample sizes. We conducted a systematic literature review to evaluate the clinical outcome of GPi-DBS for ChAc. PubMed, Embase, and Cochrane Library databases were searched for relevant articles published before August 2021. The improvement of multiple motor and nonmotor symptoms was qualitatively presented. Improvements in the Unified Huntington’s Disease Rating Scale motor score (UHDRS-MS) were also analyzed during different follow-up periods. A multivariate linear regression analysis was conducted to identify potential predictors of clinical outcomes. Twenty articles, including 27 patients, were eligible. Ninety-six percent of patients with oromandibular dystonia reported significant improvement. GPi-DBS significantly improved the UHDRS-motor score at < 6 months (p < 0.001) and ≥ 6 months (p < 0.001). The UHDRS-motor score improvement rate was over 25% in 75% (15/20 cases) of patients at long-term follow-up (≥ 6 months). The multiple linear regression analysis showed that sex, age at onset, course of disease, and preoperative movement score had no linear relationship with motor improvement at long-term follow-up (p > 0.05). GPi-DBS is an effective and safe treatment in most patients with ChAc, but no reliable predictor of efficacy has been found. Oromandibular dystonia-dominant patients might be the best candidates for GPi-DBS.