Objective To compare the different surveillance system evaluation guidelines proposed by US Center for Disease Control and Prevention (CDC) and WHO, so as to develop an evaluation strategy suitable for communicable disease surveillance systems in China. Methods Systematic collection and review on the guidelines that were proposed by US CDC and WHO.Situation analysis together with feasibility analysis were linked to the analysis of evaluation strategy used in China. Results US CDC guidelines were more appropriate for evaluating those single or appropriate for evaluating the multi-system or complicated system which focusing on data related to moment to start to evaluate the functions. Conclusion More flexible and comprehensive strategy based on national conditions is needed when constitute the national communicable disease surveillance evaluation guidelines. The multi-step strategy described in this article could be used as reference.

BACKGROUNDTo find the pathogenic agents of aseptic meningitis prevalent in Xuzhou of Jiangsu province in 2001.

METHODSThe enterovirus (EV) was cultured from CSF of the patients and identified with anti-serum by neutralization test. Neutralization titer of antibody in paired sera from meningitis children was determined. EV RNA was detected by RT-PCR.

RESULTSFour strains of Coxsackievirus B5, 2 strains of Coxsackievirus B3 and 1 strain of Echovirus 7 were isolated from 22 CSF specimens. The isolation rate of virus was 31.8% (7/22), 21 CSF were tested by RT-PCR, the positive rate of EV RNA was 52.4% (11/21); 57.9% (11/19) of patients paired-sera had over 4 folds antibody rise or became seroconverted.

CONCLUSIONEnterovirus was the pathogenic agent of aseptic meningitis prevalent in Xuzhou of Jiangsu province, the main serotype of the virus was Coxsackievirus B5.

Antibodies, Viral ; immunology ; Child ; Child, Preschool ; China ; epidemiology ; Coxsackievirus Infections ; cerebrospinal fluid ; epidemiology ; virology ; Echovirus Infections ; cerebrospinal fluid ; epidemiology ; virology ; Enterovirus ; genetics ; immunology ; isolation & purification ; Humans ; Infant ; Meningitis, Aseptic ; cerebrospinal fluid ; epidemiology ; virology ; Microscopy, Electron ; Neutralization Tests ; Prevalence ; RNA, Viral ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Virion ; isolation & purification ; ultrastructure

OBJECTIVETo investigate the prevention and treatment for postsurgical gastroparesis syndrome (PGS) after pancreaticoduodenectomy.

METHODSThe data of 18 PGS cases after pancreaticoduodenectomy were analyzed.

RESULTSPGS of these 18 patients occurred within 4-10 days after operation. All of the PGS patients were cured with mean 25.4 days by conservative therapy and no one received re-operation. PGS was closely associated with the operation procedure (chi(2)=3.90, P<0.05)and postoperative complications (chi(2)=3.92, P<0.05).

CONCLUSIONSIncidence of PGS can be decreased by improvement of surgical procedure and prevention of abdominal complications. PGS can be cured by conservative therapy generally. Re-operation should be avoided.

Adult ; Aged ; Female ; Gastroparesis ; etiology ; Humans ; Male ; Middle Aged ; Pancreaticoduodenectomy ; adverse effects ; Postoperative Complications

Objective To analyze the timeliness of detection and reporting on public health emergency events, and to explore the effective strategies for improving the relative capacity on those issues. Methods We conducted a retrospective survey on 3275 emergency events reported through Public Health Emergency Events Surveillance System from 2005 to the first half of 2006. Developed by county Centers for Disease Control and Prevention, a uniformed self-administrated questionnaire was used to collect data, which would include information on the detection, reporting of the events. Results For communicable diseases events, the median of time interval between the occurrence of first case and the detection of event was 6 days (P25=2, P75=13). For food poisoning events and clusters of disease with unknown origin,the medians were 3 hours (P25=1, P75=16) and 1 days (P25=0,P75=5). 71.54% of the events were reported by the discoverers within 2 hours after the detection. Conclusion In general, the ranges of time intervals between the occurrence, detection or reporting of the events were different, according to the categories of events. The timeliness of detection and reporting of events could have been improved dramatically if the definition of events, according to their characteristics, had been more reasonable and accessible, as well as the improvement of training program for healthcare staff and teachers.

OBJECTIVETo explore the prognostic impact of post primary percutaneous coronary intervention (PCI) reperfusion status on outcome in patients with acute ST-elevation myocardial infarction (STEMI).

METHODSA retrospective analysis was performed in 964 patients undergoing primary PCI for STEMI. Electrocardiogram and TIMI myocardial perfusion grade (TMPG) were analyzed by reader blinded to the clinical course. Patients were divided to four groups according to ST segment resolution (STR) and TMPG: group A were patients with good STR and TMPG(425/964), group B were patients with poor STR and good TMPG (239/964), group C were patients with good STR and poor TMPG (113/964) and group D were patients with poor STR and TMPG (113/964).

RESULTSAlthough TIMI grade III flow was achieved after mechanical reperfusion, abnormal reperfusion was still present in about 1/3 patients as shown by poor STR or TMPG. Older age, cardiac dysfunction and diabetes, prolonged time of pain to balloon/emergency room are independent risk factors for abnormal reperfusion post PCI. Major adverse cardiac events events in hospital (RR = 64. 63, P < 0.01) and during follow up (RR = 11.69, P < 0.01) were significantly higher in group D than in group A.

CONCLUSIONPoor post PCI reperfusion status is associated with higher in hospital and during follow up major adverse cardiac events event in STEMI patients.

Adult ; Aged ; Aged, 80 and over ; Angioplasty, Balloon, Coronary ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; diagnosis ; physiopathology ; therapy ; Myocardial Reperfusion ; Prognosis ; Retrospective Studies ; Treatment Outcome

BACKGROUNDPrimary percutaneous coronary intervention (PCI) is the best treatment of choice for acute ST segment elevation myocardial infarction (STEMI). This study aimed to determine the clinical outcomes of tirofiban combined with the low molecular weight heparin (LMWH), dalteparin, in primary PCI patients with acute STEMI.

METHODSFrom February 2006 to July 2006, a total of 120 patients with STEMI treated with primary PCI were randomised to 2 groups: unfractionated heparin (UFH) with tirofiban (group I: 60 patients, (61.2 ± 9.5) years), and dalteparin with tirofiban (group II: 60 patients, (60.5 ± 10.1) years). Major adverse cardiac events (MACE) during hospitalization and at 4 years after PCI were examined. Bleeding complications during hospitalization were also examined.

RESULTSThere were no significant differences in sex, mean age, risk factors, past history, inflammatory marker, or echocardiography between the 2 groups. In terms of the target vessel and vascular complexity, there were no significant differences between the 2 groups. During the first 7 days, emergent revascularization occurred only in 1 patient (1.7%) in group I. Acute myocardial infarction (AMI) occurred in 1 (1.7%) patient in group I and in 1 (1.7%) in group II. Three (5.0%) patients in group I and 1 (1.7%) in group II died. Total in-hospital MACE during the first 7 days was 4 (6.7%) in group I and 2 (3.3%) in group II. Bleeding complications were observed in 10 patients (16.7%) in group I and in 4 patients (6.7%) in group II, however, the difference was not statistically significant. No significant intracranial bleeding was observed in either group. Four years after PCI, death occurred in 5 (8.3%) patients in group I and in 4 (6.7%) in group II. MACE occurred in 12 (20.0%) patients in group I and in 10 (16.7%) patients in group II.

CONCLUSIONSDalteparin was effective and safe in primary PCI of STEMI patients and combined dalteparin with tirofiban was effective and safe without significant bleeding complications compared with UFH. Although there was no statistically significant difference, LMWH decreased the bleeding complications compared with UFH.

Aged ; Angioplasty, Balloon, Coronary ; Anticoagulants ; therapeutic use ; Dalteparin ; administration & dosage ; therapeutic use ; Female ; Heparin ; administration & dosage ; therapeutic use ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; drug therapy ; therapy ; Treatment Outcome ; Tyrosine ; analogs & derivatives ; therapeutic use

OBJECTIVETo describe the occupational distribution of staff who worked on detection and reporting on public health emergency events, and to explore the effective strategies for identification and reporting on emergency events.

METHODSWe conducted a retrospective survey on 3275 emergent events reported through Public Health Emergency Events Surveillance System from 2005 to the first half of 2006. Data were collected by uniform self-administrated questionnaires by county Centers for Disease Control and Prevention, including information on events detection and reporting, etc.

RESULTSAmong event discoverers, 56.40% (1847/3275) were healthcare staff, 20.58% (674/3275) were teachers, and 15.15% (496/3275) were staff from the disease control systems. Among those event reporters, 56.82% (1861/3275) were healthcare staff, 21.77% (713/3275) from disease control system and 10.75% (352/ 3275) were teachers.

CONCLUSIONHealthcare staff and teachers played the most important role in detection and reporting on events. It would be favorable to improve the ability of events detection and reporting if we could enhance the training program to the relative staff in medical facilities and school settings especially at the grass root level.

China ; Disease Notification ; statistics & numerical data ; Humans ; Internet ; Population Surveillance ; Public Health ; statistics & numerical data

OBJECTIVETo carry out epidemiological study on an outbreak caused by E. coli O157:H7 infection in Jiangsu province in 1999.

METHODSEpidemiological, microbiological and moleculebiological methods were used to find out the source, route of transmission and risk factors.

RESULTS95 severe O157:H7 infected patients with acute renal failure in 9 counties and districts of 2 municipalities were reported in Jiangsu province, 1999 while 83 of the patients died with a death rate of 87.37%. Most patients were seen in mid or late June. The ratio of male to female was 1 to 1.44 and 88.42% of the patients were over 50 years old. 38 patients occurred in 2000 with 34 deaths. Major factors contributing to the outbreak would include without drinking tap water, eating leftover food, poor sanitary status in kitchen, not washing hands before meal and after bowl movement. 2 strain of O157:H7 was isolated from severe patients and 3 from diarrhea cases. Carrier rate among animals was up to 9.62% and 99.41% of the strains carried toxic gene. Strains isolated from feces of patients and animals belonged to the same colonies.

CONCLUSIONThis outbreak was severe which caused by O157:H7 and was first seen in China, which was closely related to the high carrier rate of O157:H7 in animals and to the positive rate of high toxic gene of the strains. There were various routes of transmission and the main factors of infection would include poor personal health habits and poor sanitation of the household.

Acute Kidney Injury ; epidemiology ; etiology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antibodies, Bacterial ; immunology ; Case-Control Studies ; Child ; Child, Preschool ; China ; epidemiology ; Diarrhea ; epidemiology ; microbiology ; Disease Outbreaks ; Escherichia coli Infections ; complications ; epidemiology ; Escherichia coli O157 ; isolation & purification ; Escherichia coli Proteins ; immunology ; Female ; Hemolysin Proteins ; immunology ; Humans ; Infant ; Male ; Middle Aged ; Seroepidemiologic Studies

OBJECTIVETo explore the clinical effect of primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) induced by left main artery total or subtotal occlusion.

METHODSBetween January 1995 and June 2010, there were 28 AMI patients [24 males, mean age (61.5 ± 2.3) years, 15 patients complicated with cardiac shock] with left main occlusion or severe stenosis who were treated with PCI in our center. The clinical features were compared between death group and survival group. All survival cases were prospectively followed up for the occurrence of major adverse cardiac events.

RESULTSTotally 25 patients received stent implantation, 2 received balloon dilation followed by coronary artery bypass graft, and 1 patient died during PCI. Total in-hospital mortality was 35.7% (10/28), and mortality was 53.3% (8/15) in cardiac shock patients. Compared with survival group, ratio of cardiac shock [80.0% (8/10) vs.38.9% (7/18), P < 0.05] and poor collateral circulation flow [100% (10/10) vs. 33.3% (6/18), P < 0.01] were higher in death group, and there was no significant difference in TIMI 3 grade of forward flow post procedure (P > 0.05). Hospital stay was (22.1 ± 2.6) days and the cumulative survival was 64.3% during 3 months follow up for survival group.

CONCLUSIONSShort-term clinical outcome is favorable for survived AMI patients with left main disease who underwent PCI. The ratio of cardiac shock and poor collateral circulation flow are risk factors for in-hospital death in AMI patients with left main disease who underwent PCI.

Adult ; Aged ; Aged, 80 and over ; Coronary Artery Disease ; pathology ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; pathology ; therapy ; Percutaneous Coronary Intervention ; Risk Factors ; Treatment Outcome

BACKGROUNDThe genome of the severe acute respiratory syndrome-associated coronavirus (SARS-CoV) includes sequences encoding the putative protein X4 (ORF8, ORF7a), consisting of 122 amino acids. The deduced sequence contains a probable cleaved signal peptide sequence and a C-terminal transmembrane helix, indicating that protein X4 is likely to be a type I membrane protein. This study was conducted to demonstrate whether the protein X4 was expressed and its essential function in the process of SARS-CoV infection.

METHODSThe prokaryotic and eukaryotic protein X4-expressing plasmids were constructed. Recombinant soluble protein X4 was purified from E. coli using ion exchange chromatography, and the preparation was injected into chicken for rising specific polyclonal antibodies. The expression of protein X4 in SARS-CoV-infected Vero E6 cells and lung tissues from patients with SARS was performed using immunofluorescence assay and immunohistochemistry technique. The preliminary function of protein X4 was evaluated by treatment with and over-expression of protein X4 in cell lines. Western blot was employed to evaluate the expression of protein X4 in SARS-CoV particles.

RESULTSWe expressed and purified soluble recombinant protein X4 from E.coli, and generated specific antibodies against protein X4. Western blot proved that the protein X4 was not assembled in the SARS-CoV particles. Indirect immunofluorescence assays revealed that the expression of protein X4 was detected at 8 hours after infection in SARS-CoV-infected Vero E6 cells. It was also detected in the lung tissues from patients with SARS. Treatment with and overexpression of protein X4 inhibited the growth of Balb/c 3T3 cells as determined by cell counting and MTT assays.

CONCLUSIONThe results provide the evidence of protein X4 expression following SARS-CoV infection, and may facilitate further investigation of the immunopathological mechanism of SARS.

Amino Acid Sequence ; Animals ; BALB 3T3 Cells ; Cercopithecus aethiops ; Growth Inhibitors ; analysis ; physiology ; HeLa Cells ; Humans ; Immunohistochemistry ; Lung ; chemistry ; Mice ; Molecular Sequence Data ; SARS Virus ; chemistry ; Severe Acute Respiratory Syndrome ; metabolism ; Vero Cells ; Viral Structural Proteins ; analysis ; physiology