Objective To study epidemiological trends of leprosy for 50 years in Gansu Province. Methods Epidemiological indicators and their trends were analyzed. Results By the end of 1998, a total of 4 773 leprosy cases had been detected in Gansu Province, of which 77.76％ distributed in 24 counties in Longnan, Gannan and Linxia prefectures, and 3 507 cases were cured and other dropped out or died. Type ratio of MB to PB was more than 60％ during the period. Since the mass surveys and comprehensive control were implemented in the 1960s, prevalence and detection rates had decreased continuously and the number of endemic counties reduced from 84.88％ in 1986 to 24.14％ in 1998. There were 42 active cases at the end of 1998 with a prevalence rate of 0.0017 per 1000. Conclusion Through the efforts for 50 year running, leprosy has been successfully controlled in Gansu Province.

Objective To study angiography features and clinical significance of "multiple tumor feeding embolization".Methods Twelve patients with pelvic tumor were reviewed retrospectively.The lesions included fibrosarcoma(n=1),chondrosarcoma(n=2),osteosarcoma(n=2) and metastatic tumor(n=7).Results Angiography features were:(1)multiple origin and branch of tumor-feeding vessels.(2)large vascular mass with dense tumor stain.(3)larger size of tumor stain comparing with that of bone destraction.After treatment,symptom relief and tumor shrink were obviously using"the multiple tumor-feeding embolization".Conclusion Angiography features of pelvic tumor are great value in guiding the clinical therapy.

Objective To analyze the etiological factor and genetic feature of a familial hemophagocytic lymphohistiocytosis patient with PRF1 mutation (FHL2) with human herpesvirus 7 (HHV7)infection and its family constellation. Methods Clinical characteristics, laboratory examinations of a FHL2 case with HHV7 infection were reported. HHV1-HHV8 virus DNA was screened by PCR; NK cell function was analyzed by flow cytometry; PRF1 gene mutations were analyzed by PCR and direct sequencing, structure of mutant PRF1 proteins were analyzed using ExPasy and I-TASSER server and genetics pedigree were analyzed. Results The patient's HHV7 viral was detected positive with DNA copy number of 350/106 peripheral nucleated cells. Flow cytometry analysis showed decrease both in proportion of perforin positive NK cells and perforin protein expression. Genetic testing showed PRF1 biallelic heterozygote mutations (c. 503G ＞ A/p. S168N and c. 1177T ＞ C/p. C393R) and pedigree analysis showed they were inherited. The patient was then treated with antivirus therapy, dexamethasone and VP16 therapy, but only achieved partial response. The patient was then followed by human leukocyte antigen 10/10 allele identical nonconsanguinity allogeneic hematopoietic stem cell transplantations (allo-HSCT) and soon the successful implantation of donor hematopoietic cells and persistent recovery was achieved. The patient was now surviving without recurrence for 9 months after allo-HSCT. Conclusions FHL is prone to be misdiagnosed as lymphoma. Genetic analysis of related gene mutation and herpes simplex virus detection will help in early and accurate diagnosis. Allo-HSCT is a fundamental treatment of FHL.

Objective To study the type and corresponding clinical characteristics of primary hemophagocytic lymphohistocytosis (HLH) associated immune gene mutations in the refractory virus infection or HLH of unknown causes. Methods From December 2009 to July 2010, the patients with refractory virus infection or HLH of unknown causes were screened for the primary HLH associated immune genes mutations by DNA sequence analysis, including PRF1, UNC13D, STX11, STXBP2, SH2D1A and XIAP. The clinical characteristics and outcomes were followed up. Results Totally 25 patients with refractory virus infection or HLH of unknown causes were investigated for the 6 genes and 13 cases were found carrying gene mutations, composing of 6 of PRF1 mutation, 3 of UNC13D, and each one of STX11,XIAP, SH2D1A and STXBP2, respectively. Among the 13 cases with gene mutations, 5 suffered from Epstein-Barr virus associated HLH( EBV-HLH), 1 human herpes virus 7 associated HLH (HHV7-HLH),1 HLH without causes, 4 chronic activated EB virus infection (CAEBV) with 1 progressing to Hodgkin's lymphoma carrying abnormal chromosome of t ( 15; 17 ) (q22; q25 ) and hyperdiploid, 2 EBV associated lymphoma. Among the other 12 patients without gene mutation, 4 suffered from EBV-HLH with 1 progressing to peripheral T lymphoma, 8 suffered from CAEBV. Conclusions Primary HLH associated immune gene mutations are critical causes of refractory virus infection of unknown causes, most patients manifest as HLH,some cases appear in CAEBV and EBV associated lymphoma. DNA sequence analysis is helpful to early diagnosis and correct decision-making for treatment.

Public hospitals in the face of COVID-19, should prioritize medical services of patients as the topmost task. In order to ensure the smooth progress of diagnosis and treatment, and prevent the occurrence of nosocomial infection, the hospital took an overall response strategy featuring " logistics support mode 3+ 1" . This strategy requires to make facilities ready by transforming isolation wards, overall management and deployment of protection supplies, optimizing logistics service flow, strict sterilization and isolation of medical wastes and environment, optimizing catering service within the hospital to reduce the gathering and flow of personnel. It also enhanced personnel training, to eliminate staff panic and to stabilize the logistics support team. Meanwhile, the logistics department took over the hospital access screening work for tight access control, which maximize the safety and reliability of the logistics support within the hospital, and ensure the smooth progress of the epidemic prevention work.

Objective:To analyze the effect on the expressions of nuclear factor-erythroid 2-related factor 2(Nrf2) and NAD(P)H quinone oxidoreductase 1 enzyme (NQO1) in A549 cells exposed to hyperoxia and interfered by small interfering RNA, and to investigate the role of Nrf2 and NQO1 in hyperoxia-induced lung injury as well as their relationship with apoptosis.Methods:A549 cells were gained by serial sub cultivation in vitro and then randomly divided into 4 groups: the air group without interference ( group Ⅰ), the hyperoxia group without interference (group Ⅱ), the air group transfected with Nrf2 siRNA (group Ⅲ), and the hyperoxia group transfected with Nrf2 siRNA (group Ⅳ). The hyperoxia groups (Ⅱ, Ⅳ group) were continuously exposed to an atmosphere containing a high concentration of oxygen (950 mL/L O 2, 50 mL/L CO 2), while the air groups (group Ⅰ, Ⅲ) were still placed in the incubator with 50 mL/L CO 2. In the pre-experiment, cells were transduced with a mixture of siRNA-1, siRNA-2, and siRNA-3. Then the siRNA with the highest efficiency for repressing Nrf2 expression was used for subsequent experiments. The mRNA and protein expression levels of Nrf2 and NQO1 in the 4 groups were detected by quantitative real-time polymerase chain reaction (qPCR) and Western blot.The distribution of Nrf2, Kelch-like ECH-associated protein 1(Keap1) and antioxidant response element(ARE) proteins in A549 cells after interference with Nrf2 was analyzed by immunofluorescence and confocal laser scanning microscope, and the cell apoptosis of the 4 groups were observed. Results:(1) Nrf2 siRNA significantly down-regulated the mRNA expression of Nrf2 in the groups siRNA-1, siRNA-2 and siRNA-3, and the inhibition efficiency of group siRNA-1 was the highest (80.57%). (2) The re-lative mRNA expression levels of Nrf2 and NQO1 in the group Ⅱ were 4.553±0.498 and 5.866±0.582, respectively.The mRNA and protein expression of Nrf2 and NQO1 and the cell apoptosis rate [(21.67±0.75)%]in the hype-roxia group were significantly higher than those in the group Ⅰ (all P<0.01). (3) The relative mRNA expression levels of Nrf2 and NQO1 in the group Ⅳ were 0.937±0.057 and 0.789±0.058, respectively.Compared with the group Ⅱ, the mRNA and protein expression of Nrf2 and NQO1 in the group Ⅳ were significantly decreased, while the cell apoptosis rate [(35.83±0.42)%]was significantly increased (all P<0.01). Conclusions:The abnormal expression of Nrf2 and NQO1 in A549 cells induced by hyperoxia and siRNA interference suggests that Nrf2 and NQO1 are involved in the pathogenesis of hyperoxia induced lung injury.Nrf2 and NQO1 are possibly protective factors in the hyperoxia induced lung injury and apoptosis.

Objective To explore the association between lipid ratios and all-cause mortality among elderly adults aged 80 years and older living in longevity areas of China. Methods A total of 874 participants in the Chinese Longitudinal Healthy Longevity Survey during June 2009 were included in our baseline survey. Lipid concentrations were measured and lipid ratios including LDL-C/HDL-C, TG/HDL-C, and atherosclerosis index (AI) were calculated at baseline, and the information on questionnaires, body measurement, and blood biochemical profiles was collected. Survival time and survival status were followed up in August 2012. Subjects were stratified into three groups (low, middle and high) by tertiles of lipid ratios. All-cause mortality was calculated. Cox regression models were used to assess the association of lipid ratios with mortality. Results During 38 months of follow-up, a total of 427 participants had died, 378 participants survived, and 69 participants were lost to follow-up; overall mortality was 50.5%. For these participants, P50 (P25-P75) values for LDL-C/HDL-C were 1.68 (1.22-2.05), 1.85 (1.34-2.16), and 1.78 (1.33-2.08), respectively (H=6.93, P=0.025); values for TG/HDL-C were 1.00 (0.79-1.34), 1.20 (0.97-1.53), and 1.23 (0.95-1.72), respectively (H=9.18, P=0.008). AIs were 2.12 (1.72-2.61), 2.27 (1.84-2.75), and 2.13 (1.80-2.58), respectively (H=6.37, P=0.041). Values for 38-month all-cause mortality were 53.1%, 50.0%, and 44.0%among participants with low, middle, and high LDL-C/HDL-C ratios (<1.39, 1.39-1.92, ≥1.92), respectively (χ2=7.54, P=0.024); these values were 54.8%, 46.4%, and 45.3% among participants with low, middle, and high AIs (<1.83, 1.83-2.39, ≥2.39), respectively (χ2=6.67, P=0.035). Each 1 unit increase of LDL-C/HDL-C, TG/HDL-C , and AI corresponded to a 17%, 15%, and 13%decrease in 38-month all-cause mortality, respectively; adjusted HRs were 0.83 (0.72-0.97), 0.85 (0.74-0.99), and 0.87 (0.76-0.99), respectively. Compared with participants who had low LDL-C/HDL-C ratios, high ratios were associated with lower risk of mortality (HR 0.88;(95%CI:0.78-0.99)). Compared with low AIs, middle and high values were associated with lower risk of mortality HRs (95%CI) were 0.84 (0.72-0.98) and 0.87 (0.78-0.98);respectively. Conclusion LDL-C/HDL-C, TG/HDL-C, and AI were negatively associated with all-cause mortality among elderly adults aged 80 years and older living in longevity areas of China.

Objective To explore the association between lipid ratios and all-cause mortality among elderly adults aged 80 years and older living in longevity areas of China. Methods A total of 874 participants in the Chinese Longitudinal Healthy Longevity Survey during June 2009 were included in our baseline survey. Lipid concentrations were measured and lipid ratios including LDL-C/HDL-C, TG/HDL-C, and atherosclerosis index (AI) were calculated at baseline, and the information on questionnaires, body measurement, and blood biochemical profiles was collected. Survival time and survival status were followed up in August 2012. Subjects were stratified into three groups (low, middle and high) by tertiles of lipid ratios. All-cause mortality was calculated. Cox regression models were used to assess the association of lipid ratios with mortality. Results During 38 months of follow-up, a total of 427 participants had died, 378 participants survived, and 69 participants were lost to follow-up; overall mortality was 50.5%. For these participants, P50 (P25-P75) values for LDL-C/HDL-C were 1.68 (1.22-2.05), 1.85 (1.34-2.16), and 1.78 (1.33-2.08), respectively (H=6.93, P=0.025); values for TG/HDL-C were 1.00 (0.79-1.34), 1.20 (0.97-1.53), and 1.23 (0.95-1.72), respectively (H=9.18, P=0.008). AIs were 2.12 (1.72-2.61), 2.27 (1.84-2.75), and 2.13 (1.80-2.58), respectively (H=6.37, P=0.041). Values for 38-month all-cause mortality were 53.1%, 50.0%, and 44.0%among participants with low, middle, and high LDL-C/HDL-C ratios (<1.39, 1.39-1.92, ≥1.92), respectively (χ2=7.54, P=0.024); these values were 54.8%, 46.4%, and 45.3% among participants with low, middle, and high AIs (<1.83, 1.83-2.39, ≥2.39), respectively (χ2=6.67, P=0.035). Each 1 unit increase of LDL-C/HDL-C, TG/HDL-C , and AI corresponded to a 17%, 15%, and 13%decrease in 38-month all-cause mortality, respectively; adjusted HRs were 0.83 (0.72-0.97), 0.85 (0.74-0.99), and 0.87 (0.76-0.99), respectively. Compared with participants who had low LDL-C/HDL-C ratios, high ratios were associated with lower risk of mortality (HR 0.88;(95%CI:0.78-0.99)). Compared with low AIs, middle and high values were associated with lower risk of mortality HRs (95%CI) were 0.84 (0.72-0.98) and 0.87 (0.78-0.98);respectively. Conclusion LDL-C/HDL-C, TG/HDL-C, and AI were negatively associated with all-cause mortality among elderly adults aged 80 years and older living in longevity areas of China.

Objective To assess the association between the concentration of the air pollutant PM2.5 and daily outpatient visits for respiratory disease. Methods All records of daily outpatient visits to three hospitals in Shenzhen from January 1 to December 31, 2013 were collected. Daily air pollution monitoring and meteorology data from the same period were also collected in Shenzhen. The data were analyzed using a semiparametric generalized additive model with Poisson distribution of time series analysis controlling for long-term and seasonal trends, flu, DOW, public holidays, and meteorological factors. The excess risk (ER) of respiratory disease and its 95%CI value were calculated, along with the incremental increase of 10 μg/m3 in PM2.5 concentration. Results Number of outpatient visits for respiratory diseases totaled 1 428 672 (daily range:1 790-5 228). The annual average PM2.5 concentration was 40.2μg/m3 (daily range:7.2-137.1μg/m3). The lag1 factor had the most significant impact on the lag effect. We estimated that a 10 μg/m3 increase in day-before PM2.5 concentration was associated with a 1.809% (95% CI:1.709%-1.909%) ER of visits for respiratory disease. After controlling for other pollutants (NO2, CO, and O3), the effect remained stable. When NO2, CO, and O3 were introduced separately, for every 10μg/m3 rise in PM2.5 concentration, the excess risk of daily outpatient visits for respiratory disease was 1.814% (95% CI:1.706%-1.923%), 2.780% (95% CI: 2.668%-2.892%), and 1.513% (95% CI: 1.403%-1.624%), respectively. With simultaneous control of NO2 and O3, NO2 and CO, and CO and O3, for every 10μg/m3 rise in PM2.5 concentration, the excess risk of respiratory disease was 1.369% (95% CI: 1.242%-1.497%), 2.709% (95% CI: 2.590%- 2.828% ), and 2.577% (95% CI: 2.452%- 2.702% ), respectively. With simultaneous control of NO2, CO, and O3, for every 10μg/m3 rise in PM2.5 concentration, the excess risk of respiratory disease was 2.370% (95% CI: 2.231%-2.509%). Conclusions PM2.5 can increase the risk of outpatient visits for respiratory disease in Shenzhen.

Objective To assess the association between the concentration of the air pollutant PM2.5 and daily outpatient visits for respiratory disease. Methods All records of daily outpatient visits to three hospitals in Shenzhen from January 1 to December 31, 2013 were collected. Daily air pollution monitoring and meteorology data from the same period were also collected in Shenzhen. The data were analyzed using a semiparametric generalized additive model with Poisson distribution of time series analysis controlling for long-term and seasonal trends, flu, DOW, public holidays, and meteorological factors. The excess risk (ER) of respiratory disease and its 95%CI value were calculated, along with the incremental increase of 10 μg/m3 in PM2.5 concentration. Results Number of outpatient visits for respiratory diseases totaled 1 428 672 (daily range:1 790-5 228). The annual average PM2.5 concentration was 40.2μg/m3 (daily range:7.2-137.1μg/m3). The lag1 factor had the most significant impact on the lag effect. We estimated that a 10 μg/m3 increase in day-before PM2.5 concentration was associated with a 1.809% (95% CI:1.709%-1.909%) ER of visits for respiratory disease. After controlling for other pollutants (NO2, CO, and O3), the effect remained stable. When NO2, CO, and O3 were introduced separately, for every 10μg/m3 rise in PM2.5 concentration, the excess risk of daily outpatient visits for respiratory disease was 1.814% (95% CI:1.706%-1.923%), 2.780% (95% CI: 2.668%-2.892%), and 1.513% (95% CI: 1.403%-1.624%), respectively. With simultaneous control of NO2 and O3, NO2 and CO, and CO and O3, for every 10μg/m3 rise in PM2.5 concentration, the excess risk of respiratory disease was 1.369% (95% CI: 1.242%-1.497%), 2.709% (95% CI: 2.590%- 2.828% ), and 2.577% (95% CI: 2.452%- 2.702% ), respectively. With simultaneous control of NO2, CO, and O3, for every 10μg/m3 rise in PM2.5 concentration, the excess risk of respiratory disease was 2.370% (95% CI: 2.231%-2.509%). Conclusions PM2.5 can increase the risk of outpatient visits for respiratory disease in Shenzhen.