Objective To evaluate the effect of ?-lipoic acid(ALA)as a antioxidant on the histomorphologic changes of the kidney in type 2 diabetic Goto Kakisaki rats.Methods Four healthy Wistar rats(normal control group)and 10 GK rats were divided randomly into two groups:diabetic control group and lipoic acid-treatment diabetic group(?-lipoic acid 35 mg/kg intraperitoneal injection qd alt),who were both fed for 12 weeks.Indexes of oxidative stress of kidney were measured.Sections of renal tissue were evaluated using both a light and electron microscope to assess histomorphologic changes.Paraffin sections of the left kidneys were prepared and stained with H&E,PAS and Masson stains to compare the histomorphologic changes.The image analysis software of Motic Image Advanced 3.1 was used to measure the area of glomerulus and mesangial region,and the thickness of the glomerular basement membrane(GBM).Results Compared with normal control group,there were significant decreases in GSH,SOD,VitC and VitE levels in diabetic control group.The kidneys of the normal control group exhibited normal cortical morphology as determined by light microscope.Mild glomerulosclerosis,characterized by widening of the mesangial region,mesangial expansion and intercapillary cells proliferation,and GBM thickening under electron microscope were observed in the diabetic control group.In the ALA-treatment group,all the above pathological changes were alleviated.Conclusion In the kidney of type 2 diabetic rat,there exists oxidative stress which is associated with diabetic nephropathy.?-Lipoic acid can alleviate the abnormal histomorphologic changes of the kidney via antioxidative effects.

We investigated the serotype,drug resistance features,molecular types,and homology of Salmonella in diarrhea in Tai'an City,and provided scientific evidences for warning,control and clinical treatment.The 31 Salmonella strains isolated from stool specimens of diarrhea in Tai'an were identified by serotyping.Broth dilution technique was used to test the sensitivity of 31 strains of Salmonella to 16 antibiotics.Pulsed field gel-electrophoresis (PFGE) was used for molecular typing and cluster analysis.Results showed that 31 strains of Salmonella were divided into 10 kinds of serotype.S.enteritidis (11/31) was the predominant serotype.All 31 strains of Salmonella were sensitive to cefoxitin and imipenem.The drug resistance rates of the 31 strains of Salmonella were 77.42 ％ (24/31) to sulfafurazole.The 31 strains of Salmonella were divided into 17 patterns by PFGE,with 100％ similarity for each pattern.All the results suggest that there are more serious problems in multiple drug resistance.The genetic variation of S.enteritidis is relatively conservative.Early warning and control on S.enteritidis are exposed to reinforce.

Objective To explore the etiology and epidemiological characteristics of fever and rash syndrome a mong children under the age of five years in Northwest China from 2009 to 2015.Methods Descriptive epidemiological analysis was conducted based on the monitoring data in sentinel hospitals,which was from the information management system of national infectious disease monitoring from 2009 to 2015 in Gansu,Qinghai,Inner Mongolia and Xinjiang.Results The results showed that the major pathogens of fever and rash syndrome among children under the age of five years were enterovirus,measles virus,varicella-zoster virus (VZV) and rubella virus.The major pathogens among children in the age group of 0-years and in the age group of 1-5 years were measles virus and enteroviruses,respectively.Among the positive cases of enterovirus,the positive detectable rates of human enterovirus 71 (EV71) and coxsackie A16 (CA16) were 47.18％ and 45.59％,respectively.The incidences of enterovirus and measles virus infection were mainly concentrated on May to July and March to May,respectively.Conclusions The major pathogens of fever and rash syndrome among children under the age of five years in Northwest china were enterovirus and measles virus with seasonal epidemic characteristics.Therefore,the prevention and control of measles and hand-foot-mouth disease should be strengthened.

Objective To investigate the effect of rhubarb and ephedra prescription on the pulmonary function and blood pressure circadian rhythm in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods One hundred and enghty six patients with AECOPD admitted to Department of Integrated Medicine of Harrison International Peace Hospital from December 2013 to Auguest 2016 were enrolled, and they were divided into a control group 90 cases and an experimental group 96 cases by random number talbe method. The patients in control group were treated with conventional therapy, while those in the experimental group were treated with the conventional therapy and additionally rhubarb and ephedra prescription (including rhubarb 6 g, ephedra 5 g, agrimony 15 g, licorice 15 g), taken orally 2 times a day, the therapeutic course in the two groups being 2 weeks. The diference of blood gas analysis, pulmonary function indexes, dyspnea score (mMRC) and ambulatory blood pressure monitoring were compared before and after treatment in the two groups.Results Compared with before treatment, the pH value, arterial partial pressure of oxygen (PaO2), forced vital capacity (FVC), one second forced expiratory volume (FEV1), FEV1/FVC of the two groups were significantly increased after treatment, while the arterial partial pressure of carbon dioxide (PaCO2) and mMRC score were significantly lowered, and the changes in the experimental group were more significant than those in the control group [pH: 7.40±0.04 vs. 7.37±0.03, PaO2 (mmHg, 1 mmHg = 0.133 kPa): 81.09±12.54 vs. 76.27±12.20, PaCO2 (mmHg): 48.01±8.27 vs. 51.91±8.37, FVC (L): 2.37±0.39 vs. 2.13±0.45, FEV1 (L): 2.08±0.38 vs. 1.87±0.41, FEV1/FVC: (69.01±12.04)% vs. (64.02±11.81)%, mMRC: 2.02±0.76 vs. 2.40±0.87, allP < 0.05 orP < 0.01]. Based on the percentage of blood pressure circadian value difference, the blood pressure circadian rhythm was divided into dipper type, non dipper type, super dipper type and anti dipper type, 24.2% patients were of dipper type and 75.8% patients were of non dipper, super dipper and anti dipper types. There was no significant difference in daytime systolic blood pressure (dSBP) between patients with super dipper and dipper types (P > 0.05),and the dSBP (mmHg) in patients with non dipper type was significantly higher than that in patients with dipper, super dipper and anti dipper types (131.55±5.08 vs. 117.78±4.47, 118.26±4.24, 113.37±3.97, allP < 0.05); the daytime diastolic blood pressure [dDBP (mmHg)] of anti dipper, non dipper type, dipper type, super dipper type increased in turn (respectively, 63.27±2.80, 70.24±3.82, 73.98±2.61, 82.96±4.52, allP < 0.05); the night SBP (nSBP) of anti dipper type was the highest (127.38±4.98) mmHg, and the nSBP of super dipper type was the lowest (89.07±3.81) mmHg; the night DBP (nDBP) of dipper type was lower than that of non dipper, anti dipper and super dipper types (mmHg: 63.57±1.37 vs. 68.86±2.12, 67.15±1.56, 67.89±2.04, allP < 0.05). After treatment, the proportion of patients with dipper type [66.7% (64/96) vs. 54.4% (49/90)], no dipper type [11.5% (11/96) vs. 8.9% (8/90)], and super dipper type [5.2% (5/96) vs. 2.2% (2/90)] in experimental group was significantly higher than that in the control group, the proportion of patients with anti dipper type [16.7% (16/96) vs. 34.4% (31/90)] in experimental group were significantly lower than those in the control group (allP< 0.05).Conclusion The Rhubarb and ephedra prescription can obviously improve the blood gas analysis indexes, pulmonary function and blood pressure rhythm in patients with AECOPD.

Objective To investigate cerebrospinal fluid characteristics and clinical features in children with severe hand,foot and mouth disease (HFMD) induced by enterovirus 71 (EV71) infection.Methods A total of 114 children with severe HFMD,in whom EV71 was detected by reverse transcription polymerase chain reaction (RT-PCR),were admitted in Hangzhou Children's Hospital during May and August 2013.Seventy-eight children with severe HFMD induced by other enteroviruses admitted at the same period served as controls.The results of cerebrospinal fluids (CSF) routine examination and biochemical tests,and the clinical symptoms were compared between two groups.Differences in enumeration data were compared with x2 test,and measurement data were compared with Mann-Whitney U test.Results The incidences of vomiting and limb shaking in EV71 infection group were 35.1％ and 50.9％,which were higher than those in control group (x2 =7.864 and 19.682,P ＜ 0.05).The incidence of limb shaking in children with nucleated cells count ≥ 100 × 106/L in EV71 group was higher than that with nucleated cells count ＜ 100 × 106/L (72.3％ vs.35.8％,x2 =14.740,P =0.000).The nucleated cells count,protein quantity and their positive rates in EVT1 infected group were higher than those in control group (Z =-9.458 and-6.591,P=0.000; x2=105.421 and 10.932,P =0.000 and 0.001).Conclusion The symptoms of nervous system damage and abnormal CSF examination were more serious in HFMD induced by EV71 infection,and in EV71 infected patients the incidence of limb shaking is correlated with nucleated cell count in CSF.

Objective To observe the clinical efficacy of Tanreqing combined with cefoperazone sulbactam for treatment of patients with chronic obstructive pulmonary disease (COPD) and explore its mechanism. Methods One hundred and twenty eligible COPD patients admitted to the Harrison International Peace Hospital in Hengshui of Hebei Province from June 2015 to August 2017 were selected, their diagnostic criteria were in accordance with the diagnostic guidelines for COPD (in 2007 revision edition) and they were divided into an experimental group and a control group according to the random number table method, with 60 patients in each group. Both groups had the same routine treatment, such as continuous nasal catheter low flow oxygen inhalation, expel phlegm and relieve asthma, and electrolyte disturbance correction. In the control group, cefoperazone sulbactam intravenous drip was given on the basis of conventional treatment; and the experimental group was additionally given Tanreqing intravenous drip on the basis of treatment in the control group. Both groups received 1 course of treatment for 7 days. According to the clinical symptoms, imagelogy, laboratory indexes, the therapeutic effect was evaluated, and the levels of interleukin-2 (IL-2) and tumor necrosis factor-α (TNF-α) in serum were detected by enzyme linked immunosorbent assay (ELISA). Results After treatment, the levels of IL-2 in serum were significantly higher than those before treatment in both groups (μg/L: control group was 15.5±2.8 vs. 12.7±1.5, experimental group was 18.2±3.2 vs. 11.6±1.3, both P < 0.05), while the levels of TNF-α in serum were decreased compared with those before treatment in both groups (μg/L: control group was 23.8±2.1 vs. 26.9±6.2, experimental group was 20.1±4.3, 27.6±3.7, both P < 0.05). After treatment, the concentration of IL-2 in the serum of the experimental group was significantly higher than that of the control group (μg/L: 18.2±3.2 vs. 15.5±2.8, P < 0.05), and TNF-α level was significantly lower than that of the control group (μg/L: 20.1±4.3 vs. 23.8±2.1, P < 0.05). After 1 course of treatment, the clinical efficacy in the experimental group was significant, and its total effective rate was higher than that in the control group [93.3% (56/60) vs. 86.7% (52/60), P < 0.05], and no adverse reactions were observed during the course of treatment in both groups. Conclusion The therapeutic effect of Tanreqing combined with cefoperazone sulbactam for treatment of patients with COPD is obvious, and it can increase the concentration of IL-2 and reduce the concentration of TNF-α in serum.

OBJECTIVETo explore the appropriate early warning method for influenza epidemic in Gansu province.

METHODSBy using simple control chart, moving percentile method, exponential smoothing method and cumulative sum control chart method, the annual incidence data of influenza-like illness in Gansu province during 2014-2015 were analyzed, and the sensitivities, specificities, positive predictive values, Jorden indexes and Kappa values of the 4 methods were evaluated and compared.

RESULTSThe 2014-2015 seasonal influenza epidemic occurred in the fiftieth week of 2014 in Gansu, and the epidemic peak lasted for 6 weeks. Cumulative sum control chart method had the best early warning effect with the sensitivity of 66.67% and specificity of 93.48%.

CONCLUSIONIt is feasible to use cumulative sum control chart method to give early warning of influenza epidemic in Gansu.

China ; epidemiology ; Disease Notification ; methods ; Epidemics ; Feasibility Studies ; Humans ; Influenza, Human ; epidemiology ; Seasons

Objective To detect the spatial temporal distribution of mumps in Gansu by means of spatial statistics.Methods The county-based incidence of mumps from 2009 to 2013 was used to calculate the global Moran' s I and local G statistics, and analyze its spatial temporal distribution characteristics.Results The incidence of mumps in Gansu were spatial auto-correlated from 2009 to 2013 respectively (P＜0.001), and the hot spots were mainly distributed in Hexi area,while the cold spots were distributed in Tianshui, Longnan and Qingyang.Spatial temporal analysis showed that the high incidence of mumps was most likely to be detect in Hexi area (RR=3.05, LLR=4 670.995, P＜0.001), and the low incidence was most likely to be detect in Longdong area (RR=0.36,LLR=1 980.686,P＜0.001).Conclusion The spatial and spatial temporal clustering of mumps existed in Gansu from 2009 to 2013, the results can be used in the development of mumps prevention and control measure in Gansu.

Objective To investigate the effect of Chinese rhubarb and ephedra prescription on the pulmonary function and blood pressure rhythm in patients with chronic obstructive pulmonary disease (COPD) in remission stage. Methods One hundred and fifty-two patients with COPD were admitted to Harrison International Peace Hospital from March 2014 to December 2016, and they were divided into a western medicine control group (72 cases) and a rhubarb and ephedra prescription group (80 cases) by random number table method, the conventional therapy was given to both groups, and in the rhubarb and ephedra group, additionally Chinese rhubarb and ephedra prescription (rhubarb 6 g, ephedra 5 g, agrimony 15 g, licorice 15 g) was applied, one dose orally taken daily, once 1/2 dose, 2 times a day, the therapeutic course being 3 months. The blood gas analysis, pulmonary function, 6-minute walking distance (6MWD) were detected, and modify medical research committee (mMRC) questionnaire for dyspnea score, the change of ambulatory blood pressure level monitoring and clinical effect were observed before and after treatment for 1, 2, 3 months. Results Compared with those before treatment, the blood gas indexes, the arterial partial pressure of oxygen (PaO2), arterial blood oxygen saturation (SaO2), and pulmonary function indexes, the percentage of one second forced expiratory volume (FEV1) in predictive value (FEV1%), the ratio of FEV1/forced vital capacity (FEV1/FVC) and 6MWD levels in both groups were continuously increased after treatment, while the arterial partial pressure of carbon dioxide (PaCO2) and mMRC score were persistently decreased after treatment in the two groups. After treatment for 2 months, compared with before treatment, the statistical differences appeared in the western medicine control group, while in the rhubarb and ephedra group, the statistical differences turned up after 1 month of treatment. After 3 months of treatment,the PaO2, SaO2, FEV1%, FEV1/FVC and 6MWD in the rhubarb and ephedra group were significantly higher than those in the western medicine control group [PaO2(mmHg, 1 mmHg = 0.133 kPa): 95.42±14.88 vs. 88.28±13.38, SaO2:0.97±0.02 vs. 0.96±0.02, FEV1%: 77.35±11.57 vs. 72.63±10.66, FEV1/FVC (%): 71.01±9.47 vs. 69.28±10.04, 6MWD (m): 318.0±40.1 vs. 306.6±35.7], PaCO2and mMRC were obviously lower in the rhubarb and ephedra group than those in the western medicine control group [PaCO2(mmHg): 40.35±7.58 vs. 43.57±7.85, mMRC score: 1.09±0.65 vs. 1.23±0.69], the differences of the two groups were statistically significant (all P < 0.05). After 3 months of treatment, in the western medicine control group, the percentage of patients with abnormal blood pressure rhythm was reduced to 44.4% (32/72), while in the rhubarb and ephedra group, was decreased to 32.5% (26/72), and the decrease amplitude of the rhubarb and ephedra group was greater than that of the western medicine control group (P > 0.05). The ratio of blood pressure morning peak in the rhubarb and ephedra group was significantly lower than that in the western medicine control group [23.8% (19/80) vs. 31.9% (23/72), P < 0.05], and the total effective rate in rhubarb and ephedra group was significantly higher than that in the western medicine control group [92.5% (74/80) vs. 73.6% (53/72), P < 0.05]. Conclusion Chinese rhubarb and ephedra prescription can improve indexes of blood gas analysis, pulmonary function and blood pressure rhythm in COPD patients in remission phase, and its clinical efficacy is significant.

Objective To investigate the importance of conditional control on the results of binary Logistic regression analysis.Methods 664 male patients diagnosed with CHD and 400 healthy controls who visited the Department of Cardiology at People's Hospital of Yuxi City in Yunnan province from October 2010 to March 2013were enrolled consecutively in this case-control study, and 14 physiological and biochemical indexes[including:age,UA,TC,TG,HDL-C,LDL-C,APOA1,APOB100,Lp(a),HCY, TBIL,DBIL,IBIL,γ-GT]were collected.The correlations and differences in mathematical model results between physiological,biochemical indexes and CHD were compared by binary Logistic regression analysis under different statistical analysis strategies and then the model was analyzed by the ROC curve.Results (1)With no conditional control,all of the 14 physiological and biochemical indexes were directly inputted in the binary Logistic regression analysis,and after 11 steps regression analysis,11 indexes[age,UA,TG, HDL-C,LDL-C,APOA1,APOB100, Lp(a), HCY, DBIL, γ-GT]were retained.Because of the self-correcting ability of the binary Logistic regression analysis, relatively satisfactory results can be obtained. However,someof the resultsarehard to explain.(2)According to the application conditions of Logistic regression analysis,after performing the normality test, difference analysis and correlation analysis of these indexes, using condition analysis and control, considering the distribution characteristics of the indexes, excluding internal confounding factors among variables,9 more independent indexes[age,UA,TC,lnTG, lnLp(a),lnHCY,HDL-C,LDL-C and TBIL]were selected for Logistic regression analysis.After 7 steps regression analysis,7 indexes[age, UA, HDL-C, lnTG, lnLp(a), lnHCY and lnTBIL]were finally selected,and the area under the curve is 0.927.Conclusion When the binary Logistic regression analysis was used to confirm risk factors and establish risk assessment models for complex diseases, it is better to adopt strict conditional control to improve the reliability and validity of the analysis.