Objective To explore the application of computer-assisted telephone interviewing in the follow-up study of endemic diseases,and to provide a reference and basis for wide range application of this method.Methods In this investigation,146 patients with Keshan disease from 2 provinces were recruited in.The study mainly included two questionnaire surveys:disease follow-up questionnaire survey and cardiac insufficiency quality of life scale survey.Survey methods included computer-assisted telephone survey and face-to-face questionnaire survey.In the 18-month of follow-up study,one computer-assisted telephone survey was done in the 3ed,6th,12th,15th month,and one face-to-face questionnaire survey in 9th and 18th month.Time-consuming and quality of the two survey methods were eompaired.The computer-assisted telephone survey database was designed using Epi Info 3.32software.Results The computer-assisted telephone survey took an average of (13.10 t 1.80)min,and face-to-facequestionnaire survey took an average of (22.04 ± 2.28)min,the difference was statistically significant (t =- 36.214,P ＜ 0.05).The error rate of computer-assisted telephone survey was 6.80％ (37/544),and that of face-to-face questionnaire survey was 11.07％(28/253),the difference was statistically significant(x2 =4.195,P ＜ 0.05).The quality of computer-assisted telephone survey was better than that of face-to-face questionnaire survey.Conclusions Through the computer-assisted telephone interviewing,the work efficiency of investigators is improved during the follow-up study of Keshan disease.The validation function improves the accuracy rate during the process of data entry.Because of the application of telephone contact,a lot of research funding is saved.

Objective To investigate the efficacy and security of tirofiban with low-dose heparin for treating progressing stroke with intracranial vessel stenosis,to analyze the clinical value of tirofiban in the treatment of ischemic stroke.Methods Clinical data of 26 patients treated with tirofiban and low-dose heparin for progressing stroke were retrospectively collected with NIHSS increment ≥3 within 6 days of stroke as the diagnosis standard.The degree of intracranial vessel stenosis was checked by CT angiography (CTA).The efficacy of tirofiban for treating progressing stroke,and the correlation between the degree of intracranial vessel stenosis and the prognosis of progressing stroke were observed.Results The percentage of progressing stroke patients with intracranial vessel stenosis/lesion was higher than without intracranial vessel stenosis/lesion (88.5 ％vs.11.5％,x2=14.786,P 0.000).There was a significant difference in NIHSS scores between progressing stroke patients with and without intracranial vessel stenosis/lesion before treatment (t 2.17,P=0.046).NIHSS scores were significantly decreased (t=3.59,P=0.021) in both two groups after treatment.MRS was lower in progressing stroke patients without intracranial vessel stenosis/lesion than in progressing stroke patients with intracranial vessel stenosis/lesion after treatment (t=6.79,P=0.001).The efficacy of tirofiban was higher in progressing stroke patients without intracranial vessel stenosis/lesion than in progressing stroke patients with intracranial vessel stenosis/lesion (60.2％ vs.30.8％,x2=4.35,P＜0.05).Conclusions Combination of tirofiban with low-dose heparin is safe and effective in the treatment of progressing stroke.The degree of intracranial vessel stenosis is correalted with progressing stroke prognosis.

Objective: Angiosarcoma of the breast is a rare and heterogeneous entity and its overall incidence is reported as 0.04% of primary breast cancer and as 8% of breast sarcoma approximately. To retrospectively analyze the clinical features and prognosis of breast angiosarcoma, 13 patients were identified by mammary pathologists in Tianjin Medical University Cancer Institute and Hospital from October 1975 to June 2009. Methods:Kaplan-Meier method was carried out to analyze different tumor size, tumor margins and histological grade. Prognosis was tested with univariate analysis by Log-rank test. Results: Median and mean age at diagnosis were 48 years and 44 years, respectively. The duration of follow-up ranged from 7 to 98 months (median, 50 months). All patients underwent surgical excision. Two patients received chemotherapy. Eight patients succumbed to recurrence and distant metastasis. Conclusion:Angiosarcoma of the breast has an exceedingly poor prognosis. The median disease-free survival (DFS) and overall survival (OS) were 28 months and 45 months, respectively. Both tumor size and surgical margins were associated with prognosis (P<0.05). Patients with high histological grade had a tendency of short OS (P>0.05) and a high risk of recurrence and metastasis (P<0.05).

Objective To analyze the clinical features,epidemiologic information and outcome in confirmed cases of human infection with a highly pathogenic influenza A(H5N1).Methods The clinical features and epidemiologic findings in 2 confirmed cases of avian influenza A(H5N1)in Anhui province,in November 2005.Clinical data on vital signs,physical findings,laboratory tests and roentgenology were obtained by means of retrospective review of the hospital records.Epidemiologic data were collected through interviews of the patients and their relatives.Results In both cases,the diagnosis of influenza A(H5N1)was confirmed by means of viral culture and real-time polymerase chain reaction with specific primers for H5 and N1 in samples obtained from tracheal aspiration.All patients were previously healthy young women and resided in village.They had a clear history of di- rect contact with sick/dead poultry and prepared dead chickens at home for eating(removed feathers, washed,cut)hut no report of confirmed HSN1 animals in the village.The time between exposure and onset of illness were 5 days,no one else in family sick.The time between the onset of illness and hos- pitalization were 5 days and 6 days,respectively.Two patients have initial symptoms of high fever (typically a temperature more than 38℃).The prominent clinical features were those of influenza syndrome,including fever,cough,and shortness of breath.Upper respiratory tract symptoms were absent.The platelet counts were decreased.In both patients,there were marked abnormalities on chest radiography,radiographic changes include bilateral and unilateral lobular consolidations with air bronchograms,and had dramatic worsening of findings.Two patients developed acute respiratory dis- tress syndrome(ARDS)complicated multiple organ dysfunction syndrome(MODS)and died of pro- gressive respiratory failure.Conclusions Exposure to dead poultry within a week before the onset of illness was associated with Influenza A(H5N1)infection in humans,but no definitive evidence of hu man-to-human transmission has been found yet.Influenza A(HSNI)infection,characterized by fe- ver,an influenza-like illness with lower respiratory tract symptoms,carries a high risk of death.

AIM:To explore the differences between unilateral recess-resection (R & R) and bilateral lateral rectus recession (BLR-rec) in the treatment of basic intermittent exotropia.METHODS: A retrospective analysis of treatment of basic intermittent exotropia in 89 patients,in which 49 cases underwent unilateral recess-resection,40 cases underwent bilateral lateral rectus recession of external rectus retroperitoneal surgery January 2013 to January 2015 in our hospital.The stereopsis and strabismus were observed in 1d,1,6mo,1 and 2a after operation.RESULTS: There was no significant difference in the success rate and oblique degree between the two groups after 1d,1,6mo,1 and 2a (all P>0.05),but the success rate of the operation was reducing as time passed.After 2d of the operation,the drift of the R & R group was 12.10±5.74PD and the drift of the BLR-rec group was 7.78±4.21PD,the difference was statistically significant (P=0.021).The R & R group was more likely to cause lateral slanting than BLR-rec group.Two groups of patients with nearly stereopsis were both significantly improved,there was no significant difference between the two groups in the two groups (x2=4.530,P=0.210).CONCLUSION: The long-term stability of BLR-rec is superior to R & R.

Objective To study the clinicopathology characteristics of chronic lymphocytic thyroiditis (Hashimoto's thymiditis, HT) with occult papillary thyroid carcinoma (occult PTC) in order to improve its diagnostic and therapeutic accuracy. Methods A restrospective analysis was done on the clinical materials of 28 cases of HT with occult PTC from July 1999 to July 2005. All cases were confirmed by operation and pathologic biopsy. Clinical and gross findings were collected. All HE slides were reexamined and immunostains for CK19, galectin-3,and bcl-2 were performed (Envision method). Results In total 189 cases of chronic lymphocytic thyroiditis,28cases (14.8%,28/189)had coexistent occult papillary thyroid carcinoma. There were 19 females and 9 males with median age of 36.7 years old. Normal TSH presented in 11cases (39.3%), high in 8 cases(28.6%), and low in 9cases (32.1%). All tumor diameter was counted for <0.8 cm, 16 cases (57.1%) tumor diameter 0.2～0.5 cm, 12 cases (42.9%) >0.5 cm. Coarse calcification was seen in 6 cases(21.4%) in color ultrasonic exam and CT scans. Follow-up data showed that 28 patients were all alive with no evidence of recurrence or metastasis for 2 to 7 years by December 2007. Conclusion There are no special clinical characteristics in coexistent HT with occult PTC.Coarse calcification in HT in the group of middle-aged women increase the likelihood of the diagnosis. But the diagnosis depends on pathology. Because of the high incidence of occult PTC in HT population, it would be necessary to keep an eye on this particular type of thyroid carcinoma, and multiple sampling in suspected area of HT specimen is advised in the hope not to miss any small tumor in clinical practice.

Objective To evaluate the implication and necessity of deepithelialization in mastopexy.Methods A total of 124 patients with mastoptosis were randomly divided into 2 groups:group Ⅰ and group Ⅱ,62 cases each.A double-circle incision technique was used for all the patients.In group Ⅰ,full thickness skin around nipple-areola was resected.While in group Ⅱ,deepithelialization was performed and the peri nipple-areola dermis was preserved.Results The average full skin resection time was 4.5 minute per side in group Ⅰ and the skin deepithelialization time was 15.8 minute per side in group Ⅱ.Postoperative follow-up was carried out for all the 124 patients with duration of 2 weeks to 4 years.In group Ⅱ,sebaceous cysts,epidermal inclusion cyst and suture knot exclusion were found at the incision site in 8 patients (12.9 ％) at 3 weeks to 1.5 years after operation.Conclusions The blood supply to the nipple-areola complex is not affected by full-thickness skin removal during mastopexy,while the incidence of complication at the incision site decreases significantly.We conclude that deepithelialization has not much clinical significance in mastopexy.

Objective • To discuss the health resources and service development of traditional Chinese medicine (TCM) hospitals in Shanghai from 2009 to 2016. Methods • Analysis of the health resources and service development of TCM hospitals in Shanghai from 2009 to 2016 were conducted by calculating composition ratios and growth rates according to the data from the statistical yearbooks. Results • All the indexes of the health resources and services of TCM hospitals in Shanghai, 2009-2016, increased every year, and the numbers of beds, medical technical personnel, licensed (assistant) doctors, registered nurses, outpatients and inpatients increased by 71.72%, 53.80%, 46.83%, 76.84%, 78.20%, and 120.30%, respectively. The proportions of TCM hospitals beds and health technicians in all the city's hospitals increased by 1.70% and 1.18% on the basis of 7.06% and 9.58%, respectively. The year-on-year growth rates of beds ranged from 1.86% to 22.52%, and rates of health technicians ranged from 0.17% to 15.46%. Daily visits each doctor and daily bed days each doctor in TCM hospitals increased by an average of 2.90% and 0.07% a year, respectively. Conclusion • There was a significant increase in health resources and service development of the TCM hospitals in Shanghai from 2009 to 2016, and the work efficiency were improved. And there was a little increase in the proportion of the relevant indexes in all the city's hospitals. However, some problems do exist, such as the weak integral strength and the unstable growth of TCM hospitals.

A new magnetic affinity immunoassay (MAIA) strategy based on enzyme-labeled phage displayed antibody was developed. The assay consisted of a sandwich format in which immobilized polyclonal antibody (pcAb) on magnetic microparticle was used for capture probe, and enzyme-labeled phage displayed antibody for specific detection probe to increase enzyme amount and enhance detection signal. By the proposed method,β-bungarotoxin (β-BGT) was successfully detected. A linear relationship between absorbance value and the concentration of β-BGT in the range of 0. 016-62. 5 μg / L was obtained. The linear regression equation was Y=0. 641X+1. 355 (R =0. 9925, n = 13, p<0. 0001) with a detection limit of 0. 016 μg / L. In comparison with the traditional ELISA, this method gave a 10-fold better sensitivity in β-BGT detection. This strategy also gave a 4-fold better sensitivity comparing with the MAIA based on enzyme labeled monoclonal antibody (mcAb). Due to low detection limit, acceptable reproducibility and high specificity, this method holds great promise in toxin trace detection.

A new method for O-ethyl S-[2-( diisopropylamino) ethyl] methylphosphonothiolate ( VX) , sarin detection and its kinetic analysis based on piezoresistive microcantilever aptasensor was developed, where VX, sarin aptamers were immobilized on the microcantilever surface by biotin-avidin binding system. A linear relationship between the response voltage and the concentration of VX in the range of 2-60μg/L was obtained. The linear regression equation was △Ue=0. 886C-1. 039 (n=5, R=0. 984, p<0. 001) and the detection limit was 2μg/L ( S/N≥3 ) . A linear relationship between the response voltage and the concentration of sarin in the range of 10-60 μg/L was obtained, the linear regression equation was △Ue=0. 716C-2. 304 ( n=5, R=0 . 996 , p<0 . 001 ) and the detection limit was 10 μg/L ( S/N≥3 ) . The sensor showed no response for O-butyl methylphosphonochloridate, a structural analog of VX and sarin, which indicated high specificity and good anti-interference ability. On this basis, a reaction kinetic model based on receptor-ligand binding and the relationship with output voltage change was established. Response voltage (△Ue ) and response time( t0 ) were obtained from the fitting equation on different concentrations of VX, sarin fitted well with the measured values.