Objective: To explore the value of Hisense computer-assisted surgical systems (CAS) for precise surgery of pediatric solid pseudopapillary tumor. Methods: A total of 5 cases with pancreatic solid pseudopapi-llary tumor who were admitted at the Affiliated Hospital of Qingdao University from June 2015 to September 2018 were adopting.Upper abdominal 64-slice dynamic enhanced computed tomography (CT) scan was performed.3D models were created by computer-assisted surgery systems.Based on 3D model, surgical planning, preoperative simulated tumor resection, intraoperative assisted guidance were performed.Operation time, intraoperative blood loss volume, blood transfusion rate were analyzed. Results: Hisense CAS three-dimensional reconstruction could clearly show the adjacent relationship between pancreas, tumor and peripheral vascular organs.According to the preoperative virtual resection, pancreatic tumor resection was more accurate.Postoperative pathological results were solid pseudopapillary tumor of the pancreas.Among them, 2 tumors were located in the head of the pancreas, 1 case was located in the pancreatic neck, and 2 cases in the tail of the pancreas.The operation time was 150-360 min, with an average of 279 min.The average intraoperative blood loss was 40 mL, of which the minimum amount of bleeding was 5 mL, and the blood transfusion rate was 40%(2/5 cases). Surgical tumor removal was achieved successfully in 5 cases.All children were followed up for 6 months to 3 years, and no recurrence or metastasis was observed. Conclusions Three-dimensional reconstruction of computer-assisted surgery system can clearly show the adjacent relationship between tumor and surroun-ding vascular organs, and help to make the best surgical plan before surgery to improve the accuracy and safety of the operation.

Objective: To understand the etiological characteristics of bacterial diarrhea in different areas, including large cities, mid-sized/small cities and rural area, in China. Methods: A cross-sectional surveillance was conducted in 17 provinces of China from 2010 to 2014. The acute diarrhea outpatients were selected from clinics or hospitals in large cities, mid-sized/small cities, including rural-urban fringe zones, and rural areas. The demographical and clinical characteristics of the patients were collected by using questionnaire, and stool samples were taken from them for laboratory detection of 17 kinds of bacteria. The differences in pathogen positive rates (PPR) and pathogen spectrum across the cases from three-type areas were compared. The different infection risk in different cases were analyzed with unconditional logistic regression model. Results: In our study, we enrolled 9 253 cases from large cities, 5 138 cases from rural areas and 13 683 cases from midsized/small cites. The pathogen with largest differences in infection rate across the three-type areas was Shigella (S.) flexneri (rural area: 5.81%, mid-sized/small city: 2.78%, large city: 0.46%), followed by Aeromonas (A.) hydrophila (rural area: 2.14%, mid-sized/small city: 0.96%, large city: 0.48%). Compared with cases in large cities, the cases in mid-sized/small cities and rural areas had higher infection risks for S. flexneri (mid-sized/small city: OR=6.481, 95%CI: 4.666-9.002, rural area: OR=11.304, 95%CI: 8.018-15.938) and A. hydrophila (mid-sized/small city: OR=1.992, 95%CI:1.401-2.832, rural area: OR=4.083, 95%CI: 2.833-5.884). The constituent ratio of diarrheagenic Escherichia coli and Salmonella increased with the urbanization development, while the ratios of Shigella and A. hydrophila had an opposite trend. S. sonnei (60.00%) was the predominant serogroup of Shigella in urban infections, while S. flexneri (77.37%) was the predominant serogroup in rural infections. Conclusion: The differences in pathogen spectrum of bacterial diarrhea were obvious across large cities, mid-sized/small cities and rural areas in China, especially the differences in the infection rates of S. flexneri and A. hydrophila.
Adolescent ; Adult ; Bacterial Infections/microbiology* ; Child ; China/epidemiology* ; Cross-Sectional Studies ; Diarrhea/microbiology* ; Dysentery/epidemiology* ; Escherichia coli/pathogenicity* ; Feces/virology* ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Rural Population ; Salmonella/pathogenicity* ; Shigella/pathogenicity* ; Suburban Population ; Urban Population

OBJECTIVETo study the epidemiology and strain variations of astrovirus infection among children under 5 years of age, hospitalized for acute diarrhea in China.

METHODSInpatients under 5 years of age with acute diarrhea in hospitals of seven provinces between 1998 and 2005 were enrolled in the study Stool specimens were collected and tested for astrovirus using the Dako Amplified IDEIA Astrovirus kits or reverse-transcription polymerase chain reaction (RT-PCR). Genetic identities of the strains were determined using RT-PCR with serotype-specific primers and confirmed by sequencing of the RT-PCR products.

RESULTSA total of 1668 diarrheal stool samples tested for both rotavirus and calicivirus negative were examined. The detection rate of astrovirus infection was 5.5% (91/1668) and the diarrhea cases caused by astrovirus infection could be found in any season of the year but mainly occurred in cold season from October to next January. Astrovirus detection-rates were: 7.4% among infants aged 9-11 months followed by 6.1% in 12-17 month-olds, and 6-8 months 5.6% & 0-2 months 5.6% before 8 months. Over 95% of astrovirus infections occurred in children before 2 years of age. Among 49 strains, typed, serotype 1(45/91) was most commonly seen while serotype 5 was in two cases and serotype 3 and 8 were detected in only one case respectively.

CONCLUSIONAstrovirus seemed an important etiologic agent in young children with acute diarrhea in China and Serotype 1 was the most prevalent one.

Acute Disease ; Astroviridae ; classification ; isolation & purification ; Astroviridae Infections ; complications ; epidemiology ; Child, Preschool ; China ; epidemiology ; DNA, Viral ; analysis ; Diarrhea ; virology ; Humans ; Infant ; Infant, Newborn ; Inpatients ; Reverse Transcriptase Polymerase Chain Reaction ; Seasons ; Serotyping

Objective: To analyze the disease burden of animal injury in China between 1990 and 2016. Methods: Data obtained from the Global Burden of Disease 2016 were used to analyze the age and gender specific disease burden of animal injury in China, using the incidence and disability adjusted of life years (DALYs) rate. Relative and annual changes were evaluated. Results: In 2016, the age-standardized incidence and DALYs rate of animal injury in China showed as 245.05 per 100 000 people and 12.73 per 100 000. The age-standardized incidence of non-venomous animal injury was significantly higher than that of venomous animal injury, but the differences in age-standardized incidence and DALYs rate between venomous animal injury and non-venomous animal injury were not significant. Between 1990 and 2016, there was a significantly decreasing trend in the age-standardized incidence and DALYs rate of animal injury, and obvious decline could be seen in the incidence of non-venomous animal injury, compared with venomous animal injury. The incidence and DALYs rate of animal injury declined in both males and females and in different age groups. The obvious decline of incidence and DALYs rate could be found in children aged 5-14 years and aged <5 years. Conclusions: Between 1990 and 2016, there was a significant alleviation of the disease burden of animal injury in China. Young children were most prone to animal injury, resulting in serious disability and death, indicating more attention should be paid to this population at high risk and in animal injury prevention and control programs.
Adolescent ; Child ; Child, Preschool ; China/epidemiology* ; Cost of Illness ; Disabled Persons/statistics & numerical data* ; Female ; Global Burden of Disease ; Humans ; Incidence ; Male ; Quality-Adjusted Life Years ; Wounds and Injuries/epidemiology*

Objective: To investigate the association between three single nucleotide polymorphism (SNP) genes DRD2 (rs1800497, rs6275, and rs1799978) and the dosage used on methadone maintenance treatment (MMT). Methods: From the methadone maintenance treatment centers, 257 MMT patients were recruited to participate in a case-control study and divided into two groups-control groups under low dosage (n=89) and case (n=168) group with high dosage. Quanto software was used to estimate the sample size as 180. Information related to social-demographic status, history on drug use and medication were collected. And DRD2 SNPs were genotyped to explore the relationship between polymorphism of DRD2 gene and the dosage of methadone maintenance treatment. Results: Distributions of DRD2 rs6275 between different groups were significantly different. Patients carrying TC genotype needed lower dose of methadone when compared to the patients that carrying CC genotype counterparts (OR=0.338, 95% CI: 0.115-0.986). Patients that carrying C allele at rs6275 needed lower methadone dose than those that carrying genotype TT (OR=0.352, 95% CI: 0.127-0.975). Distributions of genotypes, alles in the other two SNPs (rs1800497, rs1799978) were not significantly different between groups under different dosages. Conclusion: DRD2 rs6275 was associated with dosage of methadone used for the MMT patients. However, no significant associations were found between rs1800497, rs1799978 and the dosage of methadone.
Alleles ; Case-Control Studies ; Drug Dosage Calculations ; Genotype ; Humans ; Methadone/therapeutic use* ; Opiate Substitution Treatment ; Opioid-Related Disorders/rehabilitation* ; Polymorphism, Single Nucleotide/genetics* ; Receptors, Dopamine D2/genetics*

BACKGROUNDHigh-voltage analog X-ray examination is a main tool for pneumoconiosis, which is challenged by digital radiography (DR). The tube voltage of DR chest films required for diagnosis and staging of pneumoconiosis is concerned technically. We investigated the influence of the tube voltage on chest X-ray DR image quality of patients exposed to occupational dust.

METHODSDR images of the CDRAD2.0model, an anatomical chest phantom, and 136 exposed workers were analyzed at different tube voltages by threereaders. Image quality factors (IQF) were calculated and compared using the CDRAD2.0 model. DR images of ten anatomic positions were scored against those of the high-kilovolt chest films in anatomical phantom and clinical cases, and differences in scores were analyzed.

RESULTSIn the CDRAD2.0 model, all three readers had a minimal IQF at 120 kV (mean: 22.25 kV). The differences in the mean IQF of DR images at different tube voltages was significant (F = 13.78, P < 0.001). The IQF of DR imaging at 120 kV was similar to high kilovolt analog imaging (t = -0.58, P > 0.05). In the anatomic phantom and clinical cases, the DR images at 120 kV were closest in anatomical detail to the high kV analog images, and the means were similar (P > 0.05).

CONCLUSIONSAmong different tube voltages, DR image quality is closest to the high kilovolt analog images at 120 kV in patients exposed to occupational dust.

Adult ; Aged ; Environmental Pollution ; Female ; Humans ; Male ; Middle Aged ; Phantoms, Imaging ; Pneumoconiosis ; diagnosis ; Radiographic Image Enhancement ; methods ; Radiography, Thoracic

Automobiles ; Hearing Loss, High-Frequency ; Hearing Loss, Noise-Induced/etiology* ; Humans ; Male ; Noise, Occupational/adverse effects* ; Occupational Diseases/epidemiology* ; Occupational Exposure

Objective: To explore the causes of secondary drug resistance among HIV infected persons who were receiving antiretroviral therapy in Shandong province, and provide evidence for the improvement of antiretroviral therapy strategy. Methods: A case-control study was designed with 1∶2 matching on case and control groups. Household and face-to-face interview were conducted in October, 2015. All the study subjects were screened from both the drug resistant database of antiretroviral therapy of Shandong provincial laboratory and national comprehensive HIV/AIDS database in Shandong. The sample size was estimated as 330 cases including 110 drug resistant and 220 non-drug resistant cases. Subjects were people living with HIV/AIDS (PLWHA) aged 15 or older and received antiretroviral therapy for more than 6 months with records of virus load (VL). Subjects who presented VL above 1 000 copies/ml would receive drug resistance testing. Subjects who were confirmed resistant to with secondary drug, were selected as case group, the rest subjects with non-secondary drug resistance would form the control group. EpiData 3.1 software and SPSS 22.0 software were used to establish a database. Related influencing factors were analyzed with non- conditional stepwise logistic regression model. Results: A total of 288 cases were enrolled, including 103 in the case and 185 cases in the control groups, with average age as (37.62±1.06) years and (37.90±0.74) years old, respectively. Most of them were male, married/cohabitant, with education level of junior/senior high school or below and under Han nationality. Results from the multivariate logistic regression model showed that ORs (95%CI) of receiving antiretroviral therapy for 1-3 years, or more than 3 years were equal to 8.80 (3.69-21.00), 3.00 (1.20-7.53), compared with receiving antiretroviral therapy less than one year, respectively. OR (95%CI) of Among the PLWHA that with missing rate above 25.0% on medication, the OR appeared as 15.41(4.59-51.71), compared with not missing medication. OR (95%CI) among those who took the medicine themselves was 0.22 (0.07-0.74). Conclusions: Factors as duration of treatment, missing rate on medication and taking medicine by oneself were of influence on secondary drug resistance. Other factors as duration on antiretroviral therapy longer than 1 year, missing rate above 25.0% on medication, were related to the risk on secondary drug resistance. However, if the medicine was taken by oneself, it served as a protective factor for secondary drug resistance. It is necessary to strengthen the intervention and health education programs related to antiretroviral therapy.
Adult ; Anti-HIV Agents ; Antiretroviral Therapy, Highly Active ; Case-Control Studies ; Drug Resistance ; HIV/isolation & purification* ; HIV Infections/drug therapy* ; Humans ; Infant ; Logistic Models ; Male

Objective: To investigate the prevalence and influencing factors on respiratory disease related symptoms (coughing, expectoration, persistent coughing and persistent expectoration) in Chinese people ≥40 years old. Methods: Data was collected from 162 surveillance points in the China Non-communicable and Chronic Disease Surveillance Project in 2010. A total number of 56 066 people, aged ≥40 years, were selected by multi-stage cluster random sampling method in this study. The prevalence rates of coughing, expectoration, persistent coughing and persistent expectoration were calculated according to gender by χ(2) test. Multivariate logistic regression model was used to analyze the related influencing factors. Results: The prevalence rates of coughing, persistent coughing, expectoration and persistent expectoration in men were significantly higher than that in women (P<0.01). The prevalence rate of respiratory symptoms was positively correlated with age and duration and amount of cigarette smoking (P<0.01), while negatively correlated with participants'education level (P<0.01). Results from multivariate logistic regression analysis showed that gender, age, education level, smoking-related parameters, areas of residency (in urban or rural areas), etc. were appeared as influencing factors on the prevalence of respiratory symptoms. Conclusion: The symptoms of chronic respiratory diseases appeared prevalent in Chinese population aged ≥40 years. Factors as older age, living in the central/western regions and smoking-related parameters were identified as of higher risks.
Adult ; Aged ; Aged, 80 and over ; Asian People/statistics & numerical data* ; China/epidemiology* ; Chronic Disease/epidemiology* ; Cough/epidemiology* ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Noncommunicable Diseases/epidemiology* ; Prevalence ; Risk Factors ; Rural Population ; Smoking