Objective To analyze malaria situation and evaluate the effect of control program in Henan Province during 1990-2005. Methods Data were collected and analyzed on the measures and effects of malaria control, vector surveillance, blood examination for cases with fever and serological surveillance in the province during 1990-2005. Results In the 16 years, a total of 802 700 people were given pre-transmission season treatment with chloroquine and primaquine for a radical cure of vivax malaria, chemoprophylaxis was given to 764 300 people at high risk during the transmission season, treatment or presumptive treatment was given to 43 891 cases. 11 216 100 cases with fever were tested and 11 213 (0.10%) were found positive accounting for 29.01% (11 213/338 654) of all malaria cases. A total of 1 332 800 bed nets were treated with insecticide and 1 999 300 people were protected in 1990-1992 and 1996-1999. 34 846 residents including pupils were tested with IFAT in 1990-2000 and 1149 (3.30%) were positive. The parasite rate amongst 71 234 local residents including pupils was 0.40% (286/71 234). The principal transmitting vectors were Anopheles sinensis and An.anthropophagus. The man-biting habit for An. sinensis and An.anthropophagus was 0.060 8 and 0.314 3 respectively, and the vectorial capacity of An.anthropophagus was 22.4 times higher than that of An.sinensis. In this period, 38 654 malaria cases were reported in the province and the annual malaria incidence was 2.62 per hundred thousand, the lowest annual incidence was in 1992 (0.37 per hundred thousand). 70.05% (27 076/38 654) of these malaria cases were from areas where An. anthropophagus was present. Conclusions In general, the malaria control activities have been effective and the epidemiological situation kept stable in Henan Province, although in some areas the situation is unstable and outbreak spots or focal epidemics occur.

Objective To study the effects of cultivation methods on growth dynamics in the aerial part and root of Angelica sinensis and Ditylenchus destructor, rate of early bolting, and yield of A. sinensis as well. Methods Compared with conventional planting, ridge planting, furrow planting, white plastic mulch coverage, and black plastic mulch coverage were used to evaluate the effects of cultivation methods on dry matter accumulating and growth dynamics of A. sinensis. Results The influence of black plastic mulch coverage to growth dynamics of A. sinensis is the biggest, next for white plastic mulch coverage. There is the best inhibition to D. destructor under ridge planting. Black plastic mulch coverage can enhance the rate of early bolting. The treatment of black plastic mulch coverage has the highest yield, which can increase the yield by 33.4% (4 650 kg/hm2) compared to conventional planting; next for the treatment of white plastic mulch coverage, which increased the yield by 24.3% (3 372.2 kg/hm2) compared to conventional planting. But there were no significant effects of ridge planting and furrow planting on increasing yield. Conclusion The cultivation methods of black plastic mulch coverage should be brought into wide use in A. sinensis cultivation.

Objective To investigate the effects of transient plateau factor on acute lung injury induced by phosgene poisoning in rabbits.Methods Forty New Zealand white rabbits of both sexes,aged 2.0-2.5 kg,were randomly divided into 4 groups (n =10 each) using a random number table:control group (group C),plateau factor group (group H),phosgene poisoning group (group P),and phosgene poisoning and plateau factor group (group HP).In group H,the rabbits were exposed to a simulated altitude of 33000 m for 2 h.In group P,the rabbits were exposed to phosgene for 3 min only.In group HP,the rabbits were exposed to phosgene for 33 min and then to a simulated altitude of 3000 m for 2 h.Respiratory rate (RR) was recorded and blood samples were taken before exposure to phosgene (T1),after exposure to phosgene (T2),and at 0,1 and 6 h after onset of exposure to a simulated altitude of 33000 m (T3-5) for determination of PaO2 and oxygenation index (OI) was calculated.The chests were opened at T5 and lungs removed for determination of lung water content (LC) and for microscopic examination.Lung coefficient (LC) was calculated.Results Compared with C group,RR was significantly increased at T3 in group H (P ＜ 0.05),and RR was increased and OI was decreased at T2-5 in P and HP groups (P ＜ 0.05 or 0.01).Compared with P group,RR was increased and OI was decreased at T3-5 in HP group (P ＜ 0.05 or 0.01).LW and LC were significantly higher in P and HP groups than in group C,and in HP group than in group P (P ＜ 0.05 or 0.01).The microscopic examination showed that pathological changes were observed in P and HP groups,however,the changes were severer in HP group.Conclusion Transient plateau factor can obviously aggravate the degree of acute lung injury induced by phosgene poisoning in rabbits.

Objective To explore the influence of pelvis obliquity in lateral position to acetabular component orientation during total hip arthroplasty (THA),and the method to correct.Methods Fifty patients (62 hips) were performed THA with posterolateral incision in lateral position by the same team.The patients were randomized and divided into experimental group (EX,with 25 cases,34 hips) and control group (CON,with 25 cases,28 hips).In EX group,the acetabular components were placed by means of the gradienter and plumb correcting technique during THA.While in CON group,the acetabular components were placed by traditional method during THA.The acetabular abduction angles were measured postoperatively,and compared between the two groups.Results The average obliquity of pelvis was-1.647°±4.512°in EX group when putting the patient in lateral position before correcting.Through the application of gradienter and plumb,the average abduction angle of acetabular component was 42.685°±3.355° postoperatively,with the difference of 1.962°±1.515° compared with the preoperative angles.And in CON group,the average abduction angle of acetabular component was 44.534°±4.844° postoperatively,with the difference of 4.244°±3.042°.The difference of abduction angle in CON group was much higher than that in EX group (P＜0.05).Conclusion The pelvic obliquity when putting the patient under lateral position will affect the surgeons'judgments of placing acetabular component during THA,furthermore,lead to inconsistency among the abduction angles obtained preoperatively,intraoperatively and postoperatively.By applying the correcting method with gradienter and plumb,the discrepancy can reduce obviously between the abduction angle measured postoperatively and that of measured during operation comparing with traditional method.

Mucinous tubular and spindle cell carcinoma of the kidney is a rare subtype of renal carcinoma. In July 2019, one case of mucinous tubular and spindle cell carcinoma of the kidney was admitted to our hospital, The laparoscopic partial nephrectomy was performed, and there was no recurrence or metastasis during the follow-up period of 13 months. The disease has no obvious clinical manifestations and its diagnosis depends on pathological and immunohistochemical features. Surgical treatment is the main treatment for this disease, and most patients have a good prognosis.Howerer, the possibility of progression remains in the late stage of the disease.

Objective To investigate the relationship of programmed death ligand-1 (PD-L1) with clinicopathological characteristics,radiosensitivity and prognosis of the patients with esophageal squamous cell carcinoma(ESCC). Methods Ninety ESCC patients who received radical radiotherapy diagnosed by ESCC in Affiliated Hospital of North Sichuan Medical College were enrolled. Twenty cases of normal esophageal mucosa were used as the controls. The expression of PD-L1 was detected by using immunohistochemical SP method. Results The expression of PD-L1 protein was not correlated with age, gender, the maximum diameter of tumor, the length of lesion, the local aggressive of tumor, clinical stage and primary tumor volume (all P> 0.05). However, it was statistically correlated with the lymphatic metastasis (χ2= 4.404, P= 0.036). Meanwhile, PD-L1 positive expression was sensitive to radiation(χ2=4.888, P< 0.05). Single factor analysis showed that the maximum diameter of tumor and radiosensitivity were correlated with progression-free survival (PFS) (χ2=6.239,P =0.013;χ2=6.852,P =0.008; χ2= 6.312, P= 0.012) and overall survival (OS) (χ2=8.170, P = 0.004; χ 2= 4.261, P = 0.039; χ2= 5.003, P= 0.025) of ESCC patients. Multifactor analysis showed that the radiosensitivity and the maximum diameter of tumor affected PFS (OR= 0.512, 95 % CI 0.275-0.954, P= 0.035) and OS (OR= 0.507, 95 % CI 0.266-0.968, P= 0.039) in ESCC patients, respectively.Conclusions The level of PD-L1 expression is increased significantly in ESCC tissues compared with the normal esophageal mucosa tissues. PD-L1 may be a novel biomarker for predicting metastatic potential and radiosensitivity in ESCC patients, rather than the prognosis predictors of ESCC patients treated by radiotherapy.

Objective:To verify the predictive value of fully-automated 3D volume segmentation of CT images for the overall survival prognosis of resectable pancreatic ductal adenocarcinoma (PDAC).Methods:From July 2018 to March 2019, the clinical data of 198 cases of resectable PDAC were continuously collected in the First Affiliated Hospital of Naval Medical University. According to the level of carbohydrate antigen(CA)19-9 and carcinoembryonic antigen(CEA), the patient were divided into low CA19-9 group(≤210 U/ml ), high CA19-9 group (>210 U/ml ), normal CEA group (<5 ng/ml ) and high CEA group (≥5 ng/ml). Using our fully-automated segmentation tool developed in the early stage, images at the plain phase and portal phase were matched to those at the late artery phase by taking the artery phase as the matching target to establish UNet model; and the PDAC tumor and pancreatic glands were three-dimensionally segmented to estimate the tumor 3D volume. Univariate and multivariate logistic regression analysis were performed to compare the tumor 3D volume with the common preoperative risk factors (tumor 2D long diameter, CA19-9 level, CEA level, etc.) in predicting the patients′ survival. C-index was used to estimate the accuracy for predicting the survival. Receiver operating characteristics curve (ROC) was drawn and AUC was calculated to evaluate the accuracy for predicting the 1-year and 2-year overall survival and the influence of CA19-9 and CEA level on the patients′ overall survival.Results:Univariate logistic analysis showed that age, tumor 3D volume, tumor location, CA19-9 and CEA level were correlated with the patients′ overall survival. Multivariate logistic analysis showed that tumor 3D volume, CA199 and CEA were correlated with the overall survival. Among them, tumor 3D volume was most strongly correlated with the overall survival ( HR=2.25, 95% CI1.49-3.39, P<0.0001). The prognostic C-index of automatic 3D tumor volume, tumor long diameter, serum CEA and CA19-9 was 0.667(95% CI0.617-0.717), 0.637(0.583-0.691), 0.593(0.527-0.659) and 0.585(0.526-0.644), respectively. The AUCs of 3D tumor volume, tumor location, tumor long diameter, serum CEA and CA19-9 for predicting 1-year and 2-year survival were 0.726 and 0.698, 0.562 and 0.562, 0.703 and 0.660, 0.583 and 0.624, 0.602 and 0.609 respectively. C-index and AUC of tumor 3D volume was significantly better than those of the other common preoperative risk factors, and the difference was statistically significant (all P value <0.05). The survival of patients with large tumor 3D volume was greatly poorer than that of patients with small tumor 3D volume in low CA19-9 group, high CA19-9 group, normal CEA group and high CEA group, and the differences were all statistically significant ( HR=2.27, 95% CI 1.39-3.72; HR=2.42, 95% CI1.23-4.74; HR=2.08, 95% CI1.07-4.06; HR=2.67, 95% CI1.63-4.38, all P value <0.01). And the automatic 3D volume was the strongest predictor for the survival in high CA19-9 group. Conclusions:The tumor 3D volume obtained by automatic CT segmentation was an objective and reliable prognostic biomarker, which can supplement the established preoperativel risk factors and was expected to guide the personalized choice of neoadjuvant therapy.

Objective: To explore the diagnosis and treatment of fourth branchial cleft deformity. Methods: The clinical data of a patient with bilateral fourth branchial cleft deformity in the neck were summarized, and the literature was reviewed Results: The patient was a 17-year-old male who had a painless lump in his neck for 10 years. During specialized examination, a lump approximately 4.0 cm × 3.0 cm in size could be palpated subcutaneously on the right side of the neck, with clear boundaries, a regular shape, a soft texture, and a wave-like sensation without obvious tenderness. A fistula with a size of approximately 0.5 cm × 0.5 cm could be observed on the left side of the neck, and yellow clear liquid could be seen flowing out of the fistula. The surrounding skin was locally red and swollen, and the surface temperature of the skin was elevated. Computed tomography examination demonstrated a circular cystic low-density shadow approximately 4.4 cm × 3.4 cm in size in the right supraclavicular and anterior cervical regions. A flocculent isodense image could be observed in the middle; moreover, nodular calcification could be observed at the edge, and the surrounding fat spaces were blurred. The enhanced scan showed mild enhancement of the cyst wall but no obvious enhancement of the contents. On the left side, a circular nodular shadow with a diameter of approximately 1.4 cm could be seen, with enhanced scanning and circular enhancement. The surrounding skin was thickened, and the subcutaneous fat gap was blurred. Multiple small lymph nodes could be observed on both sides of the neck, with the larger nodes having a short diameter of approximately 0.8 cm. The size and morphology of the thyroid gland were not significantly abnormal, and there was no obvious abnormal density shadow inside of the gland. Upon admission, the diagnosis was a fourth gill fissure cyst in the right neck and a fourth gill fissure fistula in the left neck. Under general anesthesia and intravenous anesthesia, right branchial cleft cyst resection and left branchial cleft fistula resection were performed. Postoperative pathological examination demonstrated a left branchial cleft fistula and a right branchial cleft cyst. The wound healed by first intention, and there was no recurrence after 6 months of follow-up. According to the literature, fourth branchial cleft deformity is a congenital developmental abnormality of the branchial apparatus, the incidence of which accounts for only 1% of all branchial cleft deformities; moreover, it often occurs on the left side. The anatomical position is often located in the cervical root and supraclavicular region, thus demonstrating cysts or sinuses adjacent to the thyroid gland. The diagnosis should be confirmed by anatomical location, imaging examination or laryngoscopy combined with postoperative pathological results and should be differentiated from cervical masses such as thyroglossal duct cysts and lymph node metastasis. The main treatment methods include surgical procedures and endoscopic cauterization of the internal fistula. The prognosis is generally good, and there is a risk of recurrence; however, cancer rarely occurs Conclusion Deformity of the fourth branchial fissure is very rare; thus, it should be identified early to avoid excessive and ineffective surgical drainage, reduce potential complications during resection and completely remove the lesion to prevent recurrence.