Objective To investigate the clinical epidemiology and clinical features of patients with rubella. Methods Data of clinical epidemiology, clinical manifestations, laboratory findings of patients with rubella hospitalized in Second Affiliated Hospital of Harbin Medical University from 2002 to 2004 were retrospectively analyzed. Positive rates were analyzed using chi square test. Results Of the 408 patients with rubella,90.0% had histories of contacting with patients with rubella, and 75.5% were students. The common clinical manifestations were fever(71.1%),rash(100.0%),lymphadenectasis(90.0%).Laboratory findings were liver dysfunction(10.3%),myocardial enzyme abnormality(11.8%),WBC decrease(60.0%)and lymphocythemia(70.1%).The differences between adult group(n=125)and children group(n=283)were compared. The numbers of patients with eruption time within 1-2 days were 102 and 264,respectively(X~2=12.823.P＜0.01);those with deflorescence time within 1-3 days were 43 and 129,respectively(X~2=4.447,P=0.035);those with sporadic rash were 108 and 263,respectively(X~2=4.487,P=0.034);those with erythroic rash were 99 and 247,respectively(X~2=4.392,P=0.036);those with eruption order of head to trunk were 104 and 256,respectively(X~2=4.402,P=0.036);those with thrombocytopenia were 10.4% and 2.5%,respectively(X~2=11.686,P＜0.01);those with liver dysfunction were 17.6% and 7.1%,respectively(X~2=10.416,P＜0.01);those with myocardial enzyme abnormality were 20.0% and 8.1 %,respectively(X~2=11.774,P＜0.01),those complicated with broncho pneumonia were 0.8 and 6.7%,respectively(X~2=6.505,P=0.011);those complicated with hepatitis were 17.6 % and 7.1 %,respectively(X~2=7.117,P=0.008);those complicated with myocarditis were 18.4% and 7.1%,respectively(X~2=11.811,P＜0.01) and those complicated with arthritis were 12.0% and 2.8%,respectively(X~2=13.715,P＜0.01).Conclusions Compared with children patients with rubella, the constitutional symptoms of adult patients are more severe, and the proportion of liver and myocardial enzyme abnormality is higher, which should be paid more attention.

Objective To study immune function of peripheral blood dendritic cells in chronic hepa titis B virus infected patients. Methods Peripheral blood DCs of patients and normal human were isolated and cultured in serum free media. The expression levels of DC surface molecule were analyzed by flow cytometry and the ability of DC to induce T lymphocyte proliferation were evaluated by a liquid scintillation counter and the amounts of cytokines in MLR were measured detected. Results The expression rate of CD86 (70.2?5.2)% on DC in patients was decreased compared with that in controls. (95.3?3.5)%, P

Objective To study the clinical features of patients with hemorrhagic fever with renal syndrome(HFRS)complicating hyponatremia encephaledema and therapeutic effect of manicol and high sodium hemodialysis.Methods Eighty-three patients with HFRS complicating hyponatremia encephaledema were randomly divided into high sodium hemodialysis treatment group(n=41)and control group(n=42).The serum levels of potassium,sodium,chlorine,creatinine,osmotic pressure,normalization rates and normalization time of serum sodium,mortality of patients in two groups post-treatment were compared.Statistical analysis was performed using t test or chi square test.Resalts The serum levels of sodium [(128.95±7.3)mmol/L],chlorine[(96.7±6.2)mmol/L],osmotic pressure[(253.1±7.5)mOsm/L]of patients post-treatment in high sodium hemodialysis treatment group were all significantly higher than those[(117.8±7.1)mmol/L],[(92.2±6.9)mmol/L],[(242.1±8.4)mOsm/L]of patients in control group (t=7.14,t=3.12,t=15.22,respectively;all P＜0.05).The serum sodium normalization number of patients(12/19 cases)with moderate encephaledema in high sodium hemodialysis treatment group was significantly higher than that(6/19 cases)in control group(X2=3.867,P=0.049).The serum sodium normalization time of patients with moderate encephaledema in high sodium hemodialysis treatment group WaS(4.9±1.3)d,which was significantly shorter than that[(8.3±1.9)d]in control group(t=6.438,P=0.001).The serum sodium normalization number of patients(7/14 cases)with severe encephaledema in high sodium hemodialysis treatment group was significantly higher than that(2/14 cases)in control group(X2=4.094,P=0.043).The serum sodium normalization time of patients with severe encephaledema in high sodium hemodialysis treatment group was(7.8±1.9)d,which was significantly shorter than that[(11.6±2.8)d]in control group(t=3.235.P=0.034).The mortality in high sodium hemodialysis treatment group was 36.6%(15/41 cases),which was significantly lower than that(61.9%,26/42 cases)in control group(X2=5.321,P=0.021).Conclusions The conditions of patients with HFRS complicating hyponatremia encephaledema tend to be severe.In patients with HFRS complicating moderate or severe encephaledema,manicol and high sodium hemodialysis can improve the normalization rate and normalization time of serum sodium,and reduce the mortality.

Objective To investigate the changes of epidemiological and clinical features of patients with hemmorrhagic fever renal syndrome (HFRS) over past 10 years in Harbin region. Methods The epidemiological, clinical and laboratory data of patients with HFRS in 1995 and 2005 in The Second Affiliated Hospital of Harbin Medical University were retrospectively analyzed. The genotypes of Hantaan virus of patients in 2005 having an onset within 5 days were examined by reverse transcriptase polymerase chain reaction (RT-PCR). Positive rates in different groups were compared using chi square test. Results One hundred and sixty-five cases were collected, including 78 in 1995 and 87 in 2005. There were significant differences in epidemiological area (X2=10. 483, P<0.05), clinical classification (X2=7. 907, P<0.05), clinical stage (X2=10.500, P<0.05), the variance of total white blood cells (X2=20. 315, P<0.01) and blood sugar changes (X2=9.958, P<0.01) between two groups of patients. Bases on clinical manifestations, there were significant differences in two groups (1995 and 2005): headache, 70.5% and 50.6% (X2=6.812, P<0.01); lumbago, 60.3% and 40.2% (X2=6.598, P<0.05); fossaorbitalis pain, 50.0% and 19.5% (X2=17.019, P<0.01); melena, 60.3% and 40.2% (X2=6.598, P<0.05); bleeding point and eeehymosis, 50.0% and 33.3% (X2=4.715, P<0.05) ; flush of faee, neck and upper chest, 59.0% and 40.2% (X2=5.782, P<0.05); membrane-like object in urine, 44.9 % and 29.9% (X2=3.964, P<0.05) rates of thrombocytopenia, 79.5% and 64.4% (X2=4.615, P<0.05) ; rates of liver dysfunction, 50.0% and 80.5% (X2=17.019, P<0.01); rates of cardiac muscle enzymoiogy dysfunction, 50.0% and 92.0% (X2=36.003, P<0.01). The genotypes of patients in 2005 were Hantaan virus (34.8%) and Seroul virus (65.2%). Conclusion The differences in epidemiological and clinical feature of patients with HFRS over past 10 years may be related with the change of virus genotypes, and further study should be done.

Objective To investigate epidemiological and clinical features of patients with clonorchiasis sinensis infection. Methods The epidemiological, clinical, laboratory and treatment data of clonorchiasis patients in Department of Infectious Diseases, Second Affiliated Hospital, Harbin Medical University from 2002 to 2004 were retrospectively analyzed. Results Sixty-eight point two percent patients had a history of eating raw freshwater fish and shrimp. Patients with occupations as cook, fish stock man, fishing man and fishmonger accounted for 22.6%. The transmission route was not clear in 9.1% of patients. The common clinical manifestations were abdominal pain (60.3%), fatigue (52.3%), diarrhea (33.0%), anorexia (69.3%), jaundice (23.9%), hepatomegaly (59.1%), splenomegaly (8.0%), dizziness (20.9%), fever (5.7%) and biliary colic (14.8%). Twenty-eight point four percent were asymptomatic. Other findings included liver dysfunction (70.4 %) and eosinophile granulocyteosis(69.3 %). Negative rate of stool egg of clonorchis sinensis after treatment with praziquantel or albendazole was 91.9% or 86.5%, respectively. There was no significant difference between the two groups ( χ2 = 0.561, P = 0.454). Conclusions Clinical manifestations of patients with clonorchiasis sinensis are complicated and often accompanied with liver dysfunction. Clonorchiasis sinensis is often misdiagnosed and should be paid much attention.

Objective To study the impact of ribavirin cumulative dose on virological response rates in genotype 1 hepatitis C virus(HCV)infected patients.Methods The medical records of 225 genotype 1 chronic hepatitis C(CHC)patients treated with peginterferon α-2a plus ribavirin were retrospectively analyzed.These patients were divided into four groups according to ribavirin cumulative dose:>97%,80%-97%,60%-79%and<60%of standard cumulative dose.The relationship between ribavirin cumulative dose and virological response rates was studied.Data as analyzed by chisquare test or F test.Results The incidence of ribavirin cumulative dose<97%was 43.1%(97/225),which was higher than peginterferon alfa-2a(27.1%,61/225)(x2=12.641,P=0.001).The sustained virological response rate(SVR)was 27.8%(5/18)in group of ribavirin cumulative dose <60%,which was much lower than those in groups of ribavirin cumulative dose>97%(65.6%,84/128),80%-97%(60.5%,26/43),60%-79%(58.3%,21/36)(x2=9.538,P=0.023).The relapse rate was 61.5%(8/13)in group of ribavirin cumulative dose<60%,which was significantly higher than those in groups of ribavirin cumulative dose>97%(20.0%,21/105),80%-97%(23.5% ,8/34),60%-79%(27.6%,8/29)(x2=10.837,P-0.013).Among patients achieved rapid virological response(RVR),SVR in groups of ribavirin cumulative dose>97%,80%-97%,60%-79%and<60 % of standard dose were 92.0%(23/25),88.9%(8/9),85.7%(6/7)and 75.0%(3/4),respectively(x2=1.098,P=0.778).Conclusiom Mlid reduction of ribavirin dose not affect SVR of genotype 1 HCV infected patients.However,the relapse rate is high and SVR is low in patients treated with ribavirin cumulative dose<60% of standard dose.

OBJECTIVE To study and analyze the risk factors of surgical incision infection. METHODS All of 17 044 aseptic surgery patients from 2004 to 2006 were investigated. RESULTS Totally 36(0.21%) cases occurred infection with class Ⅰ surgical site.The incision infection ratio was 0.24%,0.22% and 0.18% in 2004,2005,and 2006,respectively.The operation time more than three hours occurred in 17 patients,two and three hours were in 12 cases,and less than two hours in the seven cases,accounted for 47.23%,33.33% and 19.44%,respectively. CONCLUSIONS The risk factors of incision infection after aseptic were as age,operation times,seasons,perioperative administration and underlying diseases.In order suroery to prevent the incition infection in aseptic surgery,we should pay more attention to management and education among medical staff.

OBJECTIVE To evaluate the clinical efficacy of lamivudine on prevention of liver injury in HBV carriers complicating tuberculous exudative pleurisy after use of antituberculosis drugs.METHODS Totally 120 HBV carriers complicating tuberculous exadative pleurisy after use of antituberculosis drugs were randomly divided into lamivudine group and control group.RESULTS The incidence rate of liver injury was 10.0% in lamivudine group vs 1.7% in control group(P0.05).CONCLUSIONS Lamivudine may be good for reducing liver injury in HBV carriers complicating tuberculous exadative pleurisy after use of antituberculosis drugs.

Objective To investigate the corelation between neutropenia (ANC) incidence and infection during treatment with peginterferon alfa and ribavirin for chronic hepatitis C.Methods A retrospective cohort study of 399 patients treated with peginterferon and ribavirin derived from database of Department of Infectious Diseases, the Second Affiliated Hospital, Harbin Medical University was conducted.The incidence of infections and their relation with ANC were investigated.Potential risk factors for infection were identified by multivariate analysis.Results During treatment,neutropenia (ANC ＜ 1.50 ×109/L) occurred in 251 patients.Among which,mild neutropenia [ANC: ( ＞ 0.75-＜ 1.50) x 109/L],moderate neutropenia [ANC: ( 0.50-0.75 ) × 109/L]and severe neutropenia ( ANC ＜ 0.50 × 109/L)occurred in 132 patients,103 patients and 16 patients,respectively.A total of 80 infections (20.1％ )occurred,among which,14 infections were defined as severe.There was no significant difference in infection rate between patients with and without neutropenia ( 19.9％,50/251 vs 20.3％,50/251 ; x2 =0.007,P =0.933).There was no significant difference in infection rate between patients with and without peginterferon dose reduction ( 21.5％,31/144 vs 19.2％,49/255 ; x2 =0.307,P =0.580 ).In multivariate logistic regression analysis,the independent factors associated with infection were age (P =0.021),diabetes (P =0.004) and cirrhosis (P =0.012).Conclusions Infections during treatment with peginterferon alfa and ribavirin for chronic hepatitis C are irrelevant to neutropenia.The independent factors associated with infection are age,diabetes and cirrhosis.

Objective To assess the effects of cyclic stretch on fibroblast orientation in order to find the appropriate cyclic stretch to cause maximum fibroblast orientation and to explore the mechanism of cell signalling since cells are known to orient in response to the application of mechanical forces. Methods Human forehead dermal fibroblasts were seeded onto collagen coated flexible membranes. Membranes were then deformed at 10 cycles per minute by the application of 135 mmHg subatmospheric pressure. This corresponded to strain levels of 0% to 24% from the center to extremity of the flexible membrane. Cells orientation angles were studied by inverted microscopy. Integrin ?1 distribution were studied with immunocytochemical staining and confocal microscopy. Integrin ?1 expression and focal adhesion kinase ( FAK) phosphorylation were analyzed with Western blot analysis. Results A minimum of 15% cell stretch was required to significantly stimulate the fibroblast orientation response. Cyclic stretch induced integrin ?1 redistribution and FAK phosphorylation. Incubation of cells with anti-integrin ?1 prior to the application of stretch abrogated fibroblast orientation and FAK phosphorylation. Conclusion Fibroblast orientation in response to cyclic stretch is mediated at least in part by integrin ?1 through phosphorylation of FAK.