Objective To evaluate the epidemiological characteristics of brucellosis in Jinan city and to identify its cause in order to provide evidence for development of specific preventive strategies in the future.Methods Epidemic information of the disease and survey data of brucellosis cases from 2002 to 2008 in the Infectious and Endemic Disease Control Jinan Centre for Disease Control and Prevention were analyzed statistically.Results From 2002 to 2008, 52 cases were diagnosed as brucellosis, among which 39 cases from Zhangqiu city.The incidence rate ranged from 0.02 to 0.10 hundred thousandth from 2002 to 2006, and 0.25 and 0.26 hundred thousandth in 2007 and 2008, respectively. The disease was found each mouth throughout the year, marked with summer peak[38.46%(20/52)]. Patients increased year after year in summer and spring seasons(r = 0.92, P ＜ 0.01) .The disease was most commonly found in 30 - 59 age group[69.23%(36/52)];men women incidence ratio was 1.67: 1.00;farmers accounting for 94.23%(49/52). There were 5 clusters of family outbreak brucellosis, involving 12 cases. Forty five patients contacted with sheep, accounting for 86.54% (45/52). Conclusions Brucellosis epidemic in Jinan is in an upward trend, mainly in summer and spring, elderly and middle-aged men farmers are the majority of patients. Zhangqiu of Jinan city is a key place for prevention and control of brucellosis;source of infection is not completely eliminated, exotic livestock have not been effectively quarantined, practitioners with weak sense of self-protection is the main reason of the epidemic rise.

Child ; Child Welfare ; Education, Medical, Continuing ; Humans ; Pediatrics ; education

Child, Preschool ; Diagnosis, Differential ; Female ; Humans ; Lead Poisoning, Nervous System, Childhood ; diagnosis ; therapy ; Male

ObjectiveTo find out if the immune system derived thyroid stimulating hormone(TSH) β splice variant(TSHβ-Ⅴ) would be regulated by circulating thyroid hormone levels to get a further understanding of the function and mechanism of this TSHβ-Ⅴ in thyroid homeostasis.MethodsA total of 20 weaning Balb/c mice (half male and half female) were selected and randomly divided into two groups according to their body mass and gender(n =10).Mice of control group were fed with common diet and deionized water.Mice of the low-iodine(LI) group were fed with low-iodine diet(containing iodine 20 - 40 μg/kg,iodine-intake about 0.25 μg/d) and deionized water.The experimental period was 3 months.At the end of the experiment,mice were executed and the blood was collected to observe the levels of TSH and thyroid hormone by chemiluminescence immunoassay (CIA) ; bone marrow (BM),peripheral blood(PBL),thyroid gland and pituitary were collected to assay the TSHβ-Ⅴ mRNA expression by real-time quantitative reverse transcriptase polymerase chain reaction (RT-PCR).ResultsThe serum free thyroxine(FT4) and total thyroxine(TT4) levels in LI group of mice[(0.47 ± 0.70)nmol/L,(2.41 ± 0.28)pmol/L] were significantly lower than that of the control group of mice [(55.2 ± 3.68) nmol/L, (32.72 ± 1.02) pmol/L,t =43.81,86.04 、all P ＜ 0.01 ] and the serum total triiodothyronine(TT3) and free triiodothyronine(FT3) reduction in LI group of mice[ (0.76 ± 0.08)nmol/L,(4.01 ± 0.40)pmol/L] were significantly lower than that of the control group of mice [ (1.10 ± 0.06)nmol/L,(5.40 ± 0.38)pmol/L,t =9.81,7.5 1,P ＜ 0.01 ].Iodine insufficiency strongly elevated the serum TSH in LI group of mice[ (35.67 ± 17.39)mU/L] than that in control group of mice[ (0.24 ± 0.10)mU/L,t =- 6.11,P ＜ 0.01 ].The mRNA levels of TSH β-Ⅴ in BM (9.62 ± 0.60) and in PBL( 9.25 ± 0.83 ) of LI group of mice were lower than those in control group of mice (7.69 ± 0.36,7.11 ± 0.41,t =6.77,5.64,P ＜ 0.01),while the mRNA level of TSH β-Ⅴ in pituitary of LI group of mice (1.99 ± 0.61) was increased compared with that in control group of mice (5.75 ± 0.98,t =- 8.02,P＜ 0.01).Compared with control group of mice(9.12 ± 0.62),the level of thyroid TSH β-Ⅴ mRNA in LI group of mice (9.32 ± 0.91 ) was not significantly changed (t =0.45,P ＞ 0.05).There was no detectable native TSHβ in BM,PBL and thyroid.The mRNA level of native TSHβ in pituitary in LI group of mice( - 7.17 ± 1.78) was dramatically elevated compared to that in control group of mice( - 1.43 ± 0.51,t =- 7.60,P ＜ 0.01 ).ConclusionsThe mRNA levels of TSHβ-Ⅴ are suppressed in BM and PBL in low iodinediet induced hypothyroidism mice,which suggest that immune system derived TSHβ-Ⅴ may be more important thannative TSHβ in immune-thyroid regulation.

Objective To find out the distribution characteristics of drinking water with high arsenic in Dali Prefecture, Yunnan. Methods General investigation plus sampling survey was adopted in the city of Dali and 11 counties. The arsenic content in water was tested by half-quantitative fast reagent-box method. The water samples exceeding the standard(≥0.03 mg/L) were re-tested by silver diethyldithiocarbamate eolorimetric method or mercury-atomic fluorescence spectrometric method. Population and children exposed by high-arsenic were statistically analyzed. Results Arsenic content in 15 180 samples from 2639 villages are screened, of which 14 976 samples were less than 0.01 mg/L, reaching 98.66% (14 976/15 180); 110 samples was no less than 0.05 mg/L, only accounting for 0.72%(110/15 180). Water sources with excessive arsenic was found in 29 villages, in a percentage of 1.1% of all covered villages(29/2639). The samples were constituted of 10 399 portions of well water(well was less than 10 m deep), 3903 from spring, 93 from river water, 69 from hot spring water, 26 from reservoir water and 690 from surface water. And for the samples which arsenic content were ≥0.05 mg/L, 89 samples(0.86%, 89/10 399) were from well water, 15 from spring water(0.38%, 15/3903) and 6 from spring water(8.70%, 6/69). A total of 1 561 553 individuals were investigated, in a percentage of 67.83%(1 561 553/2 302 156) of the whole population, among those 420 513 were children, rating 26.93% of the investigated population(420 513/1 561 553); 27 865 were exposed to arsenic, accounting for 1.78% of the investigated population 27 865/1 561 553; 8993 children were exposed, rating 2.14% of the investigated population(8993/420 513). Conclusions There exists high-arsenic water resources in Dali Prefecture, Yunan, so the local inhabitants are in the danger of high-arsenic exposure. Urgent attention shall be paid for the endemic arsenic including investigation, prevention and control.

OBJECTIVETo evaluate the curative effect of Danxiaoling Pill (DXLP), a Chinese herbal preparation, in treating intrahepatic cholestasis in pregnancy (ICP).

METHODSFifty-eight cases of ICP were divided randomly into two groups and treated by DXLP and Composite Yiganling as control respectively with the other identical conventional treatment. The changes of clinical symptoms, related laboratory parameters after treatment and the condition of labor were observed.

RESULTSThe total effective rate in both groups was 100%, but the markedly effective rate in the DXLP treated group was higher than that in control group (P < 0.01). Levels of blood cholyglycine acid (CGA), alanine transaminase (ALT), aspartate transaminase (AST), total bilirubin, total cholesterol and low density lipoprotein were all decreased in both groups after treatment, but DXL showed a better efficacy in decreasing CGA, ALT and AST than that of Yiganling. Moreover, the amniotic fluid meconium contaminated rate, premature delivery occurrence in the DXLP group were lower than those in the control group, while the weight of newborn baby was higher in the former than in the latter.

CONCLUSIONDXLP could effectively lower the serum bile acid and improve liver function in treating ICP.

Adult ; Alanine Transaminase ; blood ; Aspartate Aminotransferases ; blood ; Cholestasis, Intrahepatic ; blood ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Glycocholic Acid ; blood ; Humans ; Phytotherapy ; Pregnancy ; Pregnancy Complications ; blood ; drug therapy

Objective To discuss the correlation between cervical intraepithelial neoplasia(CIN) and uterine cervix cancer and the combination of TCT and colposcope for the investigation of cervical lesion.Methods 5545 patients were preliminarily screened by cervical fluid basement cell folium smear,in which 307 patients are masculine and 219 are negative,the 526 patients are suspected cervical lesions in clinical symptoms and they further underwent colposcopy and biopsy,the results were analyzed by pathohistology which is golden standard.Results CIN coherent dangerous factors analyzed by single factor Logistic regression analysis are:cervical HPV pollution,age of sexual activity,sexual partners numbers,protection of sexual life, STD history,age and frequency of miscarriage ( P < 0.05 ).The coincidence between TCT,colposeopy and pathologic diagnosis are 49.4%, 83.8% ;the omission diagnostic rate of LSIL,HSIL and CC from TCT are 63.63% ,74.44% ,100% ;the omission diagnostic rate of LSIL,HSIL and CC from colposcopy are 33.37%, 12.22% ,0;the sensitivity of TCT,colposcopy and TCT combine colposcopy for CIN are 61.2% ,84.6% ,94.5% and specificity are 85.4% ,88.2.% ,90.8%.Conclusions (1)The generation of CIN and cervical cancer are correlated with cervical HPV pollution,sexual behavior and various kinds of lower genital tract infection.(2) Fluid basement cell folium smear can promote the property of diagnosis,meet the demands of early stage uterus neck cancer and precancer lesion investigation,are suitable to be routine cheek methods in primary hospital.

Objective To evaluate the efficacy and safety of a new drug,human urinary kallidinogenase,against acute brain infarction.Method A 15-center,randomized,double-blinded and 3:1 placebo-controlled study was carried out.Acute brain infarction within 48 hours of onset in the territory of the middle cerebral artery were indicated as subjects;kallidinogenase or placebo which was dissolved in 50 ml saline,was slowly injected intraveousely within 30 minutes daily for 3 weeks.The European Stroke Scale and Barthel Index were used to evaluate the neurological deficit and the activities of daily living(ADL),followed by a follow-up at the end of the third month.Results 446 patients were enrolled,who completed ITT analysis,including 330 in kallidinogenase group and 116 in placebo group,meanwhile 421 proceeded with PP analysis(311 and 110 respectively).There were no significant differences of the baseline data between the 2 groups.At the end of treatment,the ESS scores increased by 55.1%?33.0% and 44.7%?32.8% respectively in kallidinogenase group(KG)and placebo group(PG,P=0.0022),the difference being significant.PP analysis had similar results.As for ADL,follow-up 90 days after the treatment showed 374 cases followed,280 in KG and 94 in PG;1 died in PG,while none in KG.In KG,the cases whose BI≥50 were significantly more than those in PG(P=0.0228).Adverse events possibly or definitely attributable to the drug were observed in 27 cases(7.74%),mostly were mild,such as palpitation,flush,dizziness, nausea etc,without special management needed.Only 2 died which was confirmed not correlated to kallidinogenase,and another 2 cases of sudden blood pressure drop were observed.The blood pressure drop, quickly restoring soon after the withdrawal of kallidinogenase and use of hemopiesic drugs,was considered to be caused by the combination use of anti-hypertensive drug ACEI and quick infusion speed.Conclusion Kallidinogenase is efficacious for acute brain infarction in improving the neurological deficits,which is safe in clinical use.

Objective To discuss the causes and clinical significance of conversion to laparotomy during laparoscopic surgery.Method Three thousand two hundred and three cases who underwent laparoscopic surgery during the past five years were analyzed retrospectively.Results Three thousand one hundred and eighty cases underwent laparoscopic surgery,in which 23 cases were converted to laparotomy due to factors including severe pelvic adhesions(6 cases),complex disease with difficulties in laparoscopy (7 cases),massive haemorrhage(3 cases),bladder trauma(1 case),gastric trauma(1 case),intestinal trauma(1 case),as well as unexpected malignant genitalia neoplasm(4 cases).Conclusion The major causes for the conversion to laparotomy during gynecology laparoscopic surgery are severe pelvic adhesion and complex disease with difficulties in laparoscopy.Careful evaluation before surgery and conversion to laparotomy at the right moment can decrease the complication.

?AlM: To evaluate the clinical efficacy of posterior continuous curvilinear capsulorhexis ( PCCC ) combined with anterior vitrectomy in preventing posterior capsule opacification of congenital cataract surgery.
?METHODS:Postoperative clinical follow-up data of 82 cases ( 87 eyes ) with congenital cataract treated in Eye Center of our hospital from January 2011 to August 2014 were retrospectively analyzed. The patients were divided into the surgical control group ( 38 cases, 40 eyes, recieved phacoemulsification + PCCC ) and the study group ( 44 cases, 47 eyes, accepted phacoemulsification+ PCCC + anterior vitrectomy). The incidence of central optic axis opaque and postoperative visual acuity distribution were recorded at 1a follow - up. lntraoperative and postoperative complications were observed.
?RESULTS:The rate of central optic axis opaque grade 0 in control group was 37. 5%, compared to 76. 6% in study groups. The opacity distribution ratio of grade 1,2,3 and 4 in study group were lower than that of control group, and the central optic axis opacity distribution ratio in study group was significantly better than that of control group (P<0. 05). The 19 eyes(47. 5%) of visual acuity testing ≤0. 5 in control group , was higher than the 7 eyes(14. 89%) of that in the study group, The 21 eyes (52. 5%) of visual acuity testing >0. 5 in control group was lower than the 40 eyes ( 85. 11%) of that in study group. The visual acuity between two groups has statistical significance difference after 1a follow-up ( P<0. 05 ) , and the visual acuity in study group was significantly better than that in the control group. The postoperative intraocular pressure at 1mo and 1a follow-up was lower than before operation in two groups ( P<0. 05), but there was no significant difference between two groups in intraocular pressure (P<0. 05).
?CONCLUSlON: Combination of phacoemulsification, PCCC and anterior vitrectomy presents reliable clinical effects on postoperative central optic axis opacity distribution ratio and visual acuity, and it should be adopted to prevent the occurrence of posterior capsule opacification.