Double-hit lymphoma (DHL) is a kind of disease with features intermediated between diffuse large B-cell lymphoma (DLBCL) and Burkitt lymphoma (BL),usually accompanied by myc gene breakpoint with other recurrent chromosomal breakpoint and mainly involving myc and bcl-2 translocation.The presentation of this disease is characterized by elevated serum lactate dehydrogenase levels,B symptoms,bone marrow involvement,advanced stage disease,extranodal involvement,and central nervous system involvement.Because its features are similar with DLBCL and BL,it's difficult to distinguish them by pathological diagnosis.At present,the differential diagnosis is mainly by chromosomal analysis (G-banding),FISH and immunohistochemistry.This subtype received a poor response to conventional chemotherapy for DLBCL,and has a poor prognosis.The median survival time is only 0.2-1.5 years.Currently,the main regimens include RCHOP,RICE,RCVD,methotrexate prophylaxis for central nervous system involvement,high-dose chemotherapy and bone marrow transplantation.

Objective To evaluate the reasons for intrathecal administration of vincristine,the characteristics of patients with nerve damage,and the effective rescue measures and outcome prognosis.Methods Electronic literature databases,English and Chinese Paper Documents databases,and Network Engine were searched for Case Reports of inadvertent intrathecal injection of vincristine.SPSS 15.0 was used for statistical analysis.Results Analysis of 32 cases report showed that the intrathecal injection of vincristine in patients had adverse outcome.Of these cases 25 led to death,and survival of cases was associated with lower limb paralysis or quadriplegia.Fatalities appeared due to a progressively ascending myeloencephalopathy.Early recognition and immediate treatment with CSF drainage appeared to be the only intervention that had improved patients' survival.The survival curves of different surgical treatments,whether or not to use folic acid treatment,whether or not to use glutamate treatment,whether or not to use pyridoxinetreatment,was a significant difference.Conclusions Timely ventriculo-lumbar washout,using folic acid treatment and glutamate treatment appear critical.It is difficult to obtain satisfactory clinical outcome,so the key lies in the implementation of effective preventive measures.

Objective To understand the current status,type,and effect of training programs conducted by Health Bureau and CDC in China.Methods One person of each province was selected from China field epidemiology training network and designated as contact person who was responsible for collecting information of field practical training lasting for at least 6 months for staff of public health emergency and infectious disease control in each province from October 2001 to October 2010.Questionnaire including basic condition,organization and management,training design,faculty condition,trainee condition and training outputs was designed and filled in by contact person.Results There were 35 training programs covering over 9 provinces in China.The first province and city FETP started in 2004,including Guangdong FETP,Zhejiang FETP,Hangzhou FETP,Ningbo FETP and Guizhou FETP.Thirty-five training programs had 355 mentors,22(6％)were CFETP graduates and 57 (16％)were local FETP graduates.All program funds were paid by local governments.The training programs included two parts,theoretical lectures and field practice,which occupying 10％-20％ and 80％-90％ of the whole training time,respectively.Among 6 evaluative items including emergency investigation,surveillance analysis,surveillance evaluation,planned investigation,investigation report and paper publication,most programs(50％-94％) had less than average one person per time.Conclusions Field epidemiology training program after several years of development in china achieves the certain scale.Some provincial programs are successful,but the effect and quality of training programs in different areas are uneven.We suggest optimizing of field epidemiology training resources and further expanding China field epidemiology training network.

Objective: To study the relationship between the expressions of Bel -2, Ki -67, C -myc and prognosis in patients given chemotherapy for malignant lymphoma (ML). Methods: The expressions of Bel-2, Ki-67 and C-myc were measured by immunohistochemistry (IHC) in paraffin-embedded samples of 65 ML cases who received chemotherapy. The survival analysis was done by the Kaplan -Meier method and Log -rank test. Results: For patients with non -Hodgkin lymphoma (NHL) who received chemotherapy, the 3-year disease free survival (DFS) was 22.22% in Bcl-2(+) group compared with that of 55.56% in Bcl-2 (-) group. The difference of DFS was significant between the two groups. Meanwhile, for ML patients, the 3-year DFS was 37.50% in Ki-67(+) group, and 61.54% in Ki-67(-) group respectively(P < 0.05). Conclusion: The expressions of Bcl-2 and Ki-67 were closely related with relapse after chemotherapy in patients with ML. They were useful molecular makers for predicting the prognosis in patients with ML after chemotherapy.

Objective:To evaluate the implementation of national continuing medical education (CME) base programme about infectious disease control and prevention during 2013-2020, so as to improve the quality management of CME.Methods:According to data from national CME system, Excel and SPSS 27.0 were used to analyze project hosting days, places, teachers, students, project directors and training effect. The counting data were expressed by frequency and percentage [cases (%)], chi-square test was used to make comparison between groups, Mantel-Haenszel chi-square test was used for trend test, and the significance test level of the difference was α = 0.05. Results:A total of 116 projects were conducted from 2013 to 2020, with execution rate of 87.9%(116/132). Most hosting days were 2 to 3 days [57.8% (67/116)]. The majority [65.2% (5 785/8 871)] of trainees had junior and intermediate technical titles. As for trainers, trainers with senior technical titles accounted for 87.6% (758/865), and those with intermediate titles accounted for 12.4% (107/865). Mantel-Haenszel chi-square test showed that there was a linear relationship between the proportion of technical titles and the year ( χ2趋势 = 4.97, P趋势 = 0.026). Project directors almost had senior professional title, and nearly one third of them had the experience of undertaking three or more base projects within 8 years. The top three training modules were parasitic diseases prevention and control, AIDS prevention and control, and viral diseases prevention and control. Trainees were highly satisfied with the training contents. Conclusion:The implementation of the infectious disease prevention and control base programme went well in general from 2013 to 2020. In the future, it’s needed to be demand-oriented, rationally design training programs, enhance the evaluation of training effects, strengthen the construction of public health core capacity, and adopt a strategy of brand development in the process of the infectious disease prevention and control base programme.

China ; Humans ; Meningococcal Infections ; Serogroup

Objective:To investigate the contamination status of SARS-CoV-2 in imported frozen seafood from a Russia cargo ship in Qingdao and to analyze the risk factors for infection in local stevedores.Methods:The method of "two-stage, full coverage and mixed sampling" was used to collect the seafood packaging samples for the nucleic acid detection of SARS-CoV-2 by real-time fluorescent quantitative RT-PCR. A unified questionnaire was designed to investigate 71 stevedores in two shifts through telephone interview. The stevedores were divided into two groups, with 23 in the shit with two infections was group A and 48 in the shift without infection was group B. Software Epi Info7.2 was used to identify the risk factors for SARS-CoV-2 infections in the stevedores.Results:In the frozen seafood from a Russia cargo ship, the total positive rate of SARS-CoV-2 nucleic acid in the frozen seafood was 11.53% (106/919). The positive rate of SARS-CoV-2 nucleic acid in the frozen seafood unloaded by group A (14.29%,70/490) was significantly higher than that in the frozen seafood unloaded by group B (8.39%,36/429)( χ2=7.79, P=0.01) and the viral loads detected in the frozen seafood unloaded by group A were higher than those detected in the frozen seafood unloaded by group B. The scores of personal protection and behaviors in the stevedores in group A were significantly lower than those in group B ( P<0.05), and toilet use, smoking and improper hand washing before meals were the risk factors for the infection. Conclusions:The imported frozen seafood was contaminated by SARS-CoV-2 and the contamination distribution was uneven. Supervision and management of personal occupational protection and behaviors of workers engaged in imported frozen food transportation should be strengthened. It is suggested that a closed-loop monitoring and management system for the whole process of "fishing-transport- loading/unloading" should be established by marine fishery authority.

Objective:To understand the performance of public health risk assessment in emergencies of institutions for disease control and prevention at different levels in China, and provide suggestions for the improvement of public health risk assessment.Methods:A self-administered survey was conducted in professionals involved in public health risk assessment in emergencies from national institution, provincial institutions and some prefectural institutions for disease control and prevention (1-2 prefectural institutions were selected using convenience sampling in each province) between March and April in 2021.Results:A total of 79 institutions for disease control and prevention were investigated, including 1 national institution, 32 provincial institutions and 46 prefectural institutions. By April 2021, all the 79 institutions surveyed had conducted risk assessment of public health emergencies, in which 61 (77.2%) had established departments responsible for the public health risk assessment, i.e. emergency management office or communicable disease prevention and control office (section), and regular risk assessment mechanisms. The main sources of information for public health risk assessment were public health surveillance systems, including the National Notifiable Diseases Reporting System (100.0%) and Public Health Emergencies Management Information System (97.5%). Compared with the provincial institutions, the prefectural institutions were more likely to use specific disease surveillance systems (84.8% vs. 62.5%; χ2=5.09, P=0.024). The risk management recommendations made by 43 institutions for disease control and prevention (54.4%) after the risk assessment were accepted by the superior health administrative departments and used in epidemic prevention and control. Conclusions:Public health risk assessment in emergencies has been widely carried out by national, provincial and prefectural institutions for disease control and prevention in China. Specialized departments and mechanisms have been established, but the information sources are still confined to public health surveillance systems and the application of the risk assessment results still needs to be further improved.

Caliciviridae Infections ; prevention & control ; therapy ; Disease Outbreaks ; prevention & control ; Humans ; Norovirus ; Practice Guidelines as Topic

Objective This study investigated the epidemic characteristics and spatio-temporal dynamics of hemorrhagic fever with renal syndrome (HFRS) in Qingdao City,China. Methods Information was collected on HFRS cases in Qingdao City from 2010 to 2022. Descriptive epidemiologic,seasonal decomposition,spatial autocorrelation,and spatio-temporal cluster analyses were performed. Results A total of 2,220 patients with HFRS were reported over the study period,with an average annual incidence of 1.89/100,000 and a case fatality rate of 2.52％. The male:female ratio was 2.8:1. 75.3％ of patients were aged between 16 and 60 years old,75.3％ of patients were farmers,and 11.6％ had both "three red" and "three pain" symptoms. The HFRS epidemic showed two-peak seasonality:the primary fall-winter peak and the minor spring peak. The HFRS epidemic presented highly spatially heterogeneous,street/township-level hot spots that were mostly distributed in Huangdao,Pingdu,and Jiaozhou. The spatio-temporal cluster analysis revealed three cluster areas in Qingdao City that were located in the south of Huangdao District during the fall-winter peak. Conclusion The distribution of HFRS in Qingdao exhibited periodic,seasonal,and regional characteristics,with high spatial clustering heterogeneity. The typical symptoms of "three red" and"three pain" in patients with HFRS were not obvious.