Objective To explore the epidemic conditions of rheumatic fever (RF) with a simple method at some regions.Methods Antistreptococcal DNase B test microtiter method was adopted to detect human sera antibody in natural populations who are responsible to RF.All 216 schoolchildren aged 10～12 years old were chose by the random cluster sampling.The schoolchildren′s serum antibody against DNase B in each season from september 1988 to August 1989 was detected,and compared with antistreptolysin “O” (ASO);furthermore,5 different regional schoolchildren′s serum antibody to DNase B was tested, and 100 schoolchildren aged 10～13 years old were chose in every region.Meanwhile,the RF incidence of 5～18 year schoolchildren was investigated for 4 years,and approximately 364 915 person times were inquired.All the results of the anti DNase B and ASO were compared with the schoolchildren′s RF incidence.Results ① The levels of the anti DNase B were higher during fall,winter and spring seasons,and lower in summer,which were coincided with the RF incidence,and linear relation was very good ( r =0 913, P

Objective To analyze the epidemiologic data of patients withClostridium botulinum food poisoning, and to improve the understanding, diagnosis and treatment of food borne botulism.Methods A retrospective study was conducted. Fifty-three patients withClostridium botulinum food poisoning admitted to Chinese PLA Center of Poisoning and Treatment from January 2009 to December 2016 were enrolled, and they were divided into mild, moderate, and severe groups according to the severity of disease. The clinical data including medical history, epidemiology data, routine blood test and blood biochemistry at hospital admission, the vital signs and arterial blood gas analysis before and after treatment, as well as the occurrence frequency of symptom and sign on set were collected.Results Fifty-three patients with food borne botulism were enrolled, with 33 patients in mild group, 13 in moderate group, and 7 in severe group. Most of the patients were female, the age distribution was in large span, the outbreak of disease was in groups mainly with the family, and patients were mainly located in Hebei Province, Beijing and Henan Province. The outbreaks were mainly happened in Spring and Summer, and homemade fermentation products were still the first cause of poisoning with the average latent period of (51.01±4.78) hours. The majority of patients with botulism were in mild resulted from the type A toxin. With the aggravation of disease, hospitalization time was gradually increased, white blood cell (WBC) and neutrophils (NEUT) at hospitalization admission, and respiratory rate (RR), heart rate (HR), fraction of inspired oxygen (FiO2) before the treatment were shown in obviously rising trend, albumin (ALB) at hospitalization admission and pH, arterial partial pressure of oxygen (PaO2), arterial oxygen saturation (SaO2) before treatment were in decline. The parameters in severe group were most severe, and had significant differences as compared with those of mild group [hospitalization time (days): 72.57±39.52 vs. 6.61±3.72, WBC (×109/L): 13.01±6.44 vs. 6.85±2.07, NEUT: 0.85±0.07 vs.0.63±0.14, RR (bpm): 32.14±4.33 vs. 15.18±1.70, HR (bpm): 132.29±5.19 vs. 75.54±8.24, FiO2: 0.32±0.05 vs. 0.21±0.00, ALB (g/L): 38.57±4.65 vs. 42.09±4.57, pH: 7.08±0.10 vs. 7.38±0.07, PaO2 (mmHg, 1 mmHg = 0.133 kPa): 75.16±5.24 vs. 98.39±1.50, SaO2: 0.78±0.06 vs. 0.97±0.02, allP < 0.05]. The symptom and sign on set of 53 patients with food borne botulism was dizziness, followed by fatigue, blurred vision, nausea, and other symptoms and signs were lower than 50%, and the occurrence of dizziness with rank one happen rate was significantly higher than blurred vision and nausea (χ2 values were 7.209 and 10.502 respectively, andP values were 0.007 and 0.004 respectively). After the on time prescription of botulinum antitoxins treatment, the clinical symptoms of patients could be relived quickly. All the patients were discharged without deaths.Conclusion In order to improve the recovery of the food borne botulism poisoning patients, adequate antitoxin and the related organ supports should be prescribed on time.

ObjectiveTo investigate the D8/17 antigen expression of patients with rheumatic heart disease (RHD) in Guangdong province and study the antigen's characteristics.Methods The level of D8/17 antigen expression on B lymphocytes was determined with flow cytometry assay in 96 RHD patients and 83 unaffected controls.The percentage of B-cells expressing the D8/17 antigen having more than 10％ was considered to be positive. D8/17 antigen was extracted by immunopreeipitation,and the antigen characteristics was analyzed by tandem mass spectrometry. Results The mean percentage of B-cells expressing the D8/17 antigen was (85.36 ± 15.15)％ in the RHD patients and (82.89 ±4.55)％ in the controls,with no significant difference between the two groups ( P =0.436).Moreover,the positive rate of the D8/17 cxprcssion was 100％ in either the RHD patients or the controls.The molecular weight of D8/17 antigen was found to be 40 000-67 000,and the purified protein was most likely to match moesin or β-actin.ConclusionsB-cell antigen D8/17 is not associated with RHD in Guangdong province of China.Moesin or β-actin is the most likely protein to match D8/17 antigen.

Objective To evaluate the effects of 3-dimensional conformal radiation therapy(3DCRT) in form of local control and survival of rectal cancer patients. Methods Forty-two patients with rectal cancer were irradiation by 3DCRT. They first received 40 Gy with larger field, at 1.8-2.0 Gy/f, 1 fraction qd, then followed by a boost of 24-27 Gy with reduced field, at 3.0-4.0 Gy/f, 1 fraction qod, to a total dose of 0,64-67 Gy. Results The 1-,2-,3-year survival rates were 83.3% ,64.3% and 45.2% .The 1-,2-,3-year local recurrence rates were 2.4%,11.9% and 23.9%. Conclusion Three-dimensional conformal radiotherapy is able to prolong the survival and improve the life quality of patients with rectal cancer.

The glufosinate poisoning can cause damage to the respiratory system and nervous system. In severe cases, respiratory failure and toxic encephalopathy are life-threatening. It should be paid attention to and supportive treatment.In this paper, 15 cases of acute oral glyphosate poisoning diagnosed by toxicant test in the Poisoning Treatment Center of the Army from March to August 2018 were analyzed, and the clinical characteristics and treatment effect of acute glyphosate poisoning were summarized, so as to improve the understanding, diagnosis and treatment level of the disease.

The glufosinate poisoning can cause damage to the respiratory system and nervous system. In severe cases, respiratory failure and toxic encephalopathy are life-threatening. It should be paid attention to and supportive treatment.In this paper, 15 cases of acute oral glyphosate poisoning diagnosed by toxicant test in the Poisoning Treatment Center of the Army from March to August 2018 were analyzed, and the clinical characteristics and treatment effect of acute glyphosate poisoning were summarized, so as to improve the understanding, diagnosis and treatment level of the disease.

Objective:To summarize the clinical characteristics and treatment effect of patients with acute oral 84 disinfectant poisoning, so as to improve the understanding, diagnosis and treatment of the disease.Methods:In January 2022, 25 hospitalized patients with acute oral 84 disinfectant poisoning admitted to our department from March 2016 to August 2021 were selected as the research objects, and their general conditions, poisoning reasons, poisoning time, dose of poisoning, clinical manifestations, blood routine and biochemical indicators, diagnosis, treatment and prognosis were selected.Results:A retrospective analysis was performed. Among the 25 patients, there were 4 males and 21 females, aged from 20 to 91 years, and M ( Q1, Q3) was 38.7 (27, 46) years; The poisoning time (from exposure to poison to treatment) was 1~72 h, and M ( Q1, Q3) was 10.5 (3, 11.5) h. The length of stay was 1~20 days, and M ( Q1, Q3) was 5.72 (2, 7) days.The dose was 40-500 ml, and the M ( Q1, Q3) was 219.6 (100, 330) ml. Chest CT showed exudative changes in both lungs in 4 patients, excessive decreased permeability in 1 case and pleural effusion in 1 case. Gastroscope showed 2 cases of erosive inflammation of gastric body and antrum, 1 case of esophageal ulcer and cardiac ulcer, 1 case of corrosive gastritis, gastric fundus ulcer and esophageal stenosis. Abdominal X-ray showed 1 case of abdominal intestinal dilatation and pneumatosis with multiple gas-liquid planes.There were 1 case of type I respiratory failure, 6 cases of gastrointestinal bleeding and 1 case of incomplete intestinal obstruction. There were 19 cases of nausea and vomiting, 9 cases of abdominal pain, 6 cases of pharyngeal pain and 6 cases of retrosternal burning pain, 1 case of cough and 2 cases of fatigue. Conclusion:Acute oral 84 disinfectant will cause varying degrees of damage to the human digestive tract and lungs. In severe cases, gastrointestinal bleeding, intestinal obstruction, hypoxemia, etc, and even life-threatening, should be paid attention to clinically. The treatment is mainly symptomatic support treatment, such as protecting gastrointestinal mucosa, controlling acute inflammatory reaction, protecting the functions of liver and kidney and other important organs.

Fat emulsion is a drug commonly used clinically for parenteral nutrition support in critically ill patients.With the development of the pharmaceutical industry, fat emulsion has formed a variety of different formulations, among which different types of fat emulsion have their own metabolic and body energy supply characteristics, and the application indications are also different. In addition to providing the supply of nutrients, the role of fat emulsion in anti-toxicity, immune regulation, anti-inflammatory, anti-shock, cardiopulmonary resuscitation and other aspects has gradually been discovered. This article reviews the existing evidence-based medical evidence and expounds the mechanism and therapeutic role of fat emulsion in the treatment of critically ill patients with poisoning. Its value in the treatment of critically ill patients with poisoning was discussed, and some references were provided for the application of non-nutritional functions of fat emulsion in the future.

Objective:To explore the application effect and feedback of online pediatrics teaching for the clerkship and internship stage of medical students of clinical medicine eight-year program.Methods:In this study, 38 clerkship medical students and 12 internship medical students of clinical medicine eight-year program in pediatrics department of Peking University First Hospital from February to March, 2020 were selected as research objects. They had two weeks of online teaching, including online flipped classroom, case-based learning (CBL), and problem-based learning (PBL). The effect of online teaching, and the feedback from these students were all investigated through the questionnaire survey.Results:All students were satisfied with the overall arrangement of the online teaching and believed that the results exceed [42% (21/50)] or meet [58% (29/50)] their expectations. According to the feedback, network congestion [82% (41/50)] was the biggest problem in online teaching, followed by the inability of effective interaction [20% (10/50)]. Students all believed that the online teaching arrangement was most helpful for the cultivation of theoretical knowledge (Total scores 4.58±0.50), autonomous learning ability (Total scores 4.42±0.58) and clinical reasoning (Total scores 4.42±0.58), but had minimal impact on the skills operation (Total scores 2.68±0.87) and scientific research ability (Total 2.98±0.98). For the ability of communication between doctors and patients, the scores of clerkship students (3.79±0.99) were significantly higher than those of internship students (3.08±0.67), ( P<0.05). Clerkship students considered that online flipped classroom was the most helpful teaching mode, while internship students believed online CBL teaching was the most helpful one. Majority of the students (94%) think it's necessary to keep online teaching in the future. Conclusion:Online teaching of pediatrics is approved by the medical students of clinical medicine eight-year program in the stage of clerkship and internship, and plays an important role in the cultivation of the ability of medical students, but it can't completely replace offline clinical practice.

As a powerful reserve force for primary care institutions, general practitioners (GPs) undergoing standardized training will be essential to solve the pediatric problems of first visit to primary medical institutions and coordinated care delivery system in the future, which puts forward new require-ments for the training of post competencies of GPs.However,the training and evaluating systems for GPs in Pediatric Department still need further exploration. This article tried to summarize the two-month rotating arrangement and its advantages for GPs in Pediatric Department of a general hospital.Based on the forgotten theoretical knowledge,superficial understanding of the diseases and individual teachers' poor teaching moti-vation, this article suggested reinforcing the theoretical basis of GPs through exploring multiple learning channels and increasing self-learning enthusiasm,strengthening the training and rewarding system of teachers to promote the specialist-GPs teaching, as well as promoting the set-up of Department of General Practice and taking the advantage of key disciplines in teaching hospitals to develop characteristic teaching model of general practice.