Objective To understand the status of malaria prevalence in Shanghai,so as to provide the evidence for evaluat-ing and promoting malaria elimination. Methods The data of population,malaria endemic and monitoring in Shanghai from 2005 to 2012 were collected and analyzed. The malaria positive rates in febrile patients and normal population,the malaria antibody lev-els of the floating population and location pupils,and the species and density of mosquitoes were investigated and the results were analyzed. Results The blood examples from 400 177 febrile patients with 0.36%of the total population were examined for malar-ia,and the annual rates of blood examination varied from 0.15%to 0.83%in the period of 2005 to 2012. Before 2010,the annual blood examination rate was lower than 0.20%,but increased significantly since 2010 because of the implementation of the Action of Malaria Elimination in Shanghai from 2010 to 2020. Totally 604 malaria cases were found and the positive rate of blood examina-tion was 0.15%. During the period of 2006 to 2008,more than 100 malaria cases were found every year,but the number of malaria cases decreased since 2009,and only 26 cases was found in 2012. Since 2011,all the malaria cases have been found infected out of China according to the questionnaire investigation. The malaria positive rate of blood examinations decreased from 0.61% to 0.03%yearly. The proportion of local residents who had the blood examination was 79.02%,but that of the malaria positive in float-ing population was 83.44%. The active case detection was carried out in 15 759 persons and five cases were found in 2007 and 2008,respectively. The level of malaria antibody was tested in 1 239 440 floating population with the average positive rate of 0.04%. The level of malaria antibody was also tested in 7 065 local pupils but there was no positive for malaria. Only Anopheles si-nensis was found in Shanghai suburb,but no other Anopheles mosquitoes were found at the city or towns. The peak of Anopheles den- sity was from the end of July to August. Conclusions Malaria surveillance is carried out efficiently in Shanghai,and the result shows Shanghai is in the phase of malaria elimination. The more attention should be paid to persons coming from malaria endemic areas for the malaria blood examination and the general and advanced hospital should maintain the ability of malaria blood exami-nations simultaneously.

Objective:To establish a preoperative forecasting model for the nature of duodenal papillary tumors and to discuss its main predictors.Methods:A case-control study was conducted;the case group included patients with malignant duodenal papillary tumors and the control group included patients with benign duodenal papillary tumors.All the patients were from Changhai Hospital. Data of patients,including the demographic characteristics,clinical symptoms during onset,laboratory findings,and radiological data, were collected by face-to-face interviews or by reviewing the medical history.Chi-square,t-test or ANOVA were employed to performed univariate analysis.All factors with P values less than or equal to 0.25 in the univariate analysis were used as independent variables for multivariate analysis,and a Logistic regression forecasting model for the nature of duodenal papillary tumors was established.Results: Totally 199 patients with pathologically-confirmed duodenal papillary tumors were included in the present study,with 166 in the case group and 33 in the control group.Multivariate analysis showed that hemoglobin(Hb),total bilirubin(Tbil),direct bilirubin(Dbil), aspartate transferase(AST),alkaline phosphatase(AKP),gamma glutamyl transpeptidase(GGT),and carcinoembryonic antigen(CEA) were independent predictors for nature of duodenal papillary tumors,with their odds ratios(95% confidence interval)being 0.981 (0.959,1.003),0.867(0.794,0.948),1.207(1.075,1.355),1.028(1.008,1.048),0.996(0.992,1.000),1.002(1.000,1.004),and 0.974(0.953,0.994),respectively.Conclusion:The Logistic regression model,which takes into consideration of Hb,Tbil,Dbil,AST, AKP,GGT,and CEA,can be used to predict the nature of duodenal papillary tumors,and its clinical value need to be further studied.

ObjectiveTo evaluate the clinical efficacy of intravenous catheter in combination with ultraviolet radiation for postherpetic neuralgia (PHN).Methods96 patients with PHN were randonly divided into three groups.Intravenous catheter plus UVB radiation was given in the test group(32 patients).Intravenous catheter or UVB radiation was only given in two control groups (32 patients/group), respectively.ResultsThe total effective rate in the test group was 96.88％ (31/32) and the average onset time was 1.55 days.However,the total effective rate in two control groups was 81.25％ (26/32) and 68.75％ (22/32) ,and the average onset time was 2.48 days and 7.41days.There was a statistical difference observed in curative rate (x2 = 5.33,42.42, P ＜ 0.05 or P ＜ 0.01), the total effective rate(x2 =4.59,8.89,P＜0.05 or P＜0.01) and the average onset time(t =22.96,11.96,all P＜0.01)between the test group and two control groups.Moreove,there was also a statistical difference observed in curative rate (x2 = 22.44, P ＜ 0.001) and the average onset time (t = 29.30, P ＜ 0.01) between two control groups.ConclusionIntravenous catheter in combination with UVB radiation was much better than intravenous catheter or UVB radiation only in the treatment of PHN.

Objective To investigate the difference of leucorrhea routine tests results among 3 periods of pregnancy in pregnant women.Methods Vaginal cleanliness,the presence of clue cells,trichomonas and fungi were tested for 3 103 obstetric outpatients who were pregnant and treated in the hospital.The test results were analyzed and compared.Results Among pregnant women in different periods of pregnancy,the difference in the proportion of vaginal cleanliness degree Ⅲ and fungal infection rates were statis-tically significant(P <0.05).Among pregnant women of different pregnant periods with vaginal cleanliness degree Ⅱ,difference of fungi infection rate was statistically significant(P <0.05).Among pregnant women of different pregnant periods with vaginal clean-liness degree Ⅳ,the difference of positive rates of fungi,trichomonas and clue cells were statistically significant(P <0.05).In addi-tion,there are a number of mixed infections.Conclusion Vaginitis during pregnancy should be early detected,diagnosed and trea-ted.

Objective To prepare 99Tcm-human epidermal growth factor receptor 2 (HER2) affibody (ABH2) and explore its feasibility as an imaging agent in HER2-positive breast cancer.Methods Sodium glucoheptonate and SnCl2 · 2H2O were used to label ABH2 with 99Tcm.The labeling yield and radiochemical purity of 99Tcm-ABH2 were determined.The stability of 99Tcm-ABH2 was tested in PBS and serum.The equilibrium disassociation constant (Kd) of 99Tcm-ABH2 was measured with MBA-MD-361 breast cancer cells.SPECT/CT imaging was carried out at 1.0 h and 4.5 h after injection of 37 MBq 99Tcm-ABH2 in nude mice (n=4) xenografted with MBA-MD-361 breast cancer.The T/NT (liver,brain,lung,heart,bone and muscle) ratios were deduced from SPECT/CT acquired data.For the blocking experiment,200 μg ABH2 was injected intravenously before 99Tcm-ABH2 injection.SPECT/CT imaging was performed in the same way.The T/NT ratios were compared between non-blocked and blocked groups by one-way analysis of variance.Results Fhe labeling yield of 99Tcm-ABH2 was above 99％.99Tcm-ABH2 was substantially stable in PBS and serum;the radiochemical purity was (95.0± 1.0)％ after incubation with serum at 37 ℃ for 6.0 h.The Kd of 99Tcm-ABH2 was 1.7 nmol/L.The radioactive uptake in cancer was visualized at 1.0 h and 4.5 h after injection of 99Tcm-ABH2 in HER2 positive MDA-MB-361 breast cancer.99Tcm-ABH2 was cleared out mainly through urinary system.The ratios of tumor to liver,lung,brain,heart,muscle and bone were 1.81± 0.60,8.95±1.13,20.08±6.12,7.61±0.56,10.62±1.78,11.42±2.07,respectively at 4.5 h after 99Tcm-ABH2 injection.After ABH2 blocking,the corresponding T/NT ratios were 0.60±0.23,3.05± 1.38,5.24±2.17,2.42±1.02,8.16±2.66,2.76±0.48 (F=29.38,P＜0.05) respectively.Conclusion 99Tcm-ABH2 could be synthesized with high purity,and this new agent could be used to image HER2-positive breast cancer specifically.

Objective To analyze the epidemiologic characteristics and tendency of hemorrhagic fever with renal syndrome (HFRS) in Xi'an from 2005 to 2014,and to grasp the epidemic regularity and predict the trend of HFRS for establishing effective prevention and control measures.Methods The descriptive epidemiological method was used to analyze the epidemic situation of HFRS in Xi'an from 2005 to 2014.The autoregressive integrated moving average (ARIMA) model was applied to analyze,fit and predict the epidemic data of 2015.Results There were 8 500 HFRS patients in Xi'an from 2005 to 2014,the incidence rate was 10.60/100 000.The morbidity increased at first and then decreased from 2005 to 2014;the incidence rate was 9.06/100 000 in 2005 and up to 19.46/100 000 in 2010,then down to 3.43/100 000 in 2014.More cases were reported in spring (15.85％,1 347/8 500) and autumn-winter seasons (72.91％,6 197/8 500).The high-risk age group of HFRS was between 15 to 59 years,accounting for 77.71％ (6 605/8 500) of the overall incidence rate;there were no significant differences in ＜ 15 years,15 to 59 years and ＞ 59 years groups (x2 =15.63,P ＞ 0.05).The male to female ratio was 3.01 ∶ 1.00,male incidence was 15.57/100 000 and female incidence rate was 5.41/100 000,and the difference was statistically significant between gender (x2 =1 948.84,P ＜ 0.05).The main occupation was farmers,accounting for 66.04％ (5 613/8 500) of the overall incidence rate.The top 4 districts were Chang'an,Zhouzhi,Huxian and Lintong;the incidence rate was 31.07/100 000,22.74/100 000,21.09/100 000 and 11.06/100 000,respectively,and the 10 years cumulative incidence rate was higher than the total incidence.The monthly incidence was predicted with ARIMA (1,1,0) × (0,1,1)12 models in Xi'an from 2005 to 2014,and the predicted number of cases was 235 in 2015 (lower than 2014).Conclusions The overall trend of the epidemic has continued to fall but slowly.Positive and effective comprehensive measures should be taken to maintain the incidence of hemorrhagic fever at a lower level.

Objective To explore the application value of sensitive index of nursing quality in nursing management of patients with cancer pain.Methods One hundred and eight patients with cancer pain in the First Affiliated Hospital of Xinxiang Medical University from February 2014 to March 2015 were selected as the control group;one hundred and eight patients with cancer pain in the First Affiliated Hospital of Xinxiang Medical University from April 2015 to June 2016 were selected as the study group.The traditional cancer pain nursing quality evaluation criterion was taken in the control group,and the improved cancer pain nursing quality evaluation criterion was taken in the study group to evaluate the nursing quality.The accuracy of pain assessment,awareness rate of cancer pain knowledge,degree of satisfaction to the nursing work were compared between the two groups.Results The accuracy of pain assessment of patients in the study group (90.7％,98/108)was significandy higher than that in the control group (45.4％,49/108) (x2 =51.16,P ＜ 0.05);the awareness rate of cancer pain knowledge of patients (98.1％,106/108) in the study group was significantly higher than that in the control group (72.2％,78/108) (x2 =28.83,P ＜ 0.05);the satisfaction rate of the patients in the study group (100.0％,108/108) was significantly higher than that in the control group (85.2％,92/108) (x2 =17.38,P ＜ 0.05).Conclusion The overall quality of cancer pain care can be improved by strengthening the quality evaluation of the pain assessment accuracy and the awareness rate of cancer pain knowledge in patients with cancer pain.

Objective:To investigate the clinical characteristics and therapy of laryngeal neuroendocrine carcinoma(LNEC).Method:Ten cases of LNEC treated in our department were retrospectively analyzed.Result:Eight out of 10 cases were were atypical carcinoid:1 case treated as supraglottic horizontal partial laryngectomy died 22 months after operation; 1 case was lost;the other 6 cases were followed up for more than 2 years. Two cases were small cell type,one received supra-cricoid partial laryngectomy-cricohyoidopexy (SCPL-CHP) ,neck dissection,and radiotherapy,but died after 14 months;the other was receiving radiotherapy.Conclusion:LNEC is a rare malignant tumor and the diagnosis relies on clinical characteristics, histopathological and immunohistochemistry examination. The different types of LNEC should give different treatment protocols.

Objective To explore the influencing factors of gastrointestinal bleeding(GB) in secondary prevention patients with cerebral ischemic stroke(CIS).Methods A total of 616 patients were divided into bleeding group and control group according to the status (yes,no) of suffering GB during the 2years follow-up.Single factor analysis and Logistic regression analysis was used to explore the influencing factors of GB in CIS patients.Results The proportion of age≥65,a history of GB,gastric disease,renal insufficiency,sudden onset,NIHSS ≥12 and CIS ≥2 in the bleeding group was significantly higher than that in the control group (P ＜ 0.05) ; The proportion of combined with statins,proton pump inhibitors and gastric mucosal protective agent in the bleeding group was significantly lower than that in the control group (P ＜0.05) ; The Logistic regression analysis showed that age≥65,a history of GB,gastric disease,renal insufficiency,sudden onset,NIHSS≥12 and the times of CIS≥2 were risk factors of GB; however,combined with statins,proton pump inhibitors were protective factors.Conclusions Aging,a history of GB,gastric disease,sudden onset,higher NIHSS score and the times of CIS ≥ 2 were the risk factors of GB,combined with statins and proton pump inhibitors could reduce the risk of GB.

Objective To find out the pathologic changes and possible influencing factors in the process of spontaneous regression of plane warts.Methods One hundred and five lesional specimens taken from patients with plane warts were observed microscopically.Results The histologic features indicated slight hyperkeratosis,acanthosis and ballooning degeneration of keratinocytes in stable lesions;a combination of tower-peak shaped hyperkeratosis,cuneate hypergranulosis and ballooning degeneration in progressively increasing lesions;and infiltration of lymphocytes and necrosis of keratinocytes in inflammatory icthing lesions.Conclusions Specific cell-mediated immunity against keratimocytes may be involved in the process of regression of plane warts.There is a positive correlation between the activity of skin lesions and the induction of cellular immunity.