Objective To investigate the first human brucellosis outbreak in Fujian Province,aiming to identify the source,risk factors of infection,and recommend control measures.Methods Epidemiological investigation was conducted by combining with agricultural sector on human and animal in the incident area of Zhangzhou City of Fujian Province.Respondents included 17 professionals from the outbreak sheep farm,as well as 9 ones from four nearest farms (including 2 pig farms,1 sheep farm and 1 cow farm) in directions of eastern,southern,western and northern.Then information of cognitive level and daily protection on brucellosis among pasture breeding staffs through case studies were got,serum of pasture breeding staffs and animals was collected (including 262 from the outbreak sheep farm and 50 from another sheep farm which nearly 5 kilometres away) to detect brucellosis antibody,and sheep sources were investigated simultaneously.Results A total of 26 people were detected,the infection rate was 26.9％ (17 people,in the epidemic area),the other four farming units without brucellosis infection.In epidemic focus,seven human infections (5 confirmed cases,2 asymptomatic infected) were identified,with an infection rate 41.2％ (7/17) and the brucellosis antibody positive rate among sheep was 46.2％ (121/262),while no positive sheep in the nearest sheep farm (0/50).Both unprotected lamb handling and stillbirth treatment got a 100.0％ infection rate.Among the investigated professional staffs,92.3％ (24/26) had no awareness of clinical symptoms and signs of brucellosis,while 11.5％ (3/26) took protective measures when working.Conclusions Unquarantined sheep is the infection source of this brucellosis outbreak,unprotected lamb handling and stillbirth treatment are the main route of transmission.High sheep infection rate,lack of brucellosis awareness,precaution missing among pasture breeding staffs and animal quarantine are all contributing to this outbreak.

Objective To study the curative effect of mesenchymal stem cells(MSC)transplantation on occupational chronic benzene poisoning and summarize the nursing measures.Methods The clinical data of 5 patients with occupational chronic benzene poisoning treated with MSC transplantation for 48 times totally were retrospectively reviewed for the purpose of investigating the curative effects and summing up the nursing measures.Results After transplantation,the levels of white blood cells,hemoglobin and neutrophil,platelet were all increased significantly.The differences in white blood cells and neutrophil were significant between pre-and post-transplantation(P<0.05).Bone marrow hyperplasia was active after treatment.No adverse reactions were observed in all of the patients.Conclusion MSC is safe and effective in treating occupational chronic benzene poisoning.Observing patient’s conditions closely,implementing protective isolation and psychological nursing strictly and doing predictive nursing measures are of significance for success of MSC transplantation and improvement of the curative effect.

Objective To analyze the epidemiological characteristics and spatial distribution of human brucellosis in Fujian province during 2011-2016,and provide evidence for the prevention and control of the disease.Methods The surveillance data of human brucellosis in Fujian during 2011-2016 was analyzed with software R 3.3.1,ArcGIS 10.3.1,GeoDa 1.8.8 and SaTScan 9.4.3.Results During 2011-2016,a total of 319 human brucellosis cases were reported,the incidence increased year by year (F=11.838,P=0.026) with the annual incidence of 0.14/100 000.The male to female rate ratio of the incidence was 2.50 ∶ 1.Farmers and herdsmen accounted for 57.37％.The incidence was 0.40/100 000 in Zhangzhou and 0.32/100 000 in Nanping,which were higher than other areas.The number of affected counties (district) increased from 12 in 2011 to 28 in 2016,showing a significant increase (F=13.447,P=0.021).The Moran' s I of brucellosis in Fujian between January 2011 and December 2016 was 0.045,indicating the presence of a high value or low value clustering areas.Local spatial autocorrelation analysis showed that,high-high clustering area (hot spots) were distributed in Zhangpu,Longhai,Longwen,etc,while high-low clustering areas were distributed in Nan' an and Jiaocheng,etc.Temporal scanning showed that there were three clustering areas in areas with high incidence,the most possible clustering,occurring during January 1,2013-December 31,2015,covered 6 counties,including Yunxiao,Pinghe,Longhai,etc,and Zhangpu was the center,(RR =7.96,LLR=92.62,P＜0.001).Conclusions The epidemic of human brucellosis in Fujian is becoming serious,and has spread to general population and non-epidemic areas.It is necessary to strengthen the prevention and control of human brucellosis in areas at high risk.

OBJECTIVE To investigate the effects of Isodon ternifolius extract on Toll -like receptor 4（TLR4）/nuclear factor - κB（NF-κB）/NOD-like receptor protein 3（NLRP3）pathway in hepatic stellate cells and hepatocytes . METHODS Using primary hepatic stellate cells and primary hepatocytes of rats as subjects ，inflammatory injury model was induced by lipopolysaccharide （LPS，100 ng/mL）. Using colchicine （1 μmol/L）as positive control and TLR 4 inhibitor（TAK-242，1 μmol/L）as reference ，the contents of transforming growth factor -β1（TGF-β1），α-smooth muscle actin （α-SMA），type Ⅰ collagen（COL-Ⅰ），COL-Ⅲ in the supernatant of hepatic stellate cells ，and the contents of alanine aminotransferase （ALT），aspartate aminotransferase （AST），interleukin-1β （IL-1β） and IL -18 in the supernatant of hepatocytes were detected after intervention with I. ternifolius extract（1 mg/mL）. The mRNA expressions of TLR 4，inhibitor α of NF -κB（IκBα），NF-κB p 65，NLRP3，Gasdermin D （GSDMD），apoptosis-associated speck -like protein containing CARD （ASC） and protein expressions of TLR 4， phosphorylated I κBα（p-IκBα），NF-κB p 65，NLRP3，GSDMD，ASC in the above cells were determined . RESULTS Compared with LPS model group ，the contents of TGF -β1，α-SMA， COL-Ⅰ and COL -Ⅲ in the supernatant of hepatic stellate cells and the contents of ALT ，AST，IL-1β and IL -18 in the supernatant of hepatocytes were significantly decreased ；the mRNA expressions of TLR 4，NF-κB p 65，NLRP3，GSDMD，ASC and the protein expressions of TLR 4，p-IκBα，NF-κB p 65，NLRP3，GSDMD，ASC in the two kinds of cells were significantly down - regulated，and the mRNA expression of I κBα was significantly up -regulated in all administration groups （P＜0.05）. Compared with TLR 4 inhibitor group ，the improvement of most of above indexes was more significant in the TLR 4 inhibitor+I. ternifolius extract group （P＜0.05）. CONCLUTIONS I. ternifolius extract could inhibit the activation of TLR 4/NF-κB/NLRP3 pathway， reduce the release of fibrosis factors and inflammatory factors ，alleviate the inflammatory injury of liver cells ，and inhibit the activation of hepatic stellate cells ，so as to protect liver cells and resist liver fibrosis .

OBJECTIVE: To explore the application effect of clinical nursing pathway( CNP) in nursing care on patients with occupational noise-induced deafness( ONID) under medical observation.METHODS: The patients with ONID under medical observation in hospital were randomly selected and divided into CNP group( 50 cases) and control group( 50 cases) by random number table method.The control group was given routine nursing care,and the CNP group was given CNP care according to the nursing path table.Self-Rating Anxiety Scale,Self-rating Depression Scale and SF-36 Scale were used to observe the anxiety, depression and quality of life of these two groups.The time and expenses of hospitalization,and degree of nursing satisfaction were also observed.RESULTS: Before nursing care implementation,the scores of anxiety,depression and 8 dimension of quality of life did not show statistical significance between these two groups( P > 0.05).After nursing care implementation,the improvement of anxiety,depression and quality of life in the CNP group were significantly better than that of the control group( P < 0.01).The patients in the CNP group had shorter duration of hospitalization( P < 0.01),decreased hospitalization expenses( P < 0.05),and increased nursing satisfaction( P < 0.01) compared with the control group.CONCLUSION: CNP implementation can effectively reduce the anxiety and depression symptoms of patient with ONID under medical observation during the diagnostic process of occupational diseases.It can reduce the time and costs of hospitalization,improve their quality of life and satisfaction of nursing care.CNP can be widely used in clinical practice.

OBJECTIVE: To investigate the effect of health education in the treatment of pneumoconiosis patients with bronchoalveoar lavage( BAL) during perioperative period. METHODS: Ninety-six pneumoconiosis patients treated with BAL in hospital were divided into observation group and control group( 48 cases in each group). The patients in the control group were given routine perioperative health education, and the patients in the observation group implemented perioperative health education in accordance with the health education pathway. Adverse reactions in hospital were collected,and the awareness of perioperative health knowledge of BAL was surveyed. RESULTS: Before implement of the health education pathway,there was no difference( P > 0. 05) in the health knowledge between the 2 groups. After implementation of the health education pathway,the awareness of health knowledge of observation group and control group were higher than that of the same group before implementation of the health education pathway( P < 0. 01). The awareness of 15 items of health knowledge was higher( P < 0. 05) and the incidences of intraoperative cough and postoperative low fever were lower in the observation group than in the control group( 4. 2% vs 25. 0%,2. 1% vs 16. 7%,P < 0. 05).CONCLUSION: Executing effective healthy education pathway in perioperative BAL is helpful to improve the knowledge of disease prevention and control in pneumoconiosis patients,and reduce the occurrence of adverse reactions during BAL.