Objective To provide data evidence for early diagnosis of bone and joint damage derived from brucellosis by analyzing its clinical and imaging characteristics.Methods Patients with brucellosis accepted in Ji'nan Infectious Disease Hospital form December 2013 to December 2014 were selected.Patients with bone and joint damage confirmed through imaging were further studied,their epidemiological and clinical characters,CT and MRI characteristics,treatment and outcome were summarized.Results Total of 97.8％ (45/46) patients had a clear contact history,most of them worked in poultry farming,taking up to 67.4％ (31/46).July to October was its peak time for attacking,taking up to 58.7％ (27/46).The clinical manifestations of patients were joint pain,swelling and activities obstacles.In the CT images,there was obvious bony destruction,characterized by multiple round or large areas of low density insect damage sample spots.There was osteosclerotic bone lesions or osteophyte formatted in edge.The paravertebral soft tissue was swelling,and the vertebral body deformation was not obvious,and there was vertebra small joint damage occasionally.In the MRI images,there was vertebral ligaments damage,or soft tissue damage,or osteoproliferation at the edge of the vertebral bodies.There was abnormal signal T1W1 or T2W1 signal,and FS-T1W1 showed high signal,while FS-T2W1 showed slightly high signal.The diagnosis rate of CT,MRI and CT combined MRI for bone and joint damage derived from brucellosis was 76.1％ (35/46),84.8％ (39/46) and 91.3％ (42/46),respectively.The main therapeutic drugs were doxycycline and rifampicin,and the clinical effective rate was 91.3％ (42/46).Conclusion The epidemiological characters,CT and MRI characteristics of bone and joint damage derived from brucellosis have certain representativeness,and the comprehensive investigation is beneficial for clinical diagnosis.

Objective To present the distinction on clinical features,laboratory features,treatment schemes between the patients with and without brucellar epididymo-orchitis,and to provide a theoretical basis for clinical diagnosis and treatment.Methods A retrospective analysis of 223 male patients with brucellosis in the First Hospital of Jilin University from June 2010 to November 2016 was carried out.A comparative analysis of the clinical and laboratory features of 22 patients with epididymo-orchitis and 201 cases without epididymo-orchitis was done.The SPSS 23.0 software was used to analyze the statistical results,P ＜ 0.05 was defined as statistically significant.Results Epididymo-orchitis occurred in 9.87％ (22/223) of all male patients with brucellosis.The median ages of patients with and without epididymo-orchitis were 35.5 and 42.0 years old,respectively,the difference was not statistically significant (Z =1.323,P ＞ 0.05).Cases with and without epididymo-orchitis of brucellosis with fever [90.9％ (20/22) vs 69.2％ (139/201)],chills [54.4％ (12/22) vs 28.9％ (58/201)],hepatomegaly [22.7％ (5/22) vs 3.5％ (7/201)],abdominal symptoms [59.1％ (13/22) vs 17.4％ (35/201)],and urinary tract infection symptoms [31.8％ (7/22) vs 3.5％ (7/201)],the differences were statistically significant (x2 =4.586,6.076,14.424,20.392,27.059,all P ＜ 0.05).The medians of white blood cell (WBC) count (7.9 × 109/L),erythrocyte sedimentation value (ESR,38.0 mm/h),and aspartate aminotransferase (AST,110.0 U/L) in brucellosis with epididymo-orchitis were higher than those without epididymo-orchitis (5.1 × 109/L, 30.0 mm/h,73.8 U/L),the differences were statistically significant (Z =2.239,2.064,2.762,all P ＜ 0.05).All brucellosis patients with epididymis-orchitis were treated with antibiotics for 8 weeks.The defervescence time was 4.5 days,the time of pain relief was 3.9 days,21 patients were cured,and only Ⅰ patient relapsed.Conclusions Epididymo-orchitis is a common complication of brucellosis.Brucellar epididymo-orchitis is usually characterized with a severe acute clinical presentation,which needs timely diagnosis.Combination of antibiotics treatment for 8 weeks in brucellosis patients with epididymis-orchitis is effective.

Objective To study clinical and laboratory features of children with brucellosis and to provide a theoretical basis for clinical diagnosis and treatment.Methods Using the retrospective analysis method,the clinical diagnosed information of child patients with brucellosis from January 2013 to January 2016 in Heilongjiang Agricultural Reclamation Bureau General Hospital were selected to analysis the general characteristics,clinical symptoms and laboratory examination results.At the same time,follow the case control method,dadult brucellosis laboratory results were selected,and the laboratory examination results were compared between child and adult patients.Results The children of ＞ 12-15 years of age had the highest incidence in 65 cases of brucellosis,and the rate was 47.7％ (31/65).Clinical symptoms were fever and joint pain,which accounted for 83.1％ (54/65) and 84.6％ (55/65),respectively.The mean values of γ-glutamyl transpeptadase (γ-GT),α-hydroxybutyric dehydrogenase (HBDH),creatine kinase isoenzyme (CK-MB) and lactate dehydrogenase (LDH) were compared between child brucellosis and adult brucellosis,and the differences were statistically significant [(30.66 ± 27.05) vs (82.80 ± 36.34) U/L,(287.40 ± 35.02) vs (180.08 ± 40.90)U/L,(20.88 ± 13.01) vs (11.70 ± 4.13)U/L,(328.69 ± 37.86) vs (217.88 ± 45.67)U/L,t =-4.243,3.396,3.756,3.135,all P ＜ 0.05].After treatment,the test results of children with aspartate transaminase (AST),alanine aminotransferase (ALT),γ-GT,total protein (TP),albumin (ALB),HBDH,CK-MB and LDH were compared with those of before the treatment,the differences were statistically significant [(56.95 ± 29.50) vs (23.00 ± 12.26) U/L,(57.60 ± 35.65) vs (23.94 ± 13.38) U/L,(30.66 ± 27.05) vs (18.45 ± 12.62) U/L,(63.77 ± 5.51) vs (67.42 ± 3.50) g/L,(39.15 ± 3.89) vs (43.06 ± 3.11) g/L,(287.40 ± 35.02) vs (139.23 ± 51.70) U/L,(20.88 ± 13.01) vs (11.61 ± 10.26) U/L,(328.69 ± 37.86) vs (187.77 ± 42.32) U/L,t =4.848,2.717,2.182,-5.442,-13.752,6.989,4.749,5.993,all P ＜ 0.05].Conclusions Liver and heart of children with brucellosis are injured.By monitoring the changes of myocardial enzymes,medicines for children might be cautiously used in clinical trial,and myocardial damages of children with brucellosis can be protected and prevented.

Objective Using Beckman assay kit to establish women thyroid function indicators reference interval during pregnancy in Fujian Province.Methods Two iodine sufficient areas were selected in Fujian randomly,and the women who did pregnancy test in local hospital were investigated.A questionnaire study and physical examination were conducted and women's serum samples were collected to detect the thyroid function [thyroid stimulating hormone (TSH),free triiodothyronine (FT3),free thyroxine (FT4),total triiodothyronine (TT3),and total thyroxine (TT4)] using Beckman chemiluminescence analyzer access-2 and assay kit.Reference interval was shown with median (M) and P2.5-P97.5.At the same time,the newly established reference interval was used to evaluate the thyroid function of 830 pregnant women.Result A total of 455 pregnant women were detected (early,middle and late pregnancies were 146,157 and 152,respectively).Most of the thyroid function indexes presented skewed distribution.The thyroid function index reference intervals in early,middle and late pregnancies were TSH:0.80 (0.02-2.96),1.13 (0.07-3.56),1.18 (0.09-3.76) mU/L;FT3:4.28 (3.30-5.76),3.74 (2.78-4.83),3.63 (2.81-4.56) pmol/L;FT4:11.78 (8.66-19.68),9.34 (7.03-12.76),8.55 (6.20-11.73) pmol/L;TT3:1.91 (1.09-2.95),2.00 (0.90-2.96),1.98 (0.91-3.02) nmol/L;and T4:123.00 (79.62-194.85),115.42 (58.78-175.85),117.43 (58.29-192.00) nmol/L.The thyroid dysfunction rate diag,nosed by our reference interval was 22.0％ (183/830),whilch was lower than 28.0％ (232/830) diagnosed by American Thyroid Association (ATA) reference interval (x2 =7.714,P ＜ 0.05).Conclusions Women thyroid function indicators reference interval during pregnancy in Fujian Province is successfully established.The study shows that each area and laboratory should establish the thyroid hormone reference interval of pregnant women for diagnosis and treatment of thyroid disease.

Objective To summarize and analyze the epidemiological and clinical characteristics of patients with subacute thyroiditis (SAT),so as to provide a basis for prevention and treatment of the disease.Methods The epidemiological and clinical datas of 121 SAT patients,who were treated at the Shandong Provincial Institute for Endemic Disease Prevention and Control in 2015,were collected.The SAT patient's age,sex,lived in urban or rural areas,occupation and time of onset distributions were analyzed retrospectively.According to the clinical manifestations,the SAT patients were divided into types Ⅰ (mild/nodule type),Ⅱ (medium/normal),Ⅲ (severe/hyperthyroidism),and Ⅳ (delay),and clinical manifestations,auxiliary examination findings,treatment and outcome were summarized.Results Average age of the 121 cases of SAT patients was 41.36 years old,the youngest was 10 years old and the oldest was 76 years old.Most of the patients were 30-＜ 50 years old,which was accounted for 55.37％ (67/121).Most of the patients were female,which was accounted for 90.08％ (109/121).Most of the patients lived in rural areas,which was accounted for 59.50％ (72/121).Majority of the SAT patients were farmers,which was accounted for 43.80％ (53/121).Most onset of the disease was in November,accounted for 19.83％ (24/121),and the least was in June,accounted for 2.48％ (3/121),the peak of the incidence of SAT lied in autumn,and it was sporadic in the rest of the year.From the clinical classification,the mild type (61) and the medium type (46) were the largest part,a total of 107 cases,accounted for 88.43％ (107/121);while the severe type had 5 cases,accounted for 4.13％ (5/121);the delay type had 9 cases,accounted for 7.44％ (9/121).The clinical manifestations were as follows:anterior neck discomfort was 109 cases,accounted for 90.08％ (109/121);sore throat was 93 cases,accounted for 76.86％ (93/121).Auxiliary examination findings were as follows:thyroid iodine taken rate reduced in 121 cases,accounted for 100.00％ (121/121);thyroid nodule 96 cases,accounted for 79.34％ (96/ 121);total number of white blood cells increased in 52 cases,accounted for 42.98％ (52/121);neutrophil increased in 61 cases,accounted for 50.41％ (61/121);blood sedimentation significantly speed up in 49 cases,accounted for 40.50％ (49/121).All of the 121 patients were cured.Conclusions Majority of the patients are female,young aduhs and farmers.The peak of the incidence of SAT lies in autumn.The proportion of mild,medium type is the highest,we suggest this disease should be early diagnosis and treatment.

Epidemiological studies have indicated that a high prevalence rate of lung cancer,bladder cancer and liver cancer in the arsenic exposure population.As a weak mutagenic carcinogen,the mechanism of arsenic induced carcinogenesis has not yet been fully elucidated.In recent years,more and more studies have showed that the DNA methylation and the alternation of histone modification patterns might be involved in the carcinogenesis induced by arsenic.Therefore,in this paper we reviewed the alternation of DNA methylation and histone modification patterns,such as histone acetylation,histone methylation and histone phosphorylation,induced by arsenic exposure;and we also reviewed the role of histone modification and DNA methylation in the process of arsenic carcinogenesis.

Objective To study a method for determination of aluminum in food,and to ensure food safety and public health.Methods Microwave digestion-chrome azurol S spectrophotometric method was used to detect the aluminum content in fried dough sticks.Detection limit,linear range,precision,accuracy and maximum absorption wavelength were calculated.Results The method detection limit was 0.08 μg,precision was 0.60％-5.90％,and recovery rate was 96.0％-102.3％,maximum absorption wavelengnth was 620 mm.Aluminum content in 10 samples of fried dough sticks were all exceeded the standard,which were 709.5,980.8,1 010.3,1 151.5,1 214.0,1 243.7,1 318.1,1 374.0,1 435.0 and 1 479.4 mg/kg.Conclusion The method is simple,reliable,reproducible and easy to be used.

Objective To investigate the influence of host animals on epidemics of hemorrhagic fever with renal syndrome (HFRS) so as to provide a basis for effective control of HFRS.Methods From the national infectious disease network direct reporting system,the incidence of HFRS cases diagnosed by direct diagnosis of medical institutions in Qingdao was collected from 2011-2015.We captured rats indoor and outdoor by night trapping method quarterly and calculated the capture rates from 2011-2015 in Qingdao areas.The incidence of HFRS in different regions and the change of seasonal growth,the distribution of host animals,the characteristics and distribution of animals,and the seasonal variation of dominant species were analyzed and a database was set up and statistic analysis was conducted by SPSS 13.0.Results The peak incidence rate of HFRS in Qingdao areas occurred in 2012 (3.54/100 000) and presented a decrease trend year by year (x2 =64.15,P ＜ 0.05),but there were different characteristics among the epidemic areas,and lowest in 2015 (1.68/100 000).And the peak presented a two-peak pattern which was mainly an autumn peak and a gentle peak in late spring and early summer.The epidemics were gradually decreased from the rural areas to the urban fringes and then the urban areas.The seasonal variation was disappeared gradually.There was a heavy epidemic intensity in areas with a high capture rate and a complex type of host animals.The epidemic peak was in consistence with the distribution of rats.Capture rates were different among the epidemic areas.The capture rate in Jiaonan was the highest [5.32％(2 886/54 287)] and lowest in Pingdu [1.77％ (258/14 584)].The mean (x2 =820.39,P ＜ 0.05) and annual capture rates (x22011-2015 =32.61,356.24,233.07,129.33,33.42,all P ＜ 0.05) among epidemic areas were different.In the third quarter the accumulated capture rate was the highest [4.69％ (1 187/25 301)].In total 8 kinds of host animals were captured and the dominant species were brown rat [30.27％ (1 235/4 080)],house mouse[29.75％ (1 214/4 080)] and striped field mouse [16.25％ (663/4 080)].Conclusions The epidemic intensity of HFRS is related to the densities and the types of host animals.The gradually decreased epidemic pattern from the rural areas to the urban fringes and then the urban areas may be related to urbanization and improved health behaviors.

Objective To understand the implementation of preventive measures for iodine deficiency disorders among residents in Yunnan Province.Methods Iodized salt monitoring database and reports from states (cities) of Yunnan Province from 2011 to 2015 were collected,and the coverage rate of iodized salt,the quality of iodized salt,the rate of qualified iodized salt consumption were evaluated.Results From 2011 to 2015,at the province level,the coverage rate of iodized salt was ＞ 98％.The rate of qualified iodized salt consumption was ＞ 97％ from 2011 to 2012,and kept at higher than 95％ from 2013 to 2015.At the county level,the county (city,district) coverage rate of qualified iodized salt that ≥90％ accounted for 99.22％ (128/129),98.44％ (126/128),91.47％ (118/129),92.25％ (119/129) and 99.22％ (128/129).The constitute ratio of salt containing 18-33 mg/kg iodine increased year by year,from 64.07％ (24 297/37 923) in 2011 to 95.15％ (36 930/38 813) in 2015.Conclusions In recent years,measures for control of iodine deficiency disorders are implemented well in Yunnan Province.After production of new standard iodized salt in 2012,the rate of qualified iodized salt consumption is decreased.After the four-year transition period,the new standard iodized salt has covered over the whole province.To rectify salt market,improve quality of iodized salt and enhance monitoring quality in order to consolidate the control achievements is the focus of prevention work in the future.

Objective To investigate the progress and effectiveness of water-improving defluoridation projects comprehensively in control of fluorosis in drinking-water-borne endemic fluorosis areas in Hubei Province,and to provide a scientific basis for making strategies in prevention and control of endemic fluorosis.Methods All villages affected by fluorosis in drinking-water-borne endemic fluorosis areas were selected in Hubei Province,in which the progress and effectiveness of water-improving and defluoridation projects were investigated in 2015.Those villages were chosen to determine fluoride content of drinking water,and to check the prevalence of dental fluorosis of children 8 to 12 years old.Water fluoride content was tested with fluoride ion-selective electrode,and dental fluorosis was diagnosed by the Dean method.Results The water improvement projects were completed in 197 villages in the 30 disease affected counties (cities) with accomplishment rate 100.00％ (197/197),geometric mean of water fluorine 0.36 mg/L,qualified rate of water fluorine 100.00％ (197/197) and normal operation rate of the water-improvement projects 95.94％ (189/197).Totally 14 856 children aged 8-12 were examined their dental fluorosis.The prevalence rate was 1.78％ (265/14 856) and the dental fluorosis index was 0.04,which meant epidemic strength was negative.Totally 29 out of the 30 disease affected counties (cities) had met the disease control standards.Conclusion The prevalence of drinking-water-borne endemic fluorosis in Hubei Province has been under control,but management and monitoring of the water improvement projects still should be strengthened.