Abstract: Objective　China was certified by World Health Organization as a malaria-free country in 2021. Malaria has become a rare infectious disease, and preventing the re-transmission of imported malaria and reducing deaths are the main challenges facing China after elimination of malaria. To analyze and clarify the characteristics of imported malaria deaths, and to provide prevention and treatment recommendations for overseas workers and health care workers. Methods　The data of 17 imported malaria deaths in the analysis of malaria deaths from 2016 to 2020 by the National Severe Malaria Treatment Expert Group were collected, and the relevant clinical epidemiological data and disease course records were analyzed. Results　The 17 malaria deaths were all imported from Africa with Plasmodium falciparum infection (malarial cerebral type), with no obvious regularity in the month of onset. Among them, 16 were male patients, 5 cases with underlying diseases such as diabetes mellitus, and 10 patients were first diagnosed in a second-level or lower hospital. Excluding patients who died of respiratory cardiac arrest in ambulances, the mean time difference between first onset and malaria diagnosis in 16 patients was 6.8 days (median 5.5 days), and the mean time between first onset and antimalarial treatment was 7.4 days (median 6 days), the mean time difference from initial onset to death was 10.3 days (median 8.5 days). Excluding cases with onset abroad and unknown time of return, all 14 patients developed the disease within 30 days after returning to China. Conclusion　All the fatal cases were infected with Plasmodium falciparum imported from Africa. The patients' awareness of actively seeking medical treatment is weak, and the delay in seeking medical treatment caused by the insufficient diagnosis and treatment capacity of health institutions at the township level and below is the main reason for the deaths. It is recommended to strengthen the self-protection awareness of staff in malaria-endemic areas overseas and raise their awareness of malaria. For returnees from areas with high malaria risk, primary medical institutions should pay attention to the patient's travel history in Africa, improve the awareness of malaria diagnosis, malaria diagnosis and treatment capabilities.

Objective: To explore the safety and efficacy of lipoprotein apheresis (LA) in treating the patients with familial hypercholesterolemia (FH).
Methods: A total of 12 FH patients treated in our hospital from 2015-02 to 2016-10 were retrospectively studied. Based on intensive cholesterol lowering therapy with rosuvastatin (10-20) mg Qd and Ezetimibe 10 mg Qd, the patients received LA by double ifltration plasma pheresis (DFPP) via bilateral elbow central vein or femoral vein. The changes of lipid level were compared at before and after LA treatment.
Results: For pre- and immediately after LA treatment, the average total cholesterol (TC) was (9.42±3.65) mmol/L vs (2.84±0.83) mmol/L, low density lipoprotein cholesterol (LDL-C) was (7.31±3.46) mmol/L vs (1.95±0.82) mmol/L; at 1, 3, 7 and 30 days after treatment, TC and LDL-C levels showed increasing trend, while they were still lower than they were before treatment, allP<0.01. For pre- and immediately, 1 day, 3 days after treatment, the average HDL-C level was (0.96±0.31) mmol/L, (0.63±0.17) mmol/L, (0.56±0.15) mmol/L and (0.68±0.22) mmol/L respectively,P<0.05-0.01. For pre- and immediately after LA treatment, the average TG level was (1.90±0.86) mmol/L vs (0.88±0.38) mmol/L,P<0.05. Only 1 patient had the symptoms of hypotension, nausea and sweat, the patient was relieved by expectant treatment.
Conclusion: LA therapy may decrease blood levels of TC and LDL-C at short term in FH patients with good tolerance;even TC and LDL-C could slowly increase after treatment, while combining with lipid lowering therapy, it has been a safe and effective method for treating relevant patients.

Adolescent ; Child ; Female ; Humans ; Humeral Fractures ; surgery ; Humerus ; surgery ; Male ; Traction

To establish the water dynamics model for drying process of Angelicae Sinensis Radix, the Weibull distribution model was applied to study the moisture ratio variation curves, and compared the drying rate and drying activation energy with the drying methods of temperature controllable air drying, infrared drying under different temperatures (50, 60, 70 degrees C). The Weibull distribution model could well describe the drying curves, for the moisture ratio vs. drying time profiled of the model showed high correlation (R2 = 0. 994-0. 999). The result proved that the drying process of Angelicae Sinensis Radix belonged to falling-rate drying period. For the drying process, the scale parameter (a) was related to the drying temperature, and decreased as the temperature increases. The shape parameter (β) for the same drying method, drying temperature had little impact on the shape parameter. The moisture diffusion coefficient increase along with temperature increasing from 0.425 x 10(-9) m2 x s(-1) to 2.260 x 10(-9) m2 x s(-1). The activation energy for moisture diffusion was 68.82, 29.60 kJ x mol(-1) by temperature controllable air drying and infrared drying, respectively. Therefore, the Weibull distribution model can be used to predict the moisture removal of Angelicae Sinensis Radix in the drying process, which is great significance for the drying process of prediction, control and process optimization. The results provide the technical basis for the use of modern drying technology for industrial drying of Angelicae Sinensis Radix.
Angelica sinensis ; chemistry ; Desiccation ; methods ; Models, Theoretical ; Water

OBJECTIVETo investigate the clinical effects of bone setting manipulation on simplified operation and swelling reduction in treating calcaneal fractures.

METHODSFrom December 2005 to November 2010, 42 patients with calcaneal were reviewed, including 25 males and 17 females, ranging in age from 18 to 74 years, with an average of 41.4 years. Twenty patients had fractures in the left and 22 in the right. Twenty-three patients were treated with anatomical plate fixation, 19 patients were treated with Kirchners wires or cannulated screws fixation. The average period of swelling in soft tissue, joint function and complications were evaluated.

RESULTSForty-two patients were followed up, and the duration ranged from 3 to 18 months, with a mean of 8.3 months. The pain was markedly relieved at the next day after reduction, and the swelling was relieved in 3 to 5 days. The operative was simplified and the average operative time was 90 minutes. The swelling was relieved in 4 to 7 days after the operation, and the necrosis of skin was not found. The average postoperatively Böhler angle was (31 +/- 3.2) degrees. Gissane angle was (112 +/- 5.3) degrees. Calcaneal width was (30.2 +/- 0.89) mm. According to Maryland foot function score system, 16 patients got an excellent result, 18 good, 6 fair and 2 bad.

CONCLUSIONThe operation is simplified, and skin complications decrease, as well as the detumescence period is shortened.

Adolescent ; Adult ; Aged ; Calcaneus ; surgery ; Combined Modality Therapy ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; surgery ; therapy ; Humans ; Male ; Middle Aged ; Musculoskeletal Manipulations ; Young Adult

OBJECTIVETo study the clinicopathologic features and significance of aberrant CD56 expression in diffuse large B-cell lymphoma (DLBCL).

METHODSThe clinical and pathologic profiles of 10 cases of DLBCL with aberrant expression of CD56 were investigated. Immunohistochemical staining, in-situ hybridization for Epstein-Barr virus encoded RNA and gene rearrangement for IgH and Igκ were carried out.

RESULTSThere were 6 male and 4 female patients. The medium age of patients was 46 years. All of them presented with extranodal lymphoma involvement, with gastrointestinal tract being the commonest site (5/10). Histologic examination showed that most of the atypical lymphoid cells were centroblast-like and demonstrated a diffuse growth pattern. Apoptosis and necrosis were identified in some cases. Immunohistochemical study showed that the tumor cells were positive for CD20 or CD79α and aberrantly expressed CD56. Five cases had the GCB phenotype while the remaining cases had the non-GCB phenotype, according to Hans classification. Bcl-6 was positive in most cases (9/10). All cases showed a high proliferation index by Ki-67. The tumor cells were negative for CD3ε, CD138 and granzyme B. In-situ hybridization for Epstein-Barr virus encoded RNA was performed in 7 cases and none of them showed positive signals. IgH gene rearranged bands were detected in 4 cases (4/6) and Igκ was detected in 3 cases (3/6). Follow-up data were available in 8 patients. Two patients died of disease progression within 5 to 13 months after diagnosis and the other 6 patients were alive 8 to 60 months after therapy.

CONCLUSIONSDLBCL with aberrant expression of CD56 is rare. Most of them present with extranodal involvement, show high frequency of bcl-6 expression and high proliferation index. The patients often have good response to chemotherapy.

Antigens, CD20 ; metabolism ; Apoptosis ; CD56 Antigen ; metabolism ; CD79 Antigens ; metabolism ; Disease Progression ; Female ; Gene Rearrangement ; Granzymes ; metabolism ; Herpesvirus 4, Human ; genetics ; Humans ; Immunophenotyping ; In Situ Hybridization ; Lymphoma, Large B-Cell, Diffuse ; genetics ; metabolism ; pathology ; Male ; Middle Aged ; Necrosis ; Phenotype ; Proto-Oncogene Proteins c-bcl-6 ; metabolism ; RNA, Viral ; analysis

The purpose of this study was to investigate how Zuogui pills from the Kidney-tonifying and Nourishing Yin formula, in combination with the gonadotrophin-releasing hormone antagonist cetrorelix, affected the ovarian local oxidative stress response in decreasing ovarian reserve (DOR) mice. All animal experiments were carried out in accordance with the guidelines and standards established by Jinan University's Experimental Animal Management Committee. Cyclophosphamide (CTX)-treated DOR mice were given Zuogui pills, cetrorelix, or a combination of the two drugs intragastrically. After treatment, there were changes in the estrous cycle, serum sex hormone levels, oxidative stress-related indexes, growth biochemical factor levels, and SIRT1/P53/P21 expression. In comparison to the model group, the Zuogui pills and the cetrorelix+Zuogui pills group had significantly prolonged estrous periods and shortened interestrous periods, and the cetrorelix+Zuogui pills group had a significantly shortened cycle length. Follicle-stimulating hormone (FSH) decreased and estradiol (E₂) increased in all treatment groups compared to the model group, oxidative stress indexes nitric oxide synthase (NOS), nitric oxide (NO), and reactive oxygen species (ROS) decreased, growth biochemical factors brain derived neurotrophic factor (BDNF) and growth differentiation factor 9 (GDF-9) concentrations increased significantly, and leukemia inhibitory factor (LIF) showed no significant change. SIRT1/P53/P21 immunohistochemical results revealed that, when compared to the model group, the expression of SIRT1 increased while the expression of P53 and P21 proteins decreased in all treatment groups, with the cetrorelix+Zuogui pills group having the largest decrease, with significant differences in all indicators. We conclude that cetrorelix combined with Zuogui pills for kidney nourishing and Yin recipe improved the oxidative stress response in the follicle by regulating the SIRT1/P53/P21 pathway, reducing peroxide product production, protecting ovarian function, and regulating ovarian hormone secretion, and its efficacy is superior to that of cetrorelix or Zuogui pills alone.

Objective: To understand levels of various foods and nutrients in school lunch based on digital platform and to provide reference for food preparation and serving. Methods: A total of 13 018 school lunch recipes in Binhai New Area of 96 schools in Tianjin from November 2020 to April 2021 were collected by using digital management platform for food safety and nutritional health.Food types including cereals and tubers, vegetables, fruits, livestock and poultry meat, fish and shrimp, eggs, milk and dairy products, legumes and their products/nuts and others energy, and nutrients including protein, fat, carbohydrate, calcium, iron, zinc, selenium, vitamin A, vitamin B 1, vitamin B 2, vitamin C and dietary fiber were evaluated. Results: The qualified rate of all kinds of food for students lunch from high to low were 96.8% (116.4 g) of livestock and poultry meat, 92.3% (179.5 g) of cereal and potato, 65.0% (170.6 g) of vegetables, 47.7% (21.4 g) of soybeans and their products/nuts, 33.4% (18.0 g) of eggs, 14.4% (8.5 g) of fish and shrimp, 14.1% (19.6 g) of fruits, 0.3% (35.4 g) of milk and dairy products. There were significant differences in the qualified rate of various food intake among different grades( P <0.05). The qualified rate of students lunch energy was 76.9%(932.6 kcal). The qualified rates of various nutrients from high to low were iron 96.9%(9.7 mg), zinc 96.8%(5.9 mg), protein 96.4%(43.8 g), carbohydrate 87.6%(130.8 g) and selenium 82.9%(23.5 μg), vitamin C 78.5%(48.8 mg), vitamin B 1 75.9%(0.5 mg), fat 74.3%(28.5 g), vitamin A 74.1%(327.1 μ g) vitamin B 2 49.9%(0.5 mg), dietary fiber 19.5%(5.9 g) and calcium 13.4%(246.1 mg). There were significant differences in the qualified rates of energy and nutrients among different grades( P <0.05). Conclusion The digital platform basically meets school lunch requirments on food types and nutrients, but still with problems regarding insufficient fish and shrimp, fruits, milk and dairy products, vitamin B 2, dietary fiber and calcium. It is suggested to optimize school lunch recipes or increase corresponding nutrients content in other meals.

OBJECTIVETo investigate the relationship between parental exposure to chemicals and the risk of childhood acute leukemia.

METHODSAn exploratory case-control study was conducted among 201 new cases of childhood acute leukemia under 15 years old who went to 3 children's hospitals in Shanghai, China from January 1, 2009 to December 31, 2010, as well as 201 sex- and age-matched children (as controls) who went to the child health care clinic or department of orthopedics in the above hospitals. A survey was performed by face-to-face interviews with children's mothers.

RESULTSThe risk factors for childhood acute leukemia might include maternal exposure to total chemicals (diesel oil, gasoline, paints, insecticides, pesticides, herbicides, and chemical fertilizers) from 3 months before pregnancy to the end of pregnancy (OR = 2.9, 95%CI = 1.1 ∼ 7.8), paternal exposure to insecticides (OR = 10.1, 95%CI = 1.2 ∼ 82.9) and chemical fertilizers (OR = 9.5, 95%CI = 1.1 ∼ 79.6) within 3 months before pregnancy, maternal working experiences in agriculture and forestry before pregnancy (OR = 8.4, 95%CI = 1.4 ∼ 50.2) and in spinning, leather processing, decoration, and vehicle repair before pregnancy (OR = 3.0, 95%CI = 1.2 ∼ 7.9) and during pregnancy (OR = 3.2, 95%CI = 1.1 ∼ 9.6), and paternal working experiences in agriculture and forestry (OR = 9.6, 95%CI = 2.1-44.8) and in spinning, leather processing, decoration, and vehicle repair (OR = 2.3, 95%CI = 1.1-5.0).

CONCLUSIONParental exposure to chemicals may increase the risk of childhood acute leukemia in their offspring.

Acute Disease ; Child ; Child, Preschool ; China ; Female ; Humans ; Leukemia ; etiology ; Male ; Maternal Exposure ; adverse effects ; Paternal Exposure ; adverse effects ; Pregnancy ; Risk Factors ; Surveys and Questionnaires

OBJECTIVETo detect the GJB2 gene mutation in patients with autosomal-recessive deafness, and analyze the relationship between clinical phenotype and gene mutation.

METHODSForty-two patients were examined clinically by pure tone audiometry, acoustic impedance and auditory brainstem response. The complete coding region of the GJB2 gene was amplified by polymerase chain reaction (PCR) and the PCR products were subjected to automatic DNA sequencing.

RESULTSTwo cases had homozygous mutation of 235delC. One of them had sensorineural hearing loss while the other had mixed hearing loss. Heterozygous mutation of 176del16bp was detected in a pair of twins who had mixed hearing loss. The 109G to A, 79G to A and 341A to G mutations were observed in both the patients and the controls.

CONCLUSIONHomozygous 235delC mutation is one of the pathogeni c mutations which could occur in patients with mixed hearing loss. The heterozygous 176del16bp mutation combined with environmental factor may cause hearing loss. The 109G to A, 79G to A and 341A to G variants were considered to be polymorphisms of the GJB2 gene.

Adult ; Connexin 26 ; Connexins ; genetics ; DNA, Mitochondrial ; Deafness ; genetics ; Female ; Gene Frequency ; Genetic Testing ; Hearing Loss ; genetics ; Hearing Loss, Sensorineural ; genetics ; Humans ; Infant, Newborn ; Male ; Mutagenesis, Insertional ; Mutation ; Persons With Hearing Impairments ; Polymorphism, Genetic ; Sequence Deletion