ObjectiveTo find out the prevalence of brucellosis in Baotou,and to provide a scientific basis for integrated control of brucellosis.MethodIn 2010,high-risk people 7 to 70 years of age engaged in livestock farming,grazing,slaughtering,processing and selling were investigated in 9 districts (banners,counties)of Baotou city.In accordance with the principle of informed consent,blood samples were collected,serum titer was tested using the rose bengal agglutination test and tube agglutination test(SAT),and serum titer of 1:100(+ +) was considered as positive brucellosis,and results were evaluated based on brucellosis monitoring standards(GB 16885-1997).ResultsA total of 5832 copy blood samples were collected,and 250 cases were tested positive,the positive rate was 4.25％.The number of new cases was 164,accounting for 2.81％ (164/5832).Age was mainly concentrated in the 40 to 60 years,accounting for 66.0％(165/250).Brucellosis infection in the livestock industry accounted for 80.87％ (4757/5882).From the regional distribution,DAMAOQI had the most detected cases,and the detection rate was 12.10％ (73/603).ConclusionsContinue to increase the brucellosis prevention knowledge propaganda,carry out brucellosis surveillance of high-risk people,quarantine,and strengthen immunity is the only measure of effective control of brucellosis epidemic.

Objective To understand the arsenic level in drinking water and the current situation in prevention and control of endemic arsenic poisoning in Tuyouqi,Baotou of Inner Mongolia.Methods Through door-to-door survey,we selected patients with arsenic poisoning in order to monitor the arsenic poisoning condition of seven villages(Gangfangying,Laohuyao,Shilaozhang,Youfangying,Wanglaosi,Dajing and Xiaojing) in Tuyouqi,Baotou in 2010,and the disease was diagnosed based on Standard of Diagnosis for Endemic Arsenism(WS/T 211-2001).We also investigated the operation of Salaqi Water Company,Maodai Water Company and the Laohuyao water improvement project.We collected two samples per place in both low water period and high water period to measure water arsenic with silver diethyldithiocarbamate spectrophotometry(WS/T 28-1996).Results Three water improving projects were operating in normal conditions.Water arsenic in Salaqi Water Company and Maodai Water Company was level less than 0.01 mg/L,which met the National Safety Standards of drinking water with arsenic.Water arsenic in Laohuyao improvement project was 0.053 mg/L,which was higher than the drinking water safety standards.The seven villages in Tuyouqi had improved their water conditions.Among them,the arsenic level in Laohuyao was 0.052 mg/L,and the remaining six villages were ＜ 0.05 mg/L.There were 6 suspected cases,14 mild cases,4 moderate cases and 10 severe cases of the 2095 people monitored and no new cases found.The age of patients with arsenic poisoning was in the range of 40 to 70.Conclusions The monitoring results show that drinking water arsenic level in some villages in Tuyouqi is still excessive,but no new arsenic poisoning patients in arsenic poisoning areas are found.

Objective To understand biochemistry study situation in clinical medicine undergraduates and to improve biochemistry teaching quality.Methods Totally 120 clinical medicine undergraduates were enrolled randomly to receive investigation on problems related to biochemistry.Corresponding statistic analysis was made using softwares of Excel and SPSS 16.0 in view of the main problems.Results One hundred and twenty copies of survey questionnaires were finished.There were 114 effective copies and the effective rate was 95％ after checking on these questionnaires.61.4％ of the students neither liked nor disliked biochemistry course; 56.1％ of the students thought that learning biochemistry was difficult; students thought that chapter 4 sugar metabolism,chapter 5 lipid metabolism and chapter 6 biological oxidation to be very difficult.Only 11％ of the students did preview,further analysis found positive relation between preview and understanding (rj =0.288,P ＜ 0.01 ).Conclusion Clinical medicine undergraduates like biochemistry insufficiently with few doing preview.It suggests that teachers should pay attention to the cultivation and stimulation of students' interest in biochemistry course,improve teaching method for the difficult sections,strengthen experiment teaching and try combination and separation teaching mode.

Objective: To observe the clinical efficacy of electroacupuncture (EA) plus long-snake moxibustion for rheumatoid arthritis (RA) due to kidney deficiency and cold coagulation. Methods: A total of 60 patients in active stage of RA were randomly divided into an observation group and a control group, with 30 cases in each group. Patients in the control group took methotrexate tablets and nimesulide dispersible tablets orally for treatment, while those in the observation group received additional treatment of EA plus long-snake moxibustion. Both groups were treated for 12 weeks. The post-treatment changes in symptomatic grading and quantifying score, disease activity score with 28 joint counts (DAS28), and inflammatory indicators erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were observed, and the efficacy was evaluated. Results: The total effective rate in the observation group was 89.9％, versus 76.6％ in the control group, and there was a significant difference in the total effective rate between the two groups (P<0.05). After treatment, the symptomatic grading and quantifying score and DAS28 in both groups were significantly improved (all P<0.05), and the improvements in the observation group were more significant than those in the control group (both P<0.05). Besides, there were 11 cases with low disease activity index (DAI) and in remission in the observation group versus 5 cases in the control group, showing a statistically significant between-group difference (P<0.05). The ESR and CRP scores in both groups were significantly reduced after treatment (all P<0.05), also showing statistically significant between-group differences (both P<0.05). Conclusion: The efficacy of additional EA plus long-snake moxibustion based on oral medications for RA due to kidney deficiency and cold coagulation is better than that of the oral medications alone.

Objective: To analyze the relationship between hemoglobin ( Hb ) and serum uric acid ( SUA ), so as to provide basis for preventing hyperuricemia ( HUA ) . Methods: As the research subjects, people who underwent physical examination in Zhejiang Provincial People's Hospital from January 1, 2017 to October 31, 2020 for 4 years in a row and who were non-HUA in 2017 were selected. The physical examination data were collected, including body mass index, blood pressure, blood routine, blood biochemical tests, etc. The subjects grouped by quartiles of Hb level in 2017. The occurrence of SUA elevation ( SUA increased ≥60 μmol/L from baseline ) , significantly SUA elevation ( SUA increased ≥120 μmol/L from baseline ), HUA ( SUA>420 μmol/L ) and severe HUA ( SUA ≥480 μmol/L ) in the next 3 years were taken as end events. The incidence, occurrence time and risk of end events in different Hb groups were analyzed. Results: A total of 4 073 subjects were selected and divided into 4 groups according to the Hb level from low to high, with 969 subjects in group A, 907 subjects in group B, 1 109 subjects in group C and 1 088 subjects in group D. SUA elevation was in 745 patients ( 18.29% ); significantly SUA elevation was in 105 patients ( 2.58% ); HUA was in 514 patients ( 12.62% ); severe HUA was in 94 patients ( 2.31% ). The incidence of SUA elevation and significantly SUA elevation showed a decreasing trend with the increase of Hb level ( P<0.05 ). The occurrence time of SUA elevation in group A to D was 2.788, 2.817, 2.860 and 2.814 years, and the difference was statistically significant ( P<0.05 ). There were no statistically significant differences in the occurrence time of other end events ( P>0.05 ). The multivariate Cox proportional hazards regression analysis showed that compared with group A, other Hb groups had lower risk ( HR=0.498-0.776, 95%CI:0.253-0.981 ) of SUA elevation, significantly SUA elevation and severe HUA after adjusting for gender, age, ALT, Scr, body mass index, etc. Conclusions With the increase of Hb level, the incidence of SUA elevation may decrease and the occurrence time is prolonged. Compared with the lowest Hb group, the higher Hb groups had lower risk of SUA elevation, significantly SUA elevation and severe HUA.

OBJECTIVETo compare the effect,safety,and advantage of flexible fixation with paperboard and pad versus short leg plaster in treating the fifth metatarsal base fracture,and establish the standard of diagnosis and treatment of the fifth metatarsal base fractures in flexible fixation with paperboard and pad.

METHODSFrom June 2010 to March 2013,59 patients with the fifth metatarsal base fracture were treated with paperboard and pad fixation or short leg plaster. Patients were enrolled and divided into paperboard and pad treatment group (paperboard group) and short leg plaster treatment group (plaster group) randomly according to the random number table. In paperboard group,there were 29 cases including 9 males and 20 females with an average age of (51.79±11.40) years old; the average course of injury was (11.59±6.58) hours. In plaster group, there were 30 cases including 9 males and 21 females with an average age of (52.13+17.34) years old ;the average course of injury was (11.03±7.06) hours. According to whether the fracture line across the articular surface, in paperboard group there were 14 cases of type A,15 of type B; in plaster group,16 of type A, 14 of type B. According to the degree of dislocation,in paperboard group there were 16 cases of degree I ,13 of degree II ; in plaster group,20 were degree I ,10 were degree II. Fracture was restored according to the type in manual. Patients in paperboard group were treated with paperboard and pad, and patients in plaster group were treated with short leg plaster. Fracture was fixed for 4 to 6 weeks according to fracture healing. On the 2nd, 4th,6th, 8th week and 3rd, 6th month after fixation, patients were followed up, and the foot function score was used to evaluate the function of injured foot. X-ray of injured foot was taken on the 2nd, 4th, 6th and 8th week were used to assess fracture healing.

RESULTSAll patients got complete follow-up. The X-ray result showed that all fracture reached at clinical healing on the 8th week after fixation without skin ulcer,nonunion and displacement of fracture. From the 4th to 8th week after fixation, paperboard group had a higher X-ray score than plaster group, but the difference between two groups had no statistically significance. Repeated analysis result showed that there was interact at different time point and between groups,the difference had statistically significance (P<0.01). The foot function score showed that at all time point, paperboard group had a higher score than plaster group, and on the 2nd, 4th, and 6th week, it had statistically significant difference(P<0.01) between two groups. On the 6th months after fixation,the excellent and good rate of paperboard group was 93.10%, higher than that of plaster group, which was 86.67%. But it had no statistically difference(P=0.483) between two groups.

CONCLUSIONUsing paperboard and pad fixation to treat the fifth metatarsal base fracture has the advantage of simplicity operating,reliable fixation, satisfactory effects, easily obtainable material.

Adult ; Aged ; Casts, Surgical ; Female ; Foot Injuries ; physiopathology ; surgery ; Fracture Fixation ; instrumentation ; methods ; Fracture Healing ; Fractures, Bone ; physiopathology ; surgery ; Humans ; Male ; Metatarsal Bones ; injuries ; physiopathology ; surgery ; Middle Aged

According to the current situation of biochemistry teaching and the theoretical characteristics of constructivism,the necessity and feasibility of applying constructivism to the biochemistry teaching were analyzed.Consequently,the implementation strategies of constructivism theory in the process of biochemistry teaching were introduced in detail.Through the reasonable choice of teaching content and the optimal combination of various teaching methods,it was helpful not only to realize the student-centered active construction of knowledge,but also to improve the comprehensive quality of students.At last,we performed a dialectical thought on the constructivism theory.In the concrete teaching practice,the different teaching theories should be used rationally and comprehensively based on the actual situation to improve the teaching quality of biochemistry.

To study the role of BK virus(BK polyomavirus)in the development of the hemorrhagic cystitis(HC)after hematopoietic stem cell transplantation(HSCT)and analyze the risk fators for BK viruri4a and HC.Methods From August 2006 to November 2007,blood and urine samples were collected from 80 patients undergoing HSCT.BK virus DNA was detected with PCR.Cytomegalovirus (CMV)antigen was detected with immunofluorescence histochemical examination.A control group including 20 healthy individuals was established.Results Late-onset HC occurred in 15 of the 80 HSCT patients with an incidence of 18.8%.The median onset time of HC was 44(13-150)days after transplantation.BK viruria was detected in 30 of the 80 HSCT patients(37.5%)and the positive rate of viruria in the HC patients was 86.7%(13/15).The median time of BK viruria detection in HC patients wag 23(0-56)days after transplantation,being earlier than the onset time of HC.The persistence time of BK viruria was 7(2-14) weeks,being much longer than that of HC(11 days).CMV antigen viremia was detected in 12 of the 80 transplanted patients.with a positive rate of 36.7% in patients with BK viruria and 40.0% in HC patients.Nine of the 30 HC patients developed acute graft versus host disease(Agvhd)of grade Ⅱ-Ⅳ(30.0%).BK virus was not detected in the urine of the remainimg two HC patients and the 20 control subjects as well as in all the blood samples.Univariate analysis indicated that CMV viremia and Agvhd of grade Ⅱ-Ⅳ were agsociated with the occurrence of BK viruria.Condusions BK viruria is the main cauge of the late-onset HC after HSCT.CMV infection and Agvhd may contribute to the occurrence of HC agsociatieg with BK virus.

Objective To compare volumetric‐modulated arc therapy(VMAT) with intensity‐modulated radiation therapy (IMRT) for brain metastases with regard to the dosimetric character .Methods Sixty patients who were diagnosed with brain me‐tastases were included in this study .The target area received two dose levels using late addition amount technique ,WBRT (30 Gy/10 F) with following addition (20 Gy/10 F) to 59 Gy .For a fair comparison ,VMAT and IMRT treatment plans were respectively designed for every patient with the same dosimetric constraints .Dosimetric comparisons between VMAT and IMRT plans were ana‐lyzed to evaluate :target coverage and homogeneity ,conformity of PTV ;sparing of OARs ;monitor units (MUs) .Results Two treatment plans all reached the treatment need .When compared with IMRT ,there was no significant difference in Dmean of eyeball , len ,optic never ,visual chiasma ,parotid ,brain stem ,and external auditory canal of VMAT (P>0 .05) .The Dmax of eyeball ,len ,pa‐rotid ,and external auditory canal of VMAT were lower than that in IMRT group (P<0 .05) .The VMAT group has the less MUs (P=0 .017) and less treatment time .Conclusion VMAT can reach the big‐dose radiotherapy need on brain metastases clinically . There are no significant diffference between VMAT and IMRT on Dmax ,Dmean ,CI ,and HI .The Dmax of eyeball ,len ,parotid ,and external auditory canal of VMAT were lower than that in IMRT group .The VMAT can reduce the radiotherapy time .

Objective To evaluate the effect of nutritional intervention on neurological rehabilitation of the elderly stroke patients. Methods Forty elderly patients with sequelae of stroke were recruited and randomly divided into two groups (intervention group and control group). Nutritional intervention including patient and caregiver education and nutrient supplement was carried out for three months in intervention group in addition to the conventional pharmacotherapy and rehabilitative training, and only conventional pharmacotherapy and rehabilitative training were given to the patients of the control group. The nutritional status of both groups was examined monthly, and the infectious morbidity and neurological improvement in both groups were also monitored at the same time. Results There were significant differences between the intervention group and the control group with regard to the nutritional status as indicated by various parameters [albumin(39.65?6.11)g/L vs (37.48?6.57)g/L,hemoglobin(12.68?1.21)g/dl vs (11.72?1.81)g/dl,IgG(11.28?2.61)g/L vs (8.57?1.98)g/L,complement C3(0.84?0.11)g/L vs (0.62?0.09)g/L,BMI(25.26?3.81)vs (23.51? 3.73),all P