Objective To probe into the present family bed workloads at community health centers in Shanghai,for bettering the service mode.Methods 41 community health centers in 17 districts or counties in Shanghai were randomly sampled with questionnaires,to learn the profile of the family beds and analyze the workloads provided by the institutions from 2010 to 2012.Results For the 41 institutions surveyed,patients aged 60 or above accounted for 95.07％ of the total patients,of whom the seniors over age 80 accounted for 51.00％; 3-year family bed setup rate is 4.45‰,5.09‰ and 5.51‰ respectively;the family bed checkup interval is 6.26 days,6.08 days and 5.84 days respectively.The average monthly payment from medical insurance per person is 441.86 yuan in 2010,433.41 in 2011,and 401.26 in 2012.Diseases makeup:Cardiovascular diseases accounting for 51.16 ％of the total,stroke patients for 31.02 ％,chronic bronchitis for 4.81％,and cancer patients for 1.10％.Among those patients withdrawn from family beds,86.54％ were cured,steady plus improvements.Conclusion Further improvement of the family bed service for better elderly chronic care management; preferential policies to further enhance the family bed service capabilities; emphasis of internal management to continuously improve the social benefits.

To analyze influenza pathogen spectrum in Yunnan province during 2009-2014 years, and analyze HA and NA genes of influenza A H1N1. Analysis was made on the monitoring date of influenza cases in Yunnan province in recent 6 years, 23 strains of influenza virus of HA and NA gene was sequenced and analyzed by MEGA 5 software to construct phylogenetic tree. 4 times of influenza AH1N1 epidemic peak were monitored from 2009-2014 years in Yunnan Province, as the nucleic acid detection results of influenza A H1N1 accounted for 28.8% of the total. The sequencing result showed that HA and NA gene were divided into 3 groups, one was detected with H275Y mutation strains. Influenza A H1N1 is one of the important subtypes in Yunnan province and their genes have divided into three branches during the period of 2009-2014 years, the vast majority of influenza a H1N1 are still sensitive to neuraminidase inhibitors.
China ; epidemiology ; Hemagglutinin Glycoproteins, Influenza Virus ; genetics ; metabolism ; Humans ; Influenza A Virus, H1N1 Subtype ; classification ; enzymology ; genetics ; isolation & purification ; Influenza, Human ; epidemiology ; virology ; Molecular Sequence Data ; Mutation ; Neuraminidase ; genetics ; metabolism ; Phylogeny ; Viral Proteins ; genetics ; metabolism

Objective To investigate the risk factors of prognosis of gram-positive bacteria associated nosocomial bloodstream infections,and to investigate the drug resistance of the strains.Methods A total of 132 patients with gram-positive bacteria associated nosocomial bloodstream infections were collected from the First Affiliated Hospital of Zhejiang Chinese Medicine University during January 2010 and December 2012.Clinical data including demographic characteristics,underlying diseases,risk factors and use of antibacterial agents were retrospectively analyzed.According to 28-day prognosis,patients were divided into survival group (n =97) and death group (n =35).Binary logistic regression was used to identify the risk factors of 28-day fatality.Results Among 132 patients,49 (37.12％) were infected with coagulase-negative Staphylococcus,46 (34.85％) were infected with Staphylococcus aureus,37 (28.03％)were infected with Enterococcus.The rates of methicillin resistant coagulase negative Staphylococci (MRCNS) and methicillin-resistant Staphylococcus aureus (MRSA) were 77.55％ (38/49) and 54.35％ (25/46),respectively.The rate of linezolid resistant coagulase negative Staphylococci was 8.16％ (4/49) ; Four out of 37 strains (10.81％) of Enterococcus were both resistant to vancomycin and linezolid.Binary logistic regression showed that septic shock (OR =34.344,95％ CI:6.539-180.389,P =0.000),deep venous catheterization (OR =13.411,95％ CI:1.877-95.832,P =0.010),no catheter removal after infection (OR =8.759,95％ CI:2.197-34.911,P =0.002),parenteral nutrition (OR =3.684,95％ CI:1.072-12.663,P =0.038),inappropriate antibacterial therapy in early stage (OR =12.951,95％ CI:2.075-80.836,P =0.006) and Enterococcus associated bloodstream infections (OR =4.227,95％ CI:1.090-16.394,P =0.037) were independent risk factors of 28-day fatality in patients with gram-positive bacteria associated nosocomial bloodstream infections.Conclusions The predominant pathogens are coagulase-negative Staphylococcus,Staphylococcus aureus and Enterococcus in gram-positive bacteria associated nosocomial bloodstream infections.Patients with septic shock,deep venous catheterization,no catheter removal after infection,parenteral nutrition,inappropriate antibacterial therapy in early stage and Enterococcus associated bloodstream infections are likely to have high fatality rate.

Objective To evaluate the effects of sevoflurane postconditioning on the oncosis and apoptosis in cardiomyocytes during ischemia-reperfusion (I/R) in isolated rat hearts and the role of extracellular signalregulated protein kinase 1/2 (ERK1/2) signal transduction pathway in it.Methods Seventy-two isolated rat hearts perfused in a Langendorff apparatus were randomly divided into 6 groups (n =12 each) using a random number table:sham operation group (group S),myocardial I/R group (group I/R),sevoflurane postconditioning group (group SP),PD98059 vehicle dimethyl sulfoxide (DMSO) group (group DMSO),selective ERK1/2 inhibitor PD98059 group (group PD),and sevoflurane postconditioning + PD98059 group (group SP + PD).The hearts were subjected to ischemia for 30 min followed by 2 h reperfusion in the other groups except group S.In SP,DMSO and PD groups,the hearts were perfused with K-H solution saturated with 3.0％ sevoflurane,DMSO (＜0.2％) and PD98059 (20 μmol/L),respectively,for 15 min starting from the end of ischemia until 15 min of reperfusion,and then with plain K-H solution for 105 min.In group SP+ PD,the hearts were perfused with K-H solution saturated with 3.0％ sevoflurane and PD98059 for 15 min starting from the end of ischemia until 15 min of reperfusion.Myocardial infarct size and expression of porimin and caspase-8 proteins (by Western blot) were measured at the end of reperfusion.Results Compared with S group,the myocardial infarct size was significantly increased,and the expression of porimin and caspase-8 proteins was up-regulated in the other groups (P ＜ 0.05).Compared with I/R group,the myocardial infarct size was significantly decreased,and the expression of porimin and caspase-8 proteins was down-regulated in group SP (P ＜ 0.05),and no significant changes were found in the other groups (P ＞ 0.05).Conclusion Sevoflurane postconditioning can activate ERK1/2 signal transduction pathway and inhibit the oncosis and apoptosis in cardiomyocytes,thus attenuating I/R injury in isolated rat hearts.

Objective To understand the viral etiology of acute respiratory infection in Kunming area. Methods We collected the nasopharyngeal swab of patients with acute respiratory tract infection,and used multiple reverse transcription-polymerase chain reaction (RT-PCR) method to detect 15 kinds of respiratory viral pathogens. Results Among the 600 samples,144 strains of viruses were detected, the positive rate was 24%,among which the highest positive rate was RSV (49/600,8.2%),followed by PIV (32/600,5.3%) HRV (27/600,4.5%) and IFV27 (27/600,4.5%) . The respiratory virus infection situation was different in every age group, groups of the highest virus positive rate was ≤1 age group (72/216, 33.3%);The respiratory virus infection situation in different seasons was different, the virus positive rate of the first quarter was the highest (85/144, 59%) . Conclusion RSV was the main virus pathogen of acute respiratory tract infections in Kunming area in 2011 years, the detection rate in sick children was the highest among all patients;the detection rate in the first quarter was higher than other quarters.

Objective To investigate the mutation of hemagglutinin gene and amino acid variation of influenza B.Methods Influenza B virus was isolated from throat swab samples in sentinel surveillance of Yunnan province from 2009 to 2014.HA1 gene sequence analysis was applied to determine 12 randomly-selected strains of influenza B virus.The results were analyzed,MEGA software was used to do homology comparison and HA gene phylogenetic tree was established.Results Differences on the serotype and genotype identification of influenza strains were found and it might be caused by inadequate gene mutation accumulation.Amino acid variations were found in 3 important regions of antigenic determinants in HA1 protein:ring 120,ring 150 and ring 160.The amino acid variation of position 131 in ring 120 was N131K,and in position 137 was N137H.Two strains had P187S mutation in position 187.Conclusion There are some important variations in the hemagglutinin gene of influenza B strains in Yunnan Province,with some variations being the same as vaccine strains and some being not.

Objective To study the role of microRNAs ( miRNAs ) in ALK-negative anaplastic large cell lymphoma and CD 30 positive peripheral T cell lymphoma ( not otherwise specified ) , and discuss the pathogenesis of miRNAs in ALK-negative anaplastic large cell lymphoma.Methods Three cases of ALK-negative anaplastic large cell lymphoma of lymph node , 3 cases of CD30-positive peripheral T cell lymphoma ( not otherwise specified ) of lymph node and 3 cases of reactive hyperplasia of lymph node were detected by high flow microarray of miRNAs.The method of real-time quantitative polymerase chain reaction was further applied for 7 miRNAs in 15 cases of ALK-negatie anaplastic large cell lymphomas of lymph node and 15 cases of CD30-positive peripheral T cell lymphoma ( not otherwise specified ) of lymph node.Results The significant difference of 13 miRNAs was found between ALK-negative anaplastic large cell lymphoma and CD30 positive peripheral T cell lymphoma ( not otherwise specified ) ( P<0.05 ) , of which the result of 5 miRNAs was consistent with miRNAs expression spectrum:miR-664b-5p, miR-1275, miR-4739, miR-4736 and miR-504-5p, the difference was statistically significant (P<0.05).Compared with reactive hyperplasia of lymph nodes, miR-664b-5p, miR-1275 and miR-4739 were significantly under-expressed (P=0.004, P=0.021, P=0.031) and miR-4736 and miR-504-5p were significantly over-expressed ( P=0.009, P=0.007) in ALK negative anaplastic large cell lymphoma.Conclusions MiR-664b-5p, miR-1275, miR-4739, miR-4736 and miR-504-5p may become an important indicator in the differentiation ALK-negative anaplastic large cell lymphoma from CD 30-positive peripheral T cell lymphoma ( not otherwise specified).MiR-4739, miR-4736 and miR-1275 may play important role in pathogenesis of negative-anaplastic large cell lymphoma by target genes:TNFRSF8 and TMOD1.

Objective:To study the genetic characteristics and genetic evolution of echovirus 30 (ECHO30) isolates in Yunnan Province, China.Methods:Virus isolation was performed on nucleic acid-positive samples for hand, foot, and mouth disease pathogen surveillance in Yunnan Province, and VP1 gene sequencing was performed. The sequences of eight ECHO30 isolates from Yunnan Province and the gene sequences of the VP1 region of the ECHO30 reference strain downloaded from GenBank were compared and analyzed using MEGA 5.0 software, and then a phylogenetic tree was constructed to measure the homology of nucleotides and amino acids between the isolates.Results:The ECHO30 virus was distributed in Wenshan, Qujing, Chuxiong, and Kunming in Yunnan Province. The ECHO30 virus was relatively common in Wenshan. ECHO30 isolates belonged to the H2 subtype of the H genotype, which was close to the local reference strain LC120939 in Yunnan Province. On the VP1 gene at site 5, the amino acid change ratio was more active, the amino acids were diverse, and mutations also occurred at sites 54, 156, 258, and so on. Nucleotide and amino acid homology were 84.0% - 100.0% and 98.4% - 100.0%, respectively.Conclusions:ECHO30 isolates from Yunnan Province have certain geographical characteristics and belong to H2 of the H genotype. The nucleotide differences in virus sequences among subtypes are small and have a close genetic relationship.

Objective:To do genetic analysis on the VP1 gene of 2 Coxsackievirus A12 (CV-A12) isolated from hand, foot and mouth disease (HFMD) surveillance in Yunnan province.Methods:Coxsackievirus isolation was carried out in RD cells from the clinical samples. CV-A12 strains were identified by realtime RT-PCR and sequencing technology from the positive cultures. The VP1 region of the CV-A12 strain was further sequenced. The VP1 gene sequences were initially aligned and then used to construct the phylogenetic tree with GenBank reference strains.Results:The two CV-A12 strains had the highest homology with the Yunnan reference strains in 2018 and the amino acids in VP1 region had specific mutations with other cluster reference strains at multiple sites.Conclusions:The CV-A12 in the HFMD cases in Yunnan province has occured regional specific mutation in VP1 gene.

Objective To summarize the clinical features of 9 cases with mutations in PKHD1 gene for a better understanding of its phenotype.Methods Clinical data of nine cases with mutations in PKHD1 gene were summarized from January 2011 to December 2016 in our center,including clinical manifestations,laboratory findings,imaging data and family investigation.Next generation sequencing was used to screen 4000 genes in case 1 to 4 and whole exons in case 5 to 9.Significant variants detected by next generation sequencing were confirmed by conventional Sanger sequencing.Segregation analysis was performed using parental DNA samples.Relevant literature was reviewed.Results Among these 9 cases,5 are male,4 are female.The average age of onset was 2.6 years old (ranging from 0.5-5.2 years).Renal ultrasound revealed that all 9 cases had cysts in bilateral kidney,7 cases with enlarged kidney,1 case with normal size kidney,1 case with normal size kidney,and 1 case with bilateral renal atrophy.Two cases with renal artery stenosis,1 case with focal narrowing in left main branch and 1 case with vesico-ureteral reflux were found.Among the 9 cases,3 cases had homozygous mutations,and 6 cases had compound heterozygous mutations,including 1 nonsense mutation,1 frameshift mutation and 15 missense mutations.There were 2 cases with 3 heterozygous mutations,2 c.5935C ＞ T mutations and 2 eases with C.5869G ＞ A mutations.A total of 10 new mutations were identified.Conclusion Patients with mutations in the PKHD1 gene had normal size kidney,or even atrophic kidney.Renal artery stenosis,vesicoureteral reflux and bronchial stenosis were all first reported in patients with mutations in PKHD1 gene.The novel mutations,c.274C ＞ T,c.9059T ＞ C,c.8996delG,c.281C ＞ T,c.10424T ＞ A,c.7092T ＞ G,c.4949T ＞ C,c.5869G ＞ A,c.6197A ＞ G and c.1877A ＞ G further expanded the mutation spectrum of PKHD1 gene.