Objective To clarify the source of infection of a student brucellosis case in Ningde City, make clear its influencing range as well as risk factors of transmission, then take measures to effectively control the epidemic.Methods Clue sampling was carried out, then the survey site village was chosen where the student case came from.①Fundamental state survey: resident population as well as the situation of livestock were collected.②Human outbreak investigation: detailed interview was carried out on the first case.Base on the principle of informed consent, serum samples were collected from breeders and those who had once contacted with sheep in order to detect brucellosis antibodies, then investigation was conducted on farmers to collect cognitive information;case searching was conducted by reviewing outpatient and inpatient records as well as government broadcasting.③Livestock epidemic: serum samples from some of the sheep were collected by agricultural sector.Results There were 200 households with 500 inhabitants in the survey site of Ningde City, among which there were 5 sheep feeding families and totally 154 sheep on hand.Patient was male, 12 years old, student.Sick on June 2nd, 2014,confirmed on July 5th.The patient's neighbor was a sheep farmer, he had once contacted with the sheep.Totally we collected 8 serum samples from livestock personnel, positive Brucella antibody was 4, with a positive rate 50％ (4/8);collected 15 serum samples from those contacted with sheep, positive Brucella antibody was 2, with a positive rate 13％ (2/15).Meanwhile, agricultural sector collected 17 sheep serum samples from these two sheep farms, among which there were 7 serum samples showing a positive Brucella antibodies, with a positive rate 41％ (7/17).After surveyed of 8 livestock breeding personnel and 15 livestock non-breeding personnel, we found that no one was familiar with the clinical characteristics and transmission of brucellosis.Conclusions The direct source of brucellosis infection is local infected sheep, general population has been involved in this epidemic.Brucellosis surveillance should be seriously carried out on both human and animal.Furthermore, improving the awareness of brucellosis among professionals as well as general population is eagerly needed and health education must be carried out immediately.

BACKGROUND: Many operations for isolating, purifying and identifying bone marrow mesenchymal stem calls (BMSCs) are complicated and cost much. Also they have great effect on cell activity. Whether whole bone marrow adherent culture can avoid above-mentioned disadvantages remains unclear. At present, many studies huve been done to confirm an effective and low cost method for isolating, purifying and identifying such cells.OBJECTIVE: This study is to in vitro induce and differentiate rat BMSCs by whole bone marrow adherent culture,and to identify the cells.DESIGN: A controlled observational experiment.SETTING: Qingdao University Medical College.MATERIALS: This study was carried out in the Laboratory of Oral Cavity and Laboratory of Molecular Biology (provincial level) Qingdao University Medical College between November 2005 and March 2007. Twenty Wistar rats of either gender, aged 3 to 4 weeks, of SPF grade, weighing 120-150 g, were provided by the Qingdao Laboratory Center. The protocol was carried out in accordance with animal ethics guidelines for the use and care of animals. Fetal bovine serum (FBS, Hangzhou Sijiqing Bioengineering Material Research Institute), alkaline phosphatase (ALP) kit (Nanjing Jiancheng Bioengineering Research Institute), reverse transcription kit (American Promega Corporation) and primer (Shanghai Bioengineering Co.,Ltd.) were used in this study.METHODS: Adult rat BMSCs were isolated and cultured by whole bone marrow adherent culture. They were digested with 2.5 g/L trypse and inoculated at a density of 5 ×107 L-1 in 6-well culture plate. Then, the cells were divided into experimental group and control group. Inducing culture medium was added to experimental group, and the same amount of basic culture medium was added to control group. ① Cell differentiation and calcium tuberculation were observed under the inverted microscope. ② Biological characteristics of induced cells were detected by calcium tubercle Von Kossa and alizarin Bordeaux. ③ALP activity was detected by diazo salt staining. ④Human core binding factor alpha subunit-1 (Cbf α-1), osteocalcin (OCN) and osteoblast-specific Osterix (OSX) mRNA expressions were detected by reverse transcription-polymerase chain reaction (RT-PCR).MAIN OUTCOME MEASURES: ① Induction and differentiation results of cells. ② Biological characteristics of cells induced by rat BMSCs. ③ ALP activity. ④ Cbf α-1, OCN and OSX expressions.RESULTS: ①Inducing culture medium was added in the serial subcultivation. About 9 days later, cell clones were connected to each other. On about 21 to 28 days, some pykno-round mineralized tubercles appeared. Meanwhile,control cells were connected to each other, but they did not form the tubercle. ② In the experimental group, when MSCs were induced for 21 to 28 days, obvious round or oval calcified tubercles were seen by naked eyes. The results of Von Kossa staining exhibited black sediments, and those of alizarin Bordeaux staining exhibited salmon tubercles. Calcium tubercles were not found in the control group. ③The ALP activity after 2 weeks of induction was obviously increased in the experimental group, but was relatively weak in the control group. ④In the experimental group,Cbf α-1, OCN and OSX expressions were significantly increased after induction.CONCLUSION: After being in vitro induced and differentiated by whole bone marrow adherent culture, rat BMSCs exhibited morphological and biological characteristics similar to typical osteoblasts.

Objective To investigate the effects of different concentrations of botulinum toxin type A on hypertrophic scar fi-broblasts ,and to explore the molecular mechanism of botulinum toxin type A in the treatment of scar and prevention of postopera-tive scar hyperplasia .Methods Different concentrations of botulinum toxin A (0 .01 ,0 .1 ,1 U/L and 10 U/L) were used on hyper-trophic scar fibroblasts for 24 hours ,to observe the changes of cell adhesion and cytoskeleton under laser confocal microscopy .MTT and flow cytometry were used to detect the proliferation ,apoptosis and cycle of change ,at the same time real time fluorescence quantitative PCR and Western blot were conducted to detected the expression of TGF-β,matrix metalloproteinase MMP-1 ,MMP-2 and MMP-9 gene and protein expression changes .Results With the increase of botulinum toxin A dose ,the number of cell adhesion and cytoskeletal fluorescence intensity decreased ,cell proliferation ability decreased and mainly blocked at G0-G1 phase ,and the ap-optosis also increased with the dose increased .The results of qPCR and Western blot showed that MMP-1 and MMP-9 gene and protein were highly expressed with the increase of botulinum toxin A dose ,while TGF-βand MMP-9 showed low expression .Con-clusion Botulinum toxin A can inhibit the proliferation of hypertrophic scar fibroblasts and inhibit the expression of MMP-1 and MMP-2 ,which can inhibit scar formation .It plays a positive role in the treatment of scar .

Objective To explore the relationship between meteorological conditions and emergency visiting of acute onset of renal colic caused by kidney stones. Methods Retrospective study design was applied to collect the emergency visiting data of acute renal colic attack in zhongnan hospital of Wuhan university from January 1, 2016 to December 31, 2017, as well as the average daily temperature and humidity in wuhan, hubei province during the same period. Pearson correlation analysis and linear regression analysis were used to study the relationship between meteorological conditions and emergency visiting of acute onset of renal colic caused by kidney stones. Results The results of multivariate linear regression analysis showed that the R 2 of daily visits of patients with renal colic and daily meteorological conditions was 0.309 (P < 0.05), and the R 2 of monthly visits of patients and monthly meteorological conditions was 0.642 (P<0.05). Conclusions Both temperature and humidity are correlated with the number of emergency visits of acute attack patients with renal calculi and colic.

Objective To explore the recurrent epidemiological characteristics of hand,foot and mouth disease (HFMD) among children aged <4 years to provide evidence for HFMD prevention and control. Methods Principles on historical cohort study were followed when analyzing data related to HFMD surveillance in Fujian province. All the research objects were restricted to patients aged<4,with HFMD and who were permanent residents in Fujian province. Characteristics of the study objects were extracted as potential factors when the patients first showed symptoms of HFMD. These factors might cause the recurrence of HFMD and were filtered by the logistic stepwise regression with SAS 9.0. Results A total of 82 949 children were included. Among them,2 612 had repetitiously suffered from HFMD (occupied 3.15%),including 2 510 who had the histories of suffering twice,98 suffering three times,3 suffering four times,and 1 even suffering five times. Comparing with the objects who had the first onset at the age of 3,also with the risk increased to 4.39 (95%CI:3.80-5.07)times,when compared to those who had the first onset at the age below 2. Again, the risk among children whose first onset was at the age of 2 had increased to 2.73 (95%CI:2.35-3.18)times. According to the current residents areas,the morbidities of patients under 6 years old were below 2%when the symptoms first started,but the risk of the objects whose morbidities were higher than 4%,had increased 2.15(95%CI:1.88-2.45) times. Again,risk of the objects whose morbidities were between 3%and 4%had increased to 2.10(95%CI:1.85-2.38)times. Among those whose specific morbidities were between 2% and 3%,the risk had increased to 1.65(95%CI:1.44-1.89) times. Comparing with the objects who never visited any maternal/child care settings when started the first onset,the risk among the ones who had been to the maternal/child care settings, had increased to 1.64(95%CI:1.51-1.78)times. Boys had the risk 1.34(95%CI:1.23-1.46)times increase than girls. The preponderant pathogen causing HFMD recurrence was EV71 (33/60). Recurrence might cause more severe symptoms or signs (8/2 612). Pathogens causing the initial infection and recurrence might both belonged to the same-EV71(3/6). Conclusion Recurrence of the disease were closely related to the opportunities of contacting the pathogens. Interventions should be imposed on patients in time as soon as the disease initiated,especially at the younger age.

The 2019 European Association for the Study of the Liver (EASL) Clinical Practice Guidelines (hereinafter referred to as the EASL Guidelines) extracted the required evidence from detailed research materials, and rigorously graded and condensed the varying strengths of evidence into 32 recommendations and 14 statements (recommendations and reminders) for drug-induced Liver Injury (DILI). This guideline has important reference values for helping clinicians to further improve their understanding of DILI and the level of clinical diagnosis, treatment and prevention; however, there are still several issues worthy of further discussion.

Objective To analyze the epidemiological characteristics and spatial distribution of human brucellosis in Fujian province during 2011-2016,and provide evidence for the prevention and control of the disease.Methods The surveillance data of human brucellosis in Fujian during 2011-2016 was analyzed with software R 3.3.1,ArcGIS 10.3.1,GeoDa 1.8.8 and SaTScan 9.4.3.Results During 2011-2016,a total of 319 human brucellosis cases were reported,the incidence increased year by year (F=11.838,P=0.026) with the annual incidence of 0.14/100 000.The male to female rate ratio of the incidence was 2.50 ∶ 1.Farmers and herdsmen accounted for 57.37％.The incidence was 0.40/100 000 in Zhangzhou and 0.32/100 000 in Nanping,which were higher than other areas.The number of affected counties (district) increased from 12 in 2011 to 28 in 2016,showing a significant increase (F=13.447,P=0.021).The Moran' s I of brucellosis in Fujian between January 2011 and December 2016 was 0.045,indicating the presence of a high value or low value clustering areas.Local spatial autocorrelation analysis showed that,high-high clustering area (hot spots) were distributed in Zhangpu,Longhai,Longwen,etc,while high-low clustering areas were distributed in Nan' an and Jiaocheng,etc.Temporal scanning showed that there were three clustering areas in areas with high incidence,the most possible clustering,occurring during January 1,2013-December 31,2015,covered 6 counties,including Yunxiao,Pinghe,Longhai,etc,and Zhangpu was the center,(RR =7.96,LLR=92.62,P＜0.001).Conclusions The epidemic of human brucellosis in Fujian is becoming serious,and has spread to general population and non-epidemic areas.It is necessary to strengthen the prevention and control of human brucellosis in areas at high risk.

OBJECTIVEA Dengue outbreak was reported in Dongfen town Jianou county, Fujian province on September 19, 2014. The goal of this project was to explore the role of syndromic surveillance program in the practice of early detection on disease outbreak through the case mentioned above.

METHODSThe authors retrospectively collected data related to Outpatient log and Pharmacy drug use in Dongfen township hospital through the electronic information system of the hospital from August to November, 2014. All the abnormal events were recorded, according to related data on fever and drug use. Description of fever, syndromic characteristics, correlation and Linear regression analyses were conducted, using the surveillance data on fever syndrome and drug use from the pharmacy.

RESULTSA total of 1 102 cases with fever and 2 437 fever-related clinic visits were reported which showing an increased number of 19.6, 10.2 times respectively, when compared to the same period of the previous year in which men accounted for 45.3% (499/1 102) and female accounted for 54.7% (603/1 102). Age groups presented an atypical type " M" type. 5 and 10 year olds groups formed the largest proportion, accounted for 11.5% (127/1 102) of the total number os the patients. The correlation coefficient ranged from 0.85 to 0.97 (P<0.05). Data from the syndromic surveillance program showed an " outbreak" was occured in August 23, 2014.

CONCLUSIONSCompared to routine surveillance program, the syndromic surveillance program could detect the appearence of an outbreak, a month or even more earlier. The role of syndromic surveillance program needs to be further explored.

Data Collection ; Dengue ; diagnosis ; epidemiology ; prevention & control ; Disease Outbreaks ; prevention & control ; Drug Prescriptions ; statistics & numerical data ; Drug Utilization ; statistics & numerical data ; trends ; Early Diagnosis ; Female ; Fever ; etiology ; Health Information Systems ; Humans ; Male ; Pharmacy Service, Hospital ; Population Surveillance ; methods ; Retrospective Studies

OBJECTIVETo explore the recurrent epidemiological characteristics of hand, foot and mouth disease (HFMD) among children aged <4 years to provide evidence for HFMD prevention and control.

METHODSPrinciples on historical cohort study were followed when analyzing data related to HFMD surveillance in Fujian province. All the research objects were restricted to patients aged <4, with HFMD and who were permanent residents in Fujian province. Characteristics of the study objects were extracted as potential factors when the patients first showed symptoms of HFMD. These factors might cause the recurrence of HFMD and were filtered by the logistic stepwise regression with SAS 9.0.

RESULTSA total of 82 949 children were included. Among them, 2 612 had repetitiously suffered from HFMD(occupied 3.15%), including 2 510 who had the histories of suffering twice, 98 suffering three times, 3 suffering four times, and 1 even suffering five times. Comparing with the objects who had the first onset at the age of 3, also with the risk increased to 4.39 (95%CI:3.80-5.07) times, when compared to those who had the first onset at the age below 2. Again, the risk among children whose first onset was at the age of 2 had increased to 2.73 (95% CI: 2.35-3.18) times. According to the current residents areas, the morbidities of patients under 6 years old were below 2% when the symptoms first started, but the risk of the objects whose morbidities were higher than 4% , had increased 2.15(95% CI:1.88-2.45)times. Again, risk of the objects whose morbidities were between 3% and 4% had increased to 2.10 (95%CI:1.85-2.38) times. Among those whose specific morbidities were between 2% and 3% , the risk had increased to 1.65 (95% CI: 1.44-1.89) times. Comparing with the objects who never visited any maternal/child care settings when started the first onset, the risk among the ones who had been to the maternal/child care settings, had increased to 1.64 (95% CI:1.51-1.78) times. Boys had the risk 1.34 (95% CI:1.23-1.46)times increase than girls. The preponderant pathogen causing HFMD recurrence was EV71 (33/60). Recurrence might cause more severe symptoms or signs (8/2 612). Pathogens causing the initial infection and recurrence might both belonged to the same-EV71 (3/6).

CONCLUSIONRecurrence of the disease were closely related to the opportunities of contacting the pathogens. Interventions should be imposed on patients in time as soon as the disease initiated, especially at the younger age.

Child, Preschool ; China ; epidemiology ; Cohort Studies ; Epidemics ; Female ; Hand, Foot and Mouth Disease ; epidemiology ; Humans ; Infant ; Logistic Models ; Male ; Recurrence ; Risk Factors