Objective To discuss MRI appearance of the cerebral schistosomiasis and its clinical value through analyzing the MRI features and post surgery pathological findings. Methods MRI features of the cerebral schistosomiasis in 16,pathologically ( n =6) or clinically( n =10) proved cases were analyzed etrospectively,and compared with the post surgery pathological findings in 6 cases. Results Single masses were found in 11 cases (11/16),and multiple masses in 5 cases(5/16), amounting to 23 masses . fifteen masse(15/23) were located in right cerebral hemisphere,including frontal lobe ( n =2),frontoparietal lobe ( n =5) ,and occipitoparietal lobe ( n =8), while 8 masses (8/23) in left cerebral hemisphere,including frontal lobe ( n =1),frontoparietal lobe ( n =3), and occipitoparietal lobe ( n =4).The nodular masses were isointense with the gray mass like "island", and 12 cases (12/16) show the "gigantic hand" form of edma around them. After IV administration of Gd DTPA,15cases (15/16) revealed multiple closely spaced,intensely enhancing nodules,1 3 mm in diameter,distributed throughout the mass. Seven cases misdiagnosed by CT were revised by MRI. Conclusion The MRI appearance of the cerebral schistosomiasis is characteristic,and MRI is the most valuable tool to diagnose it without injury.

Objective To evaluate the skills in using inhalers among the asthmatic patients who visited the out-patient clinic and whether or not the nursing intervention could further improve the efficacy of the drug delivery device. Methods 321 asthmatic patients who had visited the clinic and prescribed inhalers from April to December 2009 were investigated of the basic status, former medication history and skills in using metered dose inhaler (MDI) and dry powder inhaler (DPI). Nursing intervention had been carried out and the results were analyzed. Results Subjects belonging to different educational level groups were significantly different in mastering skills using MDI and DPI after reading instructions. There also existed significant difference between MDI and DPI users. Among patients who had already used inhalers, there was significant difference between subjects who had received instruction from medical personnel and subjects who had only read paper directions. Nursing intervention could significantly improve the skills in handling the device. Conclusions Proper skills in using inhalers could not be possessed just by reading paper directions. Instructions or even multimedia presentation from medical personnel are vital for asthmatic patients to master the skills in using MDI and DPI.

Objective To study the changes in cortical activation of frontal lobes and temporal lobes between schizophrenic patients and comparison subjects during a verbal fluency task by using functional magnetic resonance imaging (fMRI). Methods Thirteen schizophrenic patients and 8 volunteers were studied during a verbal fluency task performance. fMRI of frontal lobes and temporal lobes was conducted at a GE 1.5 T Signa Horizon LX scanner while the subjects performed the task. Stimulus sequences were divided into six 30-second segments by using a task-activation paradigm that alternated between resting and stimulated states. Results Schizophrenic subjects demonstrated significantly less left frontal activation than comparison subjects during a word fluency task, and comparison subjects showed evidently more activation in left frontal lobes than in the right (P0.05). Conclusion These preliminary data suggest that fMRI has the sensitivity to detect the differences in activation between comparison subjects and schizophrenic patients during higher cortical functions.

Objective To investigate the underlying mechanism of motor recovery of the hemiplegic lower extremity in stroke patients. Methods The brain activation pattern during sequential extension-flexion of the affect-ed knee of 7 stroke patients and 8 healthy subjects was observed by blood-oxygen- level-dependent fMRI (BOLD-fM-RI) and analyzed by microsoft SPM5. Results When executing unilateral knee flexion-extension, contralateral paracentral lobe and contralateral supplementary motor area and right temporal gyms and inferior parietal lobes of both sides were significantly activated in all the healthy subjects, while the ipsilateral parietal lobe BA7 and BA5 were sig-nificantly activated in 6 of the 7 stroke patients. Conclusions Sequential extension-flexion of the affected knee of stroke patients was probably dependent on the activation of BA7 and BA5 in the intact side. Compensatory activation of the intact hemisphere might be one of the main mechanisms for the paretic lower extremity motor recovery in stroke patients.

Objective To analyze the characteristics and influencing factors of sleep disorders and nocturnal hypoxemia of patients with different degrees of obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Four hundred and twenty-five patients with snoring were scored by Epworth Sleepiness Scale ( ESS), and monitored by polysomnography (PSG). The possible correlations between sleep structure, hypoxia parameters, ESS and clinical features were analyzed and compared in those patients. Results Four hundred and twenty-five patients were divided into 4 groups according to the apnea-hypopnea index (AHI). There were 65 primary snoring patients (15.3%) and 360 OSAHS patients (84. 7% ) including 187 patients (44. 0% ) in severe OSAHS group. ESS was increased as aggravation of OSAHS. There were significant statistical differences in ESS among each group. Compared with primary snoring group, sleep efficiency, NREM1 + 2, oxygen desaturation index ( ODI), time with pulse oxygen saturation below 90% (T(SpO2 <90% ) ) were significantly higher in the OSAHS groups, and NREM3 +4, lowest pulse oxygen saturation level ( LSpO2 ) were lower. ESS was correlated positively with AHI (r= 0. 474,P <0. 01 ). They were both correlated positively with ODI, T (SpO2 <90% ) and NREM1 + 2( ESSr =0. 392, 0. 356,0. 194;AHI r = 0. 714, O. 682, 0. 365, all P < 0. 01 ), and correlated negatively with LSpO2, NREM3 + 4 ( ESS r = - 0. 414, - 0. 196; AHI r = - 0. 740, - 0. 385, both P < 0. 01 ). LSpO2, ODI and T (SpO2 < 90% ) were the primary influencing factors. Common clinical presentations and subjective symptoms were presented including daytime sleepiness, impaired memory, fatigue, dry mouth, oppressive wake and morning headache, etc. Percentage of individuals with daytime sleepiness in the severe OSAHS group was 73. 3% (137/187). These had serious impact on the patients' quality of life, leading to difficulty concentrating, poor memory and cognitive impairment. Conclusions Sleep disorders are found in the patients with different degrees of OSAHS. The excessive daytime sleepiness interrelated partly with the structure of sleep, and totally with hypoxia parameters. The more severity the patients have, the more nocturnal hypoxia, sleep disorders and higher ESS are found.

Objective To investigate the clinical and imaging features of the aquaporin-4 (AQP4)antibody-negative binocular optic neuritis and to analyze the predictive factors of visual function outcome.Methods Fifty-eight patients with AQP4-negative binocular optic neuritis were reviewed and followed up from January 2014 to December 2015.Patients at baseline and at the end of follow-up were evaluated for visual function and neurological examination.All patients underwent optic nerve and brain MRI, cerebrospinal fluid and routine laboratory tests.Results AQP4 antibody-negative binocular optic neuritis accounted for 9.4%(58/615)of the total optic neuritis in the same period.At baseline, 99 eyes (85.3%,99/116)had best corrected visual acuity<0.1.At the end of follow-up, 31 eyes(26.7%,31/116) had best corrected visual acuity < 0.1. There were 43 cases (74.1%, 43/58) with multi-segment involvement of optic nerve at the baseline.Baseline visual acuity(P=0.005), early treatment response (P=0.011), and segment numbers of optic nerve involvement(P=0.025)were independently associated with end-point outcome of visual function.Forty-nine patients(84.5%,49/58)showed monophasic course in (3.1 ± 0.9) years follow-up period, 7 cases (12.1%, 7/58) had recurrence, and 2 cases (3.4%, 2/58) converted to neuromyelitis optic spectrum disorder (NMOSD). Conclusions AQP4 antibody-negative binocular optic neuritis is common and the recovery of visual function is not satisfied. Baseline visual function and the length of optic lesion in MRI is related to the end-point prognosis. Most patients performs the single phase course during the follow-up period.

Objective: To analyze the influencing factors of acute gastroenteritis outbreaks caused by norovirus in Beijing from 2014 to 2018. Methods: Data of acute gastroenteritis events caused by norovirus in Beijing from April 2014 to March 2018 were collected. Unconditional logistic regression model was conducted to identify the risk factors of the outbreaks. Results: A total of 765 acute gastroenteritis epidemics caused by norovirus were reported in Beijing, in which 85.88% (657/765) were cluster events and 14.12% (108/765) were outbreaks. Among the outbreaks, 70.37% (76/108) were reported in 2017; 84.26% (91/108) were reported in winter and spring; 88.89% (96/108) were reported in kindergartens, primary or secondary schools; 81.48% (88/108) were through person-to-person transmission; 93.52% (101/108) were caused by norovirus GⅡ infection. The risk of outbreaks in suburban and out suburb area were 1.84 times (95%CI: 1.13-3.02) and 3.78 times (95%CI: 1.62-8.82) as high as that in urban area, respectively. The risks of outbreaks in primary, secondary schools and other institutions were 6.26 times (95%CI: 3.53-11.10), 14.98 times (95%CI: 6.23-36.01) and 8.71 times (95%CI: 3.07-24.71) as high as that in kindergartens, respectively. The risk of outbreak in which patients having lower hospital visiting rate than the median rate of all events was 2.29 times than that in the context of having higher hospital visiting rate (95%CI:1.42-3.68). The risk of foodborne outbreak was 14.55 times as high as that transmitted through person-to-person (95%CI: 3.15-67.07). Conclusion Measures such as strengthening the prevention and control of norovirus outbreaks in suburbs, primary schools, secondary schools and other institutions, promoting patients to visit the hospital actively, improving the management of foodborne events and kitchen workers should be taken to reduce the incidence of acute gastroenteritis outbreaks caused by norovirus.

Objective:To provide evidence for clinical diagnosis, prevention and control of group A rotavirus (RVA) diarrhea, the clinical characteristics of RVA diarrhea in children in Beijing from 2011 to 2018 were analyzed.Methods:From January 2011 to December 2018, 4 819 stool samples from children under 5 years old with diarrhea were collected monthly from 3 hospitals in Beijing. General information, clinical characteristics and other information of children were collected. RVA was detected by enzyme-linked immunosorbent assay (ELISA), genotype was identified by multiple semi-nested RT-PCR. The Vesikari clinical severity score was used to define the severity of diarrhea in children. Dichotomous unconditional logistic regression was used to analyze clinical symptoms and other differences between RVA positive and negative cases. Chi-square and Fisher direct probability tests were used to compare the composition among different groups.Results:A total of 4 819 fecal samples were collected, 953 were positive for RVA, the positive detection rate was 19.78%. The positive rate of RVA was high in the younger age group, and the incidence was high in winter and spring. RVA-positive children had more risk on diarrhea ≥5 times a day, vomiting symptoms, fever, mild dehydration, and Vesikari score ≥11. The positive rate of RVA in watery stool samples (26.13%, 214/819) and infectious diarrhea cases (42.20%, 265/628) was the highest respectively. There were no significant differences in clinical symptoms, clinical diagnoses and fecal traits among children with different RVA genotypes.Conclusions:The clinical symptoms of RVA diarrhea were severe in children. RVA genotype did not affect the clinical symptoms. Stool traits (watery stools) and Vesikari score can assist physicians in diagnosing RVA diarrhea.

Objective: To analyze the infection characteristics of patients in acute gastroenteritis outbreaks caused by noroviruses. Methods: Between April 2014 and March 2016, the clinical data and samples were collected from the patients in acute gastroenteritis outbreaks caused by noroviruses in Beijing. Noroviruses were detected and genotyped using real time RT-PCR, and the infection characteristics of norovirus gastroenteritis were analyzed using the descriptive epidemiological method. Results: A total of 1743 clinical diagnosed cases of norovirus gastroenteritis were collected, and children under 12 years old accounted for 77.68% (1354/1743). The detection rate of noroviruses was 73.98% (509/688). The detection rates of noroviruses in fecal, swab and vomitus samples were gradually decreased (χ²=67.798, P<0.001). Among these clinical diagnosed cases, vomiting was the most common symptom (93.98%), followed by abdominal pain (40.34%), diarrhea (30.35%) and fever (27.94%). The most common symptom of patients under 6 years old was vomiting(98.14%), whereas diarrhea was most common among over 18 years old patients (68.12%). With the increase of age of the patients, the incidence of vomiting was gradually decreased (χ²=100.913, P<0.001), whereas the incidence of diarrhea was gradually increased (χ²=261.164, P<0.001). There was no statistical difference in vomiting, diarrhea and abdominal pain symptoms between patients infected with genogroup Ⅰ and Ⅱ noroviruses, and patients infected with genogroup Ⅱ (34.49%, 149/432) had the higher incidence rate of fever than that of genogroup Ⅰ (18.18%, 14/77) (χ²=7.985, P<0.01). Conclusions Noroviruses mainly infected children under 12 years old in acute gastroentertis outbreaks. The most common symptom of patients with acute gastroenteritis caused by noroviruses was vomiting, and the incidences of vomiting and diarrhea were significantly correlated with age of the patients. Patients infected with genogroup Ⅱ had the higher incidence rate of fever than genogroup Ⅰ infection.

Objective:To understand the gene characteristics of Sapovirus from diarrhea cases in diarrhoeal disease clinics in Beijing.Methods:In 2019, stool samples were collected from diarrhea cases in diarrhoeal disease clinics in Beijing. The samples were used for the detection of nucleic acid of Sapovirus with real-time RT-PCR. Different RT-PCR methods were used for the partial gene segment amplification in the capsid protein VP1 region and the polymerase RdRp region, and sequencing was conducted for amplified positive products. The sequences were aligned with software BioEdit 7.0.9.0 and analyzed with software Mega 6.06.Results:The overall detection rate of Sapovirus was 2.89% (44/1 522), the detection rate in children under 5 years old was 3.34% (18/539) and 2.64% (26/983) in children aged ≥5 years. The capsid protein VP1 region was sequenced in 23 strains belonging to 8 genotypes (GⅠ.2 had 6 strains, GⅠ.1 and GⅡ.3 had 5 strains, respectively, GⅠ.3 and GⅡ.5 had 2 strains, respectively, GⅠ.5, GⅡ.1 and GⅣ.1 had 1 strain, respectively). A total of 16 strains were detected in the cases aged ≥5 years, and the proportion of GⅠ.2 was highest (37.50%, 6/16), and 7 strains were detected in the cases under 5 years old, the proportions of GⅠ.1 and GⅡ.3 were highest (both 42.86%, 3/7); The internal similarity of each genotype was 95.5%-100.0%, and the similarity with the 51 reference strains of human or sewage sources in different years and different countries was 92.2%-100.0%. The polymerase RdRp region was sequenced in 25 strains belonging to 8 genotypes (GⅡ.P3 had 9 strains, GⅠ.P3 had 4 strains, GⅠ.P1, GⅠ.P2 and GⅡ.P1 had 3 strains, respectively, GⅠ.P5, GⅡ.P5 and GⅣ.P1 had 1 strain, respectively). Fifteen strains were detected in the cases aged ≥5 years, and GⅡ.P3 had the highest proportion (40.00%, 6/15). Ten strains were detected in the cases under 5 years old, and the proportions of GⅠ. P1, GⅡ.P1 and GⅡ.P3 were highest (all 30.00%, 3/10); The internal similarity of each genotype was 94.0%-100.0%, and the similarity with the 39 reference strains of human or sewage sources in different years and different countries was 90.2%-99.1%.Conclusions:Sapovirus is one of the pathogens among diarrhea cases in Beijing. The main genome is GⅠ and GⅡ, and the genotypes are diverse and dispersed. The main genotypes of diarrhea cases in people aged ≥5 years and less than 5 years are different.