Objective To understand the status of disinfection in hospitals in Zibo. Methods Sanitary investigation on the disinfection quality of indoor air ,hands of doctors and nurses,surface of objects,the sanitary quality of disinfection reagents in use and the intensities of ultraviolet ray emitted from ultraviolet lamps was carried out in 34 general hospitals with bed capacity of more than 100 and special hospitals in Zibo. Results The total qualified rates of above indexes were 86.77% for municipal hospitals ,78.77% for district (county)hospitals,61.63% for factory and mine-hospitals respectively,and between them revealed significant differences (?2=59.95,P

Objective To study the expressions of metadherin (MTDH),E-cadherin and β-catenin in the tissues of hepatocellular carcinoma (HCC),to investigate the relationship between them and the clinical-pathological features,and to evaluate the prognostic values after surgical resection for hepatocellular carcinoma.Methods The protein expressions of MTDH,E-cadherin and β-catenin were studied by immunohistochemistry in tumor tissues of 107 HCC patients who underwent curative surgical resection.The data were correlated with the clinical-pathological data,tumor free time and recurrence rate.Results Positive expression of MTDH and nuclear β-catenin accumulation were correlated with the Edmondson grade (P＜0.05) and decreased E-cadherin expression was correlated with the preoperative serum level of α-fetoprotein (AFP) (P＜0.05).All these expressions were associated with a shorter tumor-free survival and a higher recurrence rate (P＜0.05).Positive MTDH expression was correlated with decreased E-cadherin expression and nuclear β-catenin accumulation (P＜0.05).On Cox regression analysis,MTDH was an independent risk factor of tumour recurrence (RR=3.431,CI=1.254～ 7.318).Conclusions Positive MTDH expression,decreased E-cadherin expression,and nuclear β-catenin accumulation indicated a higher recurrence rate after curative surgical resection for HCC.MTDH was an independent risk factor of recurrence.

Objective: To detect the expression of B cell transposition gene 3(BTG3) in pancreatic ductal adenocarcinoma(PDAC), and explore its relationship with postoperative recurrence and metastasis of tumor. Methods: Six self-paired frozen PDAC specimens and 3 normal pancreatic tissues from the Second Hospital of Jiaxing Affiliated to Jiaxing University were collected and the expression of BTG3 was detected by qPCR. Ten normal pancreatic tissues and 52 cases of PDAC tumor and paracarcinomatous tissues from the Second Hospital of Jiaxing Affiliated to Jiaxing University were collected from June 2009 to December 2016. The expression of BTG3 and relationship among BTG3 and clinicopathological characteristics of PDAC and patients′ prognosis were detected and analyzed using immunohistochemistry.χ² test, Kaplan-Meier method and Cox regression model were used to analyzed the data. Results: The results of qPCR showed that expression level of BTG3 in PDAC (0.63±0.17) was lower significantly than that in paracarcinomatous (0.96±0.04) and normal tissues (1.00)(t=4.673, 5.502; both P<0.05). Immunohistochemistrv showed that BTG3 mainly expressed in the cytoplasm.The high expression rate of BTG3 in PDAC tumor tissues was 25.0%(13/52), which was remarkably lower than that in paracarcinomatous tissues(65.4%) and normal liver tissues(7/10)(χ²=17.120 and 5.849, both P<0.05). The low expression of BTG3 in PDAC was correlated with primary tumor, and TNM stage(χ²=7.704, P=0.006; U=154.000, P=0.018, respectively). Survival analysis showed that disease free survival rate of patients with low expression of BTG3 was significantly less than that with high expression(χ²=192.493, P<0.01). The Cox multivariate analysis demonstrated that low expression of BTG3 was independent risk factors for disease free survival in patients with PDAC after a curative resection(RR=3.366, 95%CI: 1.040-10.889, P=0.043). Conclusion BTG3 may be involved in the occurence and development of tumor, and its low expression may be associated with poor prognosis in patients with PDAC.

Objective:To study the feasibility for transumbilical single-incision laparoscopic appendectomy (SILA) with conventional laparoscopic instruments, and compare SILA with the traditional three-port laparoscopic appendicectomy (LA).Methods:The clinical data of 113 patients with acute appendicitis from January 2018 to August 2020 in the Second Hospital of Jiaxing City were retrospectively analyzed. Among them, 61 patients received traditional three-port LA (three-port LA group), 52 patients received transumbilical SILA (SILA group). The operative time, intra-operative blood loss, surgical complications, length of hospital stay and hospitalization costs were recorded. Pain score 6 h after operation was assessed by visual analogue scale. C-reactive protein (CRP) on the first day after operation was detected. All patients were followed up for 1 month.Results:In 2 groups, all patients did not suffered from the conversion to open operation or multi-port method, massive bleeding and accessory injury during the operation. Moreover, severe pain, severe incision infection, residual abdominal abscess and incisional hernia did not occur. Patients in SILA group had more hidden abdominal scars. there were no statistical differences in operative time, intra-operative blood loss and CRP on the first day after operation between 2 groups ( P>0.05); the rate of moderate pain degree 6 h after operation, length of hospital stay and hospitalization costs in SILA group were significantly lower than those in three-port LA group: 15.38% (8/52) vs. 34.43% (21/61), (3.63 ± 1.22) d vs. (4.31 ± 1.38) d and (8 802 ± 1 466) yuan vs. (9 559 ± 1 617) yuan, and there were statistical differences ( P<0.05 or <0.01). Conclusions:The transumbilical SILA with conventional laparoscopic instruments is safe and feasible, the scar is more difficult to see, the cosmetic effect is much clearer, and the length of hospital stay is shorter.

Objective:To investigate the prognostic factors of patients with pancreatic body and tail carcinoma.Methods:The clinical data of 64 patients with pancreatic body and tail carcinoma who underwent surgical resection or endoscopic ultrasound biopsy and were pathologically confirmed in the Second Affiliated Hospital of Jiaxing University from January 2013 to March 2020 were retrospectively analyzed. Age, gender, diabetes mellitus, serum CEA and CA19-9 levels at initial diagnosis, tumor site, maximum tumor diameter, TNM stage and treatment method were collected. Kaplan-Meier method was used to draw survival curve, and Log-rank test was used to analyze survival rate. Univariate and multivariate Cox proportional risk regression models were used for prognostic analysis.Results:Among the 64 patients, 24 patients were complicated with diabetes; serum CEA level was increased in 36 cases, and serum CA19-9 level was increased in 46 cases; 8 cases were in TNM stage ⅠA, 4 cases were in ⅠB stage, 4 cases were ⅡA stage, 4 cases were in ⅡB stage, 8 cases were in Ⅲ stage, and 36 cases were in Ⅳ stage. Symptomatic treatment was performed in 18 cases, chemotherapy combined with immunotherapy were in 18 cases, and surgical comprehensive therapy (surgery combined with chemotherapy and immunotherapy) were in 26 cases. Univariate analysis showed that diabetes mellitus, serum CEA and CA19-9 levels, TNM stage and treatment mode were related factors affecting the prognosis of patients with pancreatic body and tail carcinoma (all P value <0.05). Multivariate analysis indicated that TNM stage ( HR=2.536) and surgical comprehensive therapy ( HR=0.285) were the independent factors affecting the prognosis of patients with pancreatic body and tail carcinoma ( P<0.05). Median survival was 25 months (95% CI 21.416-28.584) for patients with TNM stage Ⅲ+ Ⅳ pancreatic body and tail carcinoma treated with surgical comprehensive therapy, 11 months (95% CI 7.246-14.754) for patients treated with chemotherapy combined with immunotherapy, and 6 months (95% CI 3.819-8.181) for patients treated with symptomatic treatment; the median survival time of patients with surgical comprehensive therapy was significantly longer than that of patients with chemotherapy combined with immunotherapy and symptomatic treatment, and the difference was statistically significant ( P<0.05). Conclusions:TNM stage and surgical comprehensive therapy were the prognostic factors affecting the prognosis of patients with pancreatic body and tail carcinoma, and surgical comprehensive therapy may be the best choice for long-term survival of patients.

Objective: To analyze the epidemiological characteristics and genetic characteristics of sapovirus (SaV) in a cluster of schools in Changzhou, so as to provide a reference for the treatment of clustered vomiting and diarrhea events in schools. Methods: The epidemiological data and laboratory test data of sapovirus clusters in Changzhou from 2019 to 2022 were collected and analyzed. Partial VP1 genes of SaV positive samples were amplified and sequenced for phylogenetic analysis. Results: A total of 8 cases of clusters of SaV epidemics were reported in Changzhou City from 2019 to 2022, with 118 reported cases. The total attack rate was 1.47%, and the median of the attack number was 15. There were 6 outbreaks in kindergartens and 2 outbreaks in primary schools, which were reported in the epidemic period from September to December. The main clinical manifestations were vomiting (113 cases, 95.76 %), abdominal pain (39 cases, 33.05%), and diarrhea (16 cases, 13.56%). Among the 8 outbreaks, 17 sample strains were successfully sequenced. 5 outbreaks were GII.3 , and the other 3 outbreaks were GI.1, GI .3 and GII.2. GI and GII were the main genotypes in this area, and GII .3 was the predominant strain. Conclusion SaV is an important pathogen in the clusters of vomiting and diarrhea in schools after the transmission of norovirus. Continuous surveillance of SaV should be carried out to further understand its epidemiological characteristics and genotype distribution, so as to provide scientific basis for the prevention and control of the epidemic in schools.

OBJECTIVETo investigate the effect of treatment on end-stage liver disease and type-I diabetes mellitus with simultaneous liver-pancreas-duodenum transplantation.

METHODIn September 2003, one patient with chronic hepatitis B, liver cirrhosis, hepatic cellular cancer, and insulin-dependent diabetes received simultaneous orthotopic liver and heterotopic pancreas-duodenum transplantation. Liver and pancreas graft function was monitored after transplantation.

RESULTSThe function of pancreas allograft was recovered immediately and the patient became insulin-independence postoperatively. The liver allograft was experienced an acute rejection episode and reversed by intravenous bolus methylprednisolone. The recipient was currently liver disease-free and insulin-free more than 21 months.

CONCLUSIONSThe simultaneous liver-pancreas-duodenum transplantation is an effective method in the treatment of end-stage liver disease and type-I diabetes mellitus.

Diabetes Mellitus, Type 1 ; complications ; surgery ; Duodenum ; transplantation ; Female ; Follow-Up Studies ; Graft Rejection ; prevention & control ; Humans ; Immunosuppressive Agents ; therapeutic use ; Liver Cirrhosis ; complications ; surgery ; Liver Neoplasms ; complications ; surgery ; Liver Transplantation ; Male ; Middle Aged ; Pancreas Transplantation ; Transplantation, Homologous

Objective To understand the epidemiological characteristics and variation of H3N2 influenza virus hemagglutinin (HA) gene in Changzhou from 2017 to 2018. Methods Throat swab specimens of the influenza-like cases were collected from Changzhou Influenza Monitoring Sentinel Hospital from April 2017 to March 2018. RNA was extracted from the specimens for influenza diagnosing and genotyping using real-time RT-PCR．H3N2 positive samples were isolated, and extracted RNA was used for amplification, sequencing and phylogenetic analysis of HA gene. Results From April 2017 to March 2018, 28 strains of influenza A (H3N2) virus were isolated. After gene sequencing, a phylogenetic tree was constructed. It was found that all of the strains belonged to Group3C.2a, which was similar to the vaccine strain A/Hong Kong/4801/2014. The HA amino acid sequence difference was analyzed and compared between the H3N2 influenza virus strains isolated in Changzhou and the vaccine strain A/Hong Kong/4801/2014. It was found that the epidemic strain isolated in Changzhou was in the HA epitope (A-E) region. Ten amino acid site mutations in the HA epitope (A-E) region and two amino acid site mutations in the stem region of HA antigen were found. Conclusion From April 2017 to March 2018, the influenza virus H3N2 prevalent in Changzhou was distributed on the same evolutionary branch with the vaccine strain A/Hong Kong/4801/2014 (group 3C.2a), rendering the popular trend of one subgroup. However, some amino acid sites of the HA epitope had variations, suggesting that mutations may occur, which may affect the immune effect of the vaccine. Monitoring needs to be strengthened in the future work.

Humans ; Tenofovir/therapeutic use* ; Emtricitabine/therapeutic use* ; HIV Infections/drug therapy* ; Anti-HIV Agents/therapeutic use*