Acute Disease ; Bone Marrow Neoplasms ; pathology ; Hematologic Neoplasms ; pathology ; Humans ; Immunohistochemistry ; In Situ Hybridization, Fluorescence ; Leukemia ; pathology ; Lymphoma ; pathology ; Myelodysplastic Syndromes ; pathology ; Neoplasm Invasiveness ; Plastic Embedding ; Purpura, Thrombocytopenic, Idiopathic ; pathology

Objective To evaluate the epidemiological characteristics of brucellosis in Jinan, Shandong Province, and to analyze epidemic trend and its cause. Methods Epidemic data of human brucellosis from 2004 to 2007 in Jinan were collected from National Disease Supervision Information Management System. The rose bengal plate agglutination test(RBPT) and standard tube agglutination test(SAT) were employed to detect brucellosis in the serum samples of high-risk exposure groups involved in livestock transaction, slaughter and raising where brucellosis had been outbreak in the last three years, and epidemiological survey was conducted on the confirmed patients in 2007. Results A total of 32 brucellosis cases occurred in 2004-2007 in Jinan, among which 15 cases in 2007, 3.75 times(15/4) of those in 2004. One hundred and seventy-eight blood samples were collected from high risk population, and positive detective rate was 11.24%(20/178). Most of the patients were found in Zhangqiu and in the months from March to September, accounting for 93.33% (14/15). Farmers accounted for 93.33% (14/15) in all cases. Sixty-six point six seven percent(10/15) of the patients were over 50 years old. Male to female was 2.75: 1(11: 4) in ratio. There was a tendency of family aggregation. Two or three cases occurred in each of 3 families. All cases had a contact history with cattle and sheep, and the diagnosis were confirmed between 17-529 days(median being 70 days), in which 86.67%(13/15) of the cases were confirmed by The Centers for Disease Control and Prevention. Conclusions Brucellosis epidemic of Jinan is in an upward trend. Zhangqiu is the main epidemic region. Spring and summer are the prevailing periods, most of the patients are old male farmers were the majority of the patients. It is believed that the epidemic is primarily due to potential infection sources, incompetent quarantine of imported livestock and poor awareness of self-protection among high-risk occupational groups.

Objective To investigate the protective effects of creatine phosphate pretreatment on circulato ry function in prone position in elder patients with general anesthesia.Methods Forty patients in ASA physical status Ⅰ or Ⅱ of male and female,aged 60 to 75 years undergoing percutaneous nephrolithotripsy in prone position,were randomly divided into two groups (n =20 each):the control group (gToup N) and the creatine phosphate group (group P).In the group P,creatine phosphate sodium (30 mg·kg-1 in 50 mL normal saline) was continuous infused at a speed of 100 mL· h-1,while only normal saline 50 mL in the group N at the same time.HR,MAP,CO,SV,CVP,Pulse Pressure Variation (PVV) and Systemic Circulation Resistance (SVR) were monitored and recorded at 1 min before prone position (T0) and 1 min (T1),3 min (T2),5 min (T3),10 min (T4) after prone position.The requirement for vasoactive agents were also recorded.Results Compared with T0,HR began to increase significantly at T1 in the group N(P ＜ 0.05),while MAP,CO and SV began to decrease at T1 to T3,and CVP,PVV and SVR began to increase significantly at the same time in the group N (P ＜ 0.05).Compared with the group N,MAP,CO and SV were decreased,PPV,CVP and SVR were increased significantly at T1 to T2 in the group P (P ＜ 0.05).The requirement for vasoactive agents in the group P was obviously lower than that in the group N (P ＜ 0.05).Conclusion Creatine phosphate pretreatment can stabilize the hemodynamic change effectively,and prevent the adverse cardiovascular events caused by prone position in elder patients with general anesthesia.

Objective To evaluate the feasibility of real time elastosonography in estimating the characteristic of nodules in resected hepatocirrhosis specimens.Methods Thirty-eight reseeted hepatocirrhosis specimens underwent elastosonography.The nodules that have drawn attention were performed elastosonography through rhythmic pressing and releasing the probe by manual form on the liver.The hepatic strain on the region of interest was shown by chromatic scale.To compare nodules rigidity with surrounding hepatic tissues, hepatocirrhosis nodules were classified into hard nodules, medium rigidity nodules, mixture of hard and soft nodules, and soft nodules.All nodules were confirmed by pathology.Results Forty-four nodules of 38 hepatocirrhosis exemplar received real time elastosonography.Of 44 nodules, hard nodules were 18,of which 12 (66.7%) were hepatoeellular carcinomas, 2 (11.1%) were dysplasia nodules, 4 (22.2%) were regenerative nodules.Medium rigidity nodules were 7,all were regenerative nodules.Mixture of hard and soft nodules were 11, of which 8 (72.7%) were hepatocellular carcinomas, including 4 accompanied necrotic tissue, 1 (9.1%) was dysplasia nodules accompanied necrotic tissue, the other 2 (18.2%) were regenerative nodules accompanied necrotic tissue.And soft nodules were 8, of which 4(50.0%) were necrotic nodules, 1 (12.5%) was dysplasia nodules accompanied canceration, 1 (12.5%) was hepatocellular carcinoma,2(25.0 %) were regenerative nodules.Conclusions Real time elastosonography can effectively evaluate the comparative rigidity on hepatoeirrhosis nodules,and thus may have potential usefulness on estimating the characteristic of hepatocirrhosis nodules.

Objective To investigate the effects of methylprednisolone on lung function and inflammation during one-lung ventilation in patients undergoing pulmonary lobectomy.Methods Sixty patients (46 males, 10 females, aged 18-60 years, ASA grade Ⅰ or Ⅱ) scheduled for pulmonary lobectomy were randomly divided into two groups (n=30 each) using a random number table: the control group (group C) and the methylprednisolone group (group M).Patients in group M were treated with methylprednisolone before induction of anesthesia within 30 min, whereas patients in group G received equal volume of normal saline at the same time.The heart rate (HR), mean arterial pressure (MAP), peak airway pressure (Ppeak), plateau airway pressure (Pplat), and dynamic lung compliance (Cdyn) were recorded at the momment before OLV (T1), 30 min after OLV (T2), 1 h after OLV (T3), 10 min after resuming two-lung ventilation (T4) and the end of the surgery (T5).The arterial blood gas analysis were performed at the above time points in order to determined the oxygen partial pressure (PaO2) and carbon dioxide partial pressure (PaCO2), then the oxygenation index (OI), alveolar to arterial difference of oxygen tension (A-aDO2) and respiratory index (RI) of each patient was evaluated.The concentration of serum TNF-α, IL-6 and IL-10 were determined by ELISA at T0, T4, 6 h (T5) and 24 h (T6) after surgery using venous blood samples.The incidence of pulmonary complications at 72 h after operation were also recorded.Results Compared with T0, the MAP and Cdyn was decreased, whereas the Ppeak and Pplat was increased significantly in both group at T1, T2 (P＜0.05), the OI was decreased and the A-aDO2, RI was increased significantly at T1-T4 (P＜0.05), and the concentration of serum TNF-α, IL-6 and IL-10 at T4-T6 was increased significantly in both group (P＜0.05).Compared with group C, the Cdyn was increased, the Ppeak and Pplat were decreased significantly in group G at T1, T2 (P＜0.05), the concentration of serum TNF-α and IL-6 were decreased, and IL-10 was increased significantly in group G at T4-T6 (P＜0.05).The incidence of postoperative pulmonary complications had no statistically signifcant differences between the two groups.Conclusion Methylprednisolone can significantly improve the pneumodynamics and lung compliance, alleviates the inflammatory responses, but have no significant effect on intrapulmonary oxygenation and gas exchange during one-lung ventilationin patients undergoing pulmonary lobectomy.

Objective To find out the status of prevention and control of iodine deficiency disorders and evaluate the iodine nutritional status of Jinan residents,to explore appropriate iodine level in drinking water,and to provide a scientific basis for adjustment of intervention strategies.MethodsAccording to the Monitoring Program of the National Iodine Deficiency Disorders (Trial),qualified iodized salt consumption rate,drinking water iodine content and urinary iodine levels of women of childbearing age were determined in iodine deficiency areas from 2003 to 2010.Salt iodine was detected by direct titrimetry,urinary iodine by As-Ce catalytic spectrophotometric assay and iodine in drinking water by cerous sulfate catalytic spectrophotometric method.Results Intake rate of qualified iodized salt was up to 90％ and above from 2003 to 2010,median water iodine was 13.65 μg/L in the 10 counties(cities,districts),of which less than 100 μg/L accounted for 79.82％(4560/5713 ) and ＞ 150 μg/L accounted for 12.73％(727/5713).With the increase of water iodine(0 ～ ＜ 10,10 ～ ＜ 50,50 ～ ＜ 100,100 ～ ＜ 150,150 ～ ＜ 300 and ≥300 μg/L),urinary iodine levels of women of childbearing age increased successively(median 156.56,175.81,267.04,349.00,524.22,583.20 μg/L,respectively,x2 =121.20,P ＜ 0.05),while the ratio of urinary iodine ＜ 100 μg/L was significantly lower.The ratio of urinary iodine between 100 and 300 μg/L was decreased gradually,but the ratio of great than 300 μg/L was gradually increased.ConclusionsIodine deficiency areas in Jinan have reached the standard of elimination of iodine deficiency disorders.We should insist to carry out our measures to suit local conditions,classified guidances and scientific principals of iodine supplementation.

Background Corneal blindness caused by ocular surface disease is one of the main reasons for the global blinding corneal diseases.With the development and progress of tissue engineering technology,tissueengineered cornea offers a new approach to the treatment of ocular surface disease.Objective This study was to obscrve the growth and differentiation of human umbilical cord mesenchymal stem cclls (UC-MSCs) on thc corneal stroma of receipts and investigate the feasibility of human UC-MSCs differentiated into corneal epithelium-like cells and the reparation of injury cornea.Methods Human UC-MSCs were isolated from human umbilical cord using collagenase Ⅳ digestion and passaged in DMEM/F12 containing fetal bovine serum in vitro.The immunophenotype of cultured human UC-MSCs was evaluated by flow cytometry.The differentiated osteoblasts from the human UC-MSCs by directional induce was identified.Twenty-four New Zealand albino rabbits were randomly divided into 2 groups.The human UC-MSCs were cultured on porcine corneal matrix without corneal epithelium for 4 days and then transplanted onto the 12 left eyes of 12 New Zealand albino rabbits,and porcine corneal matrix without corneal epithelium was transplanted onto the left eyes of other 12 New Zealand albino rabbits as control group.The rabbits received keratoplasty were examined using in vivo confocal microscope through focusing(CMTF).The eyeballs were taken off after 2,4 and 8 weeks,the growth and differentiation,expression of cytokeratin 3 (CK3),CK12 and ATP-binding cassette superfamily G memben 2 (ABCG2)of human UC-MSCs were observed by histopathology and immunofluorescence staining.This use of the experimental animals complied with ARVO Statement.Results Digestive human UCMSCs formed round in shape and was large in size.The attached cells displayed long-fusiform shape like fibroblasts.The cultured human UC-MSCs phenotype was CD105+/CD29+/CD44+/CD34-/CD45-and could be induced toward osteoblast differentiation under the appropriate experimental conditions.Human UC-MSCs grew well on the porcine corneal matrix.The corneal grafts survived wcll without rejection till the experiment end in experimental eyes,but the rejection of corneal graft occurred in control eyes.Confocal microscope could observe corneal epithelium-like cells.The corneal epithelium cells showed the positive response for CK3 and CK12 and absent response for ABCG2.Conclusions Human UC-MSCs with porcine corneal matrix can survive,proliferate and differentiate into corneal epithelium-like cells after transplanting onto the corneal stroma of rabbits.This result suggests that human UC-MSCs is able to repair and reconstruct the injured corneal surfaces.

Objective: To analyze the epidemiological characteristics of influenza clusters in Hangzhou from 2018 to 2019, so as to provide references for the prevention and control of influenza. Methods: The data came from the epidemic investigation reports of influenza clusters in Hangzhou from the 27th week of 2018 and the 26th week of 2019. The time distribution, school types, population distribution and etiology of influenza were analyzed. Multivariate logistic regression model was employed to analyze the influencing factors for the attack rate of influenza clusters. Results: During the surveillance season, a total of 231 school influenza clusters involving 4 233 cases were reported. The median of the attack rate was 21.74%. The peak of the clusters was in March 2019, with 89 events and 1 476 cases ( 34.87% ). The clusters occurred mainly in primary schools ( 188 events, 81.39% ) and were mainly caused by Victoria-like strains of influenza B virus ( 84 events, 36.36% ). The multivariate logistic regression analysis indicated that infection of teachers increased the risk of high attack rate ( OR=3.133, 95%CI: 1.180-8.320 ), and kindergartens had higher risk of high attack rate than primary schools ( OR=4.123, 95%CI: 1.579-10.763 ). Conclusions The influenza clusters in Hangzhou from 2018 to 2019 is mainly caused by Victoria-like strains of influenza B virus. Kindergartens and teachers are the key points for the prevention and control of influenza clusters.

Objective: To observe the effects of acupoint thread-embedding therapy on serum apelin and glucagon-like peptide-1 (GLP-1) in type 2 diabetes mellitus patients with obesity due to dampness-heat encumbering spleen.Methods: Sixty-six patients were randomly divided into a control group and an observation group according to the random number table method, with 33 cases in each group. Patients in the control group were treated with exenatide and metformin, while patients in the observation group were treated with additional acupoint thread-embedding. After 12-week treatment, the obesity-related indicators, including body mass index (BMI), waist circumference and body fat rate, the glycometabolism indicators, including fasting blood glucose, 2 h postprandial blood glucose and glycosylated hemoglobin, and the lipid metabolism indicators, including total cholesterol (TC), triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C), as well as serum apelin and GLP-1 levels were observed in patients of the two groups. Results: After treatment, the BMI, waist circumference and body fat rate of patients in the two groups were all reduced (all P<0.05), and were lower in the observation group than in the control group (all P<0.05); the fasting blood glucose, 2 h postprandial blood glucose and glycosylated hemoglobin levels of patients in both groups were all decreased (all P<0.05), and were significantly lower in the observation group than in the control group (all P<0.05); the TC level was decreased (P<0.05), while the TG and LDL-C levels did not change significantly in the control group (both P>0.05); the TC, TG and LDL-C levels were all significantly reduced in the observation group (all P<0.05), lower than those in the control group (all P<0.05); the serum apelin level was decreased (P<0.05) and the serum GLP-1 level was increased (P<0.05) in the observation group, statistically different from those in the control group (both P<0.05). Conclusion: Combined with the conventional medication, acupoint thread-embedding therapy can significantly improve the obesity-related indicators, glycometabolism and lipid metabolism in type 2 diabetes mellitus patients with obesity due to dampness-heat encumbering spleen. This may be achieved by regulating the serum apelin and GLP-1 levels.

Objective To explore the relationship between genetic variation in PAF-AH V279F and coronary heart disease among Han population in Beijing.Methods A case-control study was held which enrolled 124 patients with coronary heart disease and 103 normal subjects.The genotype of PAF-AH V279F was determined with allele-specific polymerase chain reaction(AS-PCR)method. Results The highest frequency of PAF-AH V279F genetic variation was VV genotype(92.2%),the next was VF genotype(5.8%)and the lowest was FF genotype(2.0%)among the studied Han population in Beijing.In the coronary heart disease group the frequency of 279 V→F carriers was significantly higher than in the control group(19.3% vs.7.8%,P＜0.05)and F allele frequency was also higher(12.1% vs.4.9%,P＜0.01).Among the coronary heart disease group,the V279F variation frequency and the F allele frequency were significantly higher in patients with myocardial infarction than in those without myocardial infarction(27.3% vs.13.0%,17.3% vs.8.0%,both P＜0.05).In multiple logistic regression analysis,the odds ratio(OR)of V279F genetic variation for coronary heart disease was 1.919(95% CI:1.448-2.544,P=0.033).Conclusions The PAF-AH V279F genetic variation may be a novel genetic marker for high risk of coronary heart disease.