Objective By analyzing the epidemiological characteristics and trends of brucellosis in Ji'nan City,to provide a scientific basis for further prevention and control of the disease.Methods Serum samples of suspected brucellosis patients were collected from every county (city,district) of Ji'nan City from 2008 to 2014,and these samples were screened by Rose-bengal plate agglutination test (RBPT).Then positive samples were confirmed by Standard tube agglutination test (SAT),and experimental data and results were analyzed by statistics.Results Totally 2713 serum samples of suspected brucellosis patients were tested,and 200 were positive by SAT.Temporal distribution:the serum antibody positive specimens were detected each month throughout the year,and the results showed clear seasonal prevalence by concentrating from March to September (82.07％,151/184).Population distribution:the serum antibody positive rate of males was higher than that of females,the ratio was 2.08:1.00,and the cases were found among 15 to 75 years old,while concentrated from 30 to 65 (67.00％,134/200).Spatial distribution:except Huaiyin District,positive samples were detected in all other 10 counties (cities,districts) of Ji'nan City,most of them (92.5％,185/200) in Shanghe,Zhangqiu,Changqing,Shizhong and Licheng counties (cities,districts).Conclusions Brucellosis epidemic in Ji'nan is serious,and cases have occurred mostly in spring,summer and autumn.It is recommended that health propaganda and education should be strengthened in order to enhance selfprotection awareness of the exposed population,and then improve the physical examination for early discovery,early reporting and early treatment.At the same time,it is important to cooperate with the Department of Livestock to prevent and control brucellosis.

Objective To study the precision of computer-aided preoperative templating for total hip arthroplasty. Methods Thirty patients (11 males, 19 females; age ranged from 42 to 85 years, mean 56 years) received unilateral total hip arthroplasty from March 2008 to December 2008. Preoperative tem-plating was done with LINK -Preop-PlanTM to compare the size of the planned hip joint with the size of the prosthesis, as well as the discrepancy of the limbs before and after operation. Results The predicted sizes of the prosthesis corresponded well with the actual ones. The cup size of the prosthesis completely matched the actual ones in 19 patients (63%), and the variation was within 1 size in 8 patients (27%) and ≥2 sizes in 3 patients (10%). The stem size of the prosthesis completely matched the actual ones in 19 patients (63%), and the variation was within 1 size in 9 patients (30%) and ≥2 sizes in 2 patients (7%). The variation of the cemented and cementless stem size of the prosthesis was within 1 size in 16 patients (89%) and 12 patients (100%), respectively, with no statistical difference (P > 0.05). The discrepancy of limb length was (9.0±8.5) mm preoperatively and (1.1±2.4) mm postoperatively. Conclusions Preoperative planning is of paramount significance in total hip arthroplasty. Computer-ai-ded preoperative templating can accurately anticipate the type of the prosthesis, which is helpful in correc-ting the discrepancy in leg length.

Objective To evaluate the clinical value of full-field digital mammography three-dimensional (3D) positioning system for localization and excision of nonpalpable breast lesions.Methods 106 patients with nonpalpable breast lesions and underwent preoperative localization were analyzed retrospectively.They underwent wire-localization operation guided by mammography 3D positioning system (GE Senogrphe DS).The depth of wire insertion was calculated manually and automatically.Combined with the manual measurement, systematic measurement, skin elasticity and breast parenchyma structure, the positioning wire was placed.Then, the clinical resection was performed according to the wire localization.Results The localization accuracy of mammography 3D positioning system was 100%.11 patients appearedsyncope.With the rest, psychological comfort and fluid infusion, patients recovered quickly.Conclusion Full-field digital mammography 3D positioning system can improve the accuracy of clinical resection of nonpalpable breast lesion.

Objective To explore pathogenic bacteria distribution and drug susceptibility testing results in children with purulent meningitis in Jinan area. Methods A total of 54 children with purulent meningitis were selected from January 2010 to December 2014, the cerebrospinal fluid smear and culture, according to the national standard of clinical inspection technology for bacteria isolation and identification by disc diffusion method for drug sensitive test were retrospectively analyzed. Results A total of 54 strains of pathogenic bacteria including 36 strains of gram-positive coccus, and 17 strains of gram-negative bacillus and one strain of suspected Neisseria meningitides were found. A total of 31 strains gram positive coccus is Streptococcus pneumoniae, and most gram-negative bacilli is E. coli. In the Gram-positive coccus, 61.3% was sensitive to penicillin, and more than 90% was sensitive to ceftriaxone and cefepime, 83.3% was sensitive to meropenem, 94.7% resistant to azithromycin, and 58.1% resistant to oxazocilline. In Gram-negative bacilli, 60% was sensitive to ampicillin sulbactam 71.4% was sensitive to cephalosporin , 57.1% was sensitive to ceftriaxone , 66.6% was sensitive to cefepime. Conclusions From cerebrospinal fluid cultured of purulent meningitis, Streptococcus pneumoniae and E. coli were major pathogenic bacteria in children with purulent meningitis in Jinan area.

Objective To evaluate safety and efficacy of conversion of calcineurin inhibitors (CNI) to sirolimus (SRL) therapy for treatment of new-onset diabetes after kidney transplantation (NODAT). Methods Of 321 kidney transplant recipients, 34 patients who developed NODAT (10.59%) were divided into 3 groups to receive continued CNI therapy at a reduced dose (group A, 14 cases), sirolimus conversion therapy (group B, 12 cases), or oral hypoglycemic drugs (group C, 12 cases). All the patients had dietary and exercise therapies, and insulin injections were given in patients with postprandial (2 h) blood glucose over 14.0 mmol/L. The patients were followed up regularly for 5 years. Results The mean blood glucose level was 13.02 ± 1.74 mol/L upon the diagnosis of NODAT in the 34 patients without significant differences between the 3 groups. At 6 months of therapy, fasting plasma glucose levels in the 3 groups decreased to 8.05±2.45, 7.45±2.44, and 9.30±3.89 mmol/L, repsrectively;at 12 months, blood glucose became normal in both groups A and B, but the patients in group A needed a greater daily insulin dose (P<0.05). In group B, the mean serum creatinine level was 165.1±61.82 mmol/L at the conversion and lowered to 150±53.05 mmol/L at 5 years (P<0.05), which were similar to those in group A at the two time points (152±43.05 and 145.88±53.05 mmol/L, respectively;P>0.05). In group C, creatinine level further increased after medication with oral hypoglycemic drugs. At 5 years, the patient and graft survival rates were 100%and 75%in group A, respectively, similar to those in group B (83.4%and 68%, respectively; P>0.05); group C showed lower patient and graft survival rates than groups B and C. Conclusion Conversion from CNI to SLR therapy can significantly the metabolism of patients with NODAT without increasing the risk of acute graft rejection.

Objective To evaluate safety and efficacy of conversion of calcineurin inhibitors (CNI) to sirolimus (SRL) therapy for treatment of new-onset diabetes after kidney transplantation (NODAT). Methods Of 321 kidney transplant recipients, 34 patients who developed NODAT (10.59%) were divided into 3 groups to receive continued CNI therapy at a reduced dose (group A, 14 cases), sirolimus conversion therapy (group B, 12 cases), or oral hypoglycemic drugs (group C, 12 cases). All the patients had dietary and exercise therapies, and insulin injections were given in patients with postprandial (2 h) blood glucose over 14.0 mmol/L. The patients were followed up regularly for 5 years. Results The mean blood glucose level was 13.02 ± 1.74 mol/L upon the diagnosis of NODAT in the 34 patients without significant differences between the 3 groups. At 6 months of therapy, fasting plasma glucose levels in the 3 groups decreased to 8.05±2.45, 7.45±2.44, and 9.30±3.89 mmol/L, repsrectively;at 12 months, blood glucose became normal in both groups A and B, but the patients in group A needed a greater daily insulin dose (P<0.05). In group B, the mean serum creatinine level was 165.1±61.82 mmol/L at the conversion and lowered to 150±53.05 mmol/L at 5 years (P<0.05), which were similar to those in group A at the two time points (152±43.05 and 145.88±53.05 mmol/L, respectively;P>0.05). In group C, creatinine level further increased after medication with oral hypoglycemic drugs. At 5 years, the patient and graft survival rates were 100%and 75%in group A, respectively, similar to those in group B (83.4%and 68%, respectively; P>0.05); group C showed lower patient and graft survival rates than groups B and C. Conclusion Conversion from CNI to SLR therapy can significantly the metabolism of patients with NODAT without increasing the risk of acute graft rejection.

We identified the routes of infection and evaluate the effect of disinfection on the field of an outbreak of an-thrax in a village of Wengan County ,Guizhou ,China ,thus trying to provide with basis for the implementation of policies for pre-vention and control of anthrax .The authors gathered the cases information by searching and interviewing the targeted persons house by house ,and reviewed the medical records in hospitals .The samples including patient’s discharging fluid ,residues of died horse ,and soil from the places where the villagers dismembered horse were gathered and cultured for Bacillus anthracis . The technique of multiple-locus variable-number tandem repeat analysis (MLVA-8) was applied for revealing the genetic rela-tionships among those isolated Bacillus anthracis strains .Five cases of cutaneous anthrax occurred in the outbreak and the total attack rate was 7 .58% (5/66) among those contactors evolved in the activity of carrying ,dismembering ,washing ,chopping and eating the died horse .The attack rate was 100% (3/3) for those who carried ,dismembered ,washed ,chopped and ate that horse ,100% (1/1) for those who carried ,dismembered and ate ,and 7 .14% (1/14) for those who washed ,chopped and ate . The 25% (1/4) of the samples of discharging fluid from the cases with cutaneous anthrax were positive .After disinfection , 15 .38% (4/26) of the soil samples retained positive .The genetic similarity was 100% among the 5 isolate strains .The results suggested that the outbreak of anthrax in villagers occurred through the activities of carrying ,dismembering ,washing and chop-ping the died horse .Strengthening the risk communication and disinfection of the dismemberment places should be the crucial strategies to prevent and control anthrax epidemics in Guizhou in the future .

Objective To explore the clinical effect and application value of four-point internal fixation technique (internal fixation of C_1-C_2 transarticular screws combined with Apofix laminar clamp technique) for traumatic atlantoaxial instability.Methods A total of 16 patients with traumatic atlanto- axial instability,who had reducible atlantoaxial dislocation with reduction after traction and irreducible at- lantoaxial dislocation with traction reduction after anterior laxation,were treated with four-point internal fixation technique using autologous bone grafts.Results All patients' symptoms were improved to some extent,and no severe complications,such as injury of nerve blood vessels were found.All patients were followed up for 8-26 months (average 16 months).Bony fusion was obtained in all cases.The spinal cord function improvement was marked in 5 cases (31%),good in 8(50%),mild in 2(13%),but un- changed in 1 (6%).No deterioration occurred in all cases.There was no loosening or breakage of screws and clamps.Conclusion Fixation of C_1-C_2 transarticular screws combined with Apofix laminar clamp technique can atlain four-point internal fixation,and can provide three-dimensional stability of atlantoaxial complex and excellent biomechanics environment for bony fusion if the structure of the posterior arch of C_1-C_2 is intact.

Objective To investigate the value of emergency observation time of chest pain patients for ruling-out myocardial infarction by using high-sensitive troponin T. Method Total 1 687 patients with chest pain from December 2015 to August 2016 visiting Sichuan University Huaxi Hospital emergency department were en-rolled.We included 1082 patients who diagnose with AMI finally.We define the time from the start of the chest pain to visiting the emergency as the onset time.We analyzed the level of high-sensitive troponin T of AMI patients at dif-ferent onset time and calculated the rate of patients with hs-cTnT level lower than the conventional hs-cTnT thresh-old of 14 ng/L. Result Among 1082 cases of AMI patients,32 patients with hs-cTnT level below threshold(14 ng/L).The for whose The onset time over 5h was observed in AMI patients with hs-cTnT level over 14 ng/L.Con-clusion AMI can not be excluded in chest pain patients whose hs-cTnT levels below the conventional threshold value of 14 ng/L,and these people should be dynamically monitored for 5h in emergency department.The patients can exclude AMI if the hs-cTnT levels are below 14 ng/L after 5 hours.

OBJECTIVETo explore the correlation of multi-slice CT findings to the clinical staging and prognosis of intestinal obstruction due to mesenteric blood vessel infarction.

METHODSFifty-four patients with intestinal obstruction resulting from infarction of the mesenteric vein or artery underwent multi-slice CT scanning, and the CT findings were analyzed for their relation with the intestinal ischemia and prognosis.

RESULTSSixteen patients were confirmed to have mesenteric arterial thrombosis (29%) and 40 had mesenteric venous thromboses (71%) by multi-slice CT scanning. The total mortality rate was 29%, of which mesenteric artery infarction took up 87% and mesenteric vein infarction 5%. The prognosis of the patients was closely related to the cause of the bowel infarction. Such CT findings as increased intensity of the intestinal canal and decreased enhancement and thickening of the bowel wall indicated favorable prognosis, whereas the signs of paper-thin wall sign, fecal sign, pneumatosis of the bowel wall, mesenteric veno gas and pneumoperitoneum all suggested poor prognosis.

CONCLUSIONMulti-slice CT scanning can identify mesenteric blood vessel infarction resulting in intestinal obstruction, and the CT signs can offer objective and valuable information for clinical staging and prognostic evaluation.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Infarction ; diagnostic imaging ; pathology ; Intestines ; blood supply ; Ischemia ; diagnostic imaging ; pathology ; Male ; Mesenteric Ischemia ; Middle Aged ; Neoplasm Staging ; Prognosis ; Tomography, Spiral Computed ; methods ; Vascular Diseases ; diagnostic imaging ; pathology