Objective To understand the quality of malaria blood examinations in township?level hospitals,so as to provide the evidence for continuing the malaria blood examinations in the stage of post?malaria elimination. Methods A total of 64 township hospitals were investigated and 640 negative malaria blood slides were scored individually according to 10 indicators inMalaria Elimination Technical Schemein 2013 and 2014. The single and multiple indicators were calculated,and the work of blood examinations and situation of technicians were investigated. The data of malaria blood examinations and patient discovery in township hospitals of Nantong City were collected and analyzedduring the period of 2011-2014. Results Forthe single indi?cator,29.5%of the thick blood films did not reach the standard,and 35.8%of thin blood films did not reach the standard. For the multiple indicators,blood slides with more than 4 indicators below the standard(poor quality)accounted for 32.5%. From ma?laria blood examinations and malaria situation,the number of slides was 194 635 during the period of 2011-2014,and there were no local vivax malaria casesin 4consecutive years from 2011 to 2014,andlocal malaria has been effectively controlled in Nantong City. For health facilities where malaria patients initially presented,the township and village level accounted for 16.3%,and county and higher level accounted for 83.7%. Conclusions The quality of malaria blood examinations in township level hospitals of Nantong City is not high and the microscopic examination has a relatively low efficiency in the discovery of ma?laria cases. A new model for malaria blood examinations needs to be further explored.

Objective To explore the surgical skills and evaluate the efficacy of single small incision herniorrhaphy for bilateral inguinal hernia. Methods From August 2006 to January 2013, 26 patients with bilateral inguinal hernia received single small incision herniorrha-phy,and the clinical data,including the operation time, hospital stay,postoperative complications and the recurrence,were analyzed retrospec-tively. Results In 26 cases of bilateral inguinal hernia,the operation time was (50. 6 ± 11. 6) min,the postoperative hospital stay was (5. 8 ± 1. 4) d,the incidence of postoperative complications was 3. 8%. No recurrence occurred during the follow-up of 10 to 58 months. Conclu-sion The single small incision herniorrhaphy for bilateral inguinal hernia is proved to be effective,safe and convenient,and it has few post-operative complications. This method is worth popularizing in the clinical practice.

Objective To study the protective effect of hydrogen sulfide(H2S) on intestinal ischemia-reperfusion(I/R) injury so as to provide a new clinical treatment on I/R.Methods NaHS was taken as a donor of H2S.Forty Sprague-Dawley rats were divided into 5 groups with 8 rats in each group: sham operation group,I/R model group,tetram ethylpyrazine group,and NaHS 7 ?mol/kg and 14 ?mol/kg groups.The contents of superoxidase dismutase(SOD),malondialdehyde(MDA) and glutathione peroxidase(GSH-Px) in serum and intestinal tissue were measured,respectively.The intestinal mucosal injury and histological alteration were observed.Results The content of MDA within serum and intestinal tissue was significantly reduced and the activities of SOD and GSH-Px were significantly increased.H2S could obviously reduce the injury in intestinal mucosa and glands.Conclusion H2S possesses a protective effect on intestinal I/R injury in rats.

Objective To investigate the relationship between impaired fasting glucose(IFG) and the distribution of body fat in adolescents.Methods Stratified cluster sampling was used to select 3874 adolescents aged 13-18 years for this cress-sectional study.Measurements included height,weight,waist circumference,hip circumference and fasting plasma glucose (FPG).Family history of diabetes was determined by using a serf-administered questionnaire.Participants were divided into normal fasting glucose group(FPG＜5.6 mmol/L,n=3738) and impaired fasting glucose group (5.6 mmol/L≤FPG ＜ 7.0 mmoL/L,n=136) according to their FPG levels. Results (1) After adjusting for age and sex using covariance analysis,the impaired fasting glucose group showed increased levels of body mass index,weight circumference,waist/hip ratio,waist/height ratio,as compared to the normal fasting glucose group (P＜ 0.05).(2) After the age and gender were adjusted,body mass index,weight circumference,waist/hip ratio and waist/height ratio were positively correlated with FPG level (P＜0.05).Among the partial relation coefficients, that between waist/height ratio and FPG(r'=0.0925) was the highest (3) In multiple regression analyses,age (β=-0.102,P＜0.05),family history of diabetes (β=0.186,P＜0.05) and waist/height ratio (β=0.842,P＜0.05) were consistently associated with FPG.Conclusion Central obesity was an important predictor of IFG in adolescents.Waist/height ratio may be an useful index of central obesity and an important predictor of IFG in adolescents.

Objective To investigate the awareness of knowledge about stroke rehabilitation in medical professionals in Gansu. Methods 520 professionals of neurology, neurosurgery, and others from 10 hospitals of different level were investigated with questionnaire. Results The awareness of the knowledge about stroke rehabilitation was different with the gender (χ2=17.50), education levels (χ2=66.35), professional levels (χ2=16.81), specialities (χ2=124.39) and duties (χ2=29.99) of the professionals (P<0.05). Conclusion It is necessary to improve the education of rehabilitation in hospitals.

AIM: To study the roles of Toll-like receptor 4 ( TLR4 ) and TLR4 activator lipopolysaccharide ( LPS) in colonic inflammation recovery .METHODS:Normal intestinal epithelial cells were cultured with LPS in vitro. The subgroups of the intestinal epithelial cells with differential expression of TLR 4 ( low, normal and high ) were construc-ted by the technique of lentivirus transfection .The cells with normal and high expression of TLR 4 were induced by LPS for 0 h, 2 h and 4 h.Inflammatory cytokines TNF-α, IL-6 and IL-8 in the culture supernatant were detected by ELISA .The mRNA levels of TNF-α, IL-6, IL-8, IL-10 and IL-1βwere detected by qPCR .The cell mobility was also monitored by wound healing assay .RESULTS:The protein expression of TLR 4 was significantly higher after LPS treatment than that in control groups of both cells with TLR4 normal and high expression (P<0.05).The inflammatory cytokines TNF-α, IL-6, IL-8 and IL-1βat mRNA and protein levels were also significantly increased after LPS treatment compared with control group (P<0.05).The protein levels of TNF-α, IL-6 and IL-8 between the 2 groups were also different with statistical sig-nificance ( P<0.05 ) .Higher mobility was observed in the cells with TLR 4 high expression compared to control cells . CONCLUSION:LPS induction might play a role in the activation of TLR 4-mediated inflammatory pathways by up-regula-ting the expression of inflammatory cytokines at both transcriptional and translational levels .

Objective In order to accumulate data for the final evaluation and acceptance of the Twelfth Five-Year Plan of National Endemic Disease Prevention and Control,we investigated the endemic scopes and basic situation of Keshan disease (KD) in Harbin.Methods According to the Criteria for Diagnosis of Keshan Disease (WS/T 210-2011),we conducted clinical survey of KD prevalence in 10 KD endemic counties in Harbin in 2013.2011-2015,we detected and searched for cases in 10 ward counties of Keshan disease.According to the Delimitation and Classification of Keshan Disease Areas and the Evaluation of Endemic Disease Control and Elimination,we determined the regional type,the situation of control and elimination of the disease,at the same time all KD patients were positioned by global positioning system (GPS).Results There were 2 KD endemic counties,12 endemic townships,and 37 KD patients in Harbin.All 12 townships were the light endemic regions of KD.Other townships were conformed to be the history regions with KD.The management index scores of KD reached the elimination requirements which were more than 85 points in every region county (city).Ten region counties got to technical standards for KD elimination.Harbin basically reached the index of KD elimination.The GPS satellite positioning of KD patients were concentrated in the 45.1-45.5 degrees north latitude,and 127.7-128.3 degrees east longitude.Conclusion The regions of KD endemic areas have narrowed down and the prevalence rate has declined significantly in Harbin,which have reached the basic elimination standards of KD by the 12th Five-Year Plan.

Objective To master the area scope and epidemic situation of Kaschin-Beck disease (KBD) in Harbin,and to accumulate data and information for the midterm examination and evaluation of the 12th Five-Year Plan of the National Endemic Disease Prevention and Control.Methods In the original 10 counties (districts,cities) of Harbin with KBD,2 surveys were carried out from 2011 to 2015,5 townships were extracted in each county (district,city),3 villages were extracted in each township,clinical investigation and X-ray examination of 7-12 years old children were carried out;according to the criteria for Diagnosis of Kaschin-Beck Disease,a clinical survey was conducted in 2013 in the 10 counties (districts,cities) with KBD.According to the KBD prevalence and X-ray examination results in each county (district,city),reference to Criteria for Control of Kaschin-Beck Disease Areas,Criteria for Delimitation and Classification of Kaschin-Beck Disease Area,Evaluation Methods for Endemic Diseases Control and Elimination,the types of the disease areas,control and eliminating situation were determined;organization and management of the control and prevention measures were evaluated.Results Currently,there were 10 counties (districts,cities),373 villages,6 969 patients with KBD in Harbin.According to the KBD area division and control standard,369 villages were light KBD areas (prevalence of clinical degrees Ⅰ and above patients or detection rate of 7-12 children by X-ray for local residents ≤ 10％) and 4 villages were medium KBD areas (prevalence of clinical degrees Ⅰ and above patients or detection rate of 7-12 children by Xray for local residents ＞ 10％-≤20％).Clinical census showed that the people under 20 years had no cases with degree Ⅰ and above in each village,X-ray detection rate was 0 in 7-12 years old children,in line with the standards of history KBD areas.There were no clinical KBD cases in 7-12 years old children in all villages of KBD areas,positive detection rate of children by X-ray was 0 in the sampling KBD area villages,in line with the standards of eliminate technical standards of KBD area village.The management index scores of KBD were from 85 to 95 points in every area county (district,city),getting to the eliminating requirement which was more than 85 points.Conclusion The KBD areas have narrowed down and prevalence has declined significantly in Harbin,which has reached the area eliminating standards and the index of basically eliminating KBD proposed by the 12th Five-Year Plan.

Objective To investigate the knowledge of stroke risk factors, early symptoms, and rehabilitation in stroke patients. Methods 1043 cases with stroke were stratified randomly sampled from 10 hospitals at different levels in Gansu, and were surveyed with self-designed questionnaire. Results For risk factors for stroke, hypertension was the most aware (61.55%), 6.42% knew all the factors. For the prevention and treatment, reasonable diet was the most aware (56.18%), followed with giving up smoking and drinking (52.92%). For the early symptoms, dysaesthesia of one side body was the most aware (53.88%), and then the headache and dizzy (50.14%). It was less than 30% to know the blurring, nausea and vomiting, and stiff tongue, etc. as the early symptoms. 60% of the patients did not know any about the rehabilitation, 22% did not know if rehabilitation be needed. 80% of the patients with stroke chose medication regardless of family income, and rehabilitation was chosen less than 30%. Conclusion It is important to popularize the knowledge of risk factors, early symptoms, and rehabilitation of stroke.

Objective To explore the inflammatory mechanisms of pulmonary embolism ( PTE ) and/or deep venous thrombosis ( DVT ) in elders secondary to chronic obstructive pulmonary disease ( COPD) exacerbation.Methods A total of 26 elders with acute exacerbation of high-risk COPD secondary PTE and/or DVT and 26 patients with low-risk COPD during stable phase diagnosed during the period of January 2008 to December 2012 were enrolled.The relevant parameters of routine blood examination , blood viscosity, D-dimer, fibrinogen ( FIB), arterial blood gas, blood cytokine, erythrocyte sedimentation rate ( ESR ) and C-reactive protein ( CRP ) were retrospectively analyzed.Results The major nonspecific symptoms were cough, sputum and dyspnea.The mean of neutrophile percentage (N%), D-dimer, FIB, interleukin-6 (IL-6), tumor necrosis factor (TNF), C-reactive protein (CRP), low and high shear blood viscosity in blood samples of patients with acute exacerbation of high-risk COPD secondary PTE and ( or ) DVT were higher than those of the control group ( t =3.339, 2.700, 2.207, 2.431, 2.257, 2.143, 2.223, 2.797, all P<0.05).However arterial partial pressure of oxygen ( PaO2 ) was lower than that of lower-risk COPD patients (t=4.312, P<0.05).IL-6 in blood of patients with acute exacerbation of high-risk COPD secondary PTE and ( or) DVT was positively correlated with low-shear blood viscosity , D-dimer and FIB (r=0.437, 0.624, 0.429, all P<0.05).TNF in blood of patients with acute exacerbation of high-risk COPD secondary PTE and ( or ) DVT was positively correlated to FIB , low and high cut blood viscosity ( r =0.624, 0.519, 0.513, all P <0.05 ).Plasma CRP in blood of patients with acute exacerbation of high-risk COPD secondary PTE and/or DVT was positively correlated with D-dimer, FIB, IL-6 and TNF ( r=0.478, 0.541, 0.533, 0.491, all P<0.05).Conclusions Inflammation may exist in elders with acute exacerbation of high-risk COPD secondary thrombotic disease.IL-6 and TNF may promote thrombosis secondary to acute exacerbation of COPD disease.Early screening and/or prophylactic anticoagulation are necessary for prevention.