Objective:To analyze the clincial characteristics and laboratory findings of patients with neurobrucellosis (NB).Methods:Using retrospective analysis, clinical diagnosed patients with NB from June 2016 to February 2019 in Heilongjiang Agricultural Reclamation Bureau General Hospital were selected to analyze the general characteristics, clinical symptoms, laboratory examination results [white blood cell (WBC), hemoglobin(Hb), c-reactive protein (CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total protein (TP), albumin (ALB), cerebrospinal fluid routine and biochemical, serum tube agglutination test (SAT), blood culture and cerebrospinal fluid culture of Brucella] , diagnosis and treatment effect. Results:A total of 25 patients were diagnosed with NB, including 19 males and 6 females, with an average age of (41.7 ± 14.2) years old, ranged from 11 to 70 years old. The main clinical symptoms were fever, headache, joint pain, vomiting and sweating, which accounted for 92.0% (23/25), 88.0% (22/25), 76.0% (19/25), 64.0% (16/25), and 64.0% (16/25), respectively. Positive neck ankylosis and mumbness of lowerlimbs were both 9 cases (36.0%), and mental disorders were 7 cases (28.0%). In 25 patients with NB, the WBC increased in 5 cases (20.0%), Hb decreased in 4 cases (16.0%), CRP increased in 13 cases (52.0%), ALT and AST both increased in 6 cases (24.0%), TP decreased in 21 cases (84.0%); SAT was positive in 25 cases (100.0%), cerebrospinal fluid SAT positive in 7 cases (28.0%); and blood culture was positive in 2 cases (8.0%). Cerebrospinal fluid changes were mainly manifested in 14 cases (56.0%) of chloride reduction, 13 cases (52.0%) of gluose reduction and 19 cases (76.0%) of protein increase. In 25 patients with NB, 17 cases were treated with doxycycline + rifampicin + ceftriaxone, 7 cases with etimicin + rifampicin + ceftriaxone, and 1 case with doxycycline + rifampicin + piperacillin sulbactam. After 6 to 12 months follow-up, 21 cases recovered well, whereas mild sequelae were observed in 4 patients.Conclusion:Clinical features of NB are hetorogeneous, and nerurological symptoms and cerebrospinal fluid examination are of great value in the diagnosis of NB.

Objective To investigate the differents of rapid enzyme-linked immunosorbent assay(IELISA) and the traditional serological methods in diagnosis of human brucellosis.Methods Brucella antibody was detected by IELISA,rose bangel plate test (RBPT),standard agglutination test (SAT),Coomb's test and cysteine test of serological methods in 430 confirmed and suspected patients and 300 healthy controls during the same period.The consistency was analyzed between IELISA and other tests.Results Positive rates of patients were significandy higher than those in healthy controls (IELISA:83.49％ vs.0;RBPT:86.97％ vs.0;SAT:76.27％ vs.0;Coomb's:65.58％ vs.0.02％;and cysteine test:67.91％ vs.0,x2 =535.05,412.47,437.66,339.22,489.49,all P ＜ 0.01).Positive consistency rates between IELISA and other tests were 87.19％,79.39％,71.59％ and 76.60％,the highest was between IELISA and RBPT,the lowest was between IELISA and Coomb's.Conclusions Brucella antibody is detected conveniently,quickly,and accurately by the joint application of RBPT and IEHSA,which provides important technical support for prevention and control of brucellosis.It is worthy of application extensively.

Objective To analyze the diagnostic value of fluorescence polarization assay (FPA) for human brucellosis.Methods From April 2013 to August 2014,240 positive sera of brucella patients were collected as case group and 287 normal sera as control group in Heilongjiang Agricultural Reclamation Bureau General Hospital.Four milliliters of venous blood were withdrawn for separation of serum.Fluorescence polarization assay was used and the consistency,sensitivity and specificity were compared with those of four classical serological methods,including rose bengal plate agglutination test (RBPT),standard tube agglutination test (SAT),Coomb's test and cysteine test.Results The results of FPA were complied with those of the four conventional serological methods,Kappa ≥ 0.75.The sensitivity of FPA (89.17％) was higher than that of RBPT (87.08％),SAT (85.00％),Coomb's (74.17％) and cysteine test (75.83％).The specificity of FPA (94.08％) was higher than that of RBPT (89.90％) and Coomb's (81.53％),but lower than that of SAT (98.95％) and cysteine test (99.30％).Conclusion FPA can be used as a laboratory diagnostic method for human brucellosis,which is worthy to be widely used.

Objective To analyze the epidemiology and clinical characteristics of Brucella infection in Heilongjiang Province,and to provide experience and basis for clinical treatment and prevention of brucellosis.Methods Using retrospective analysis method,clinically diagnosed patients with brucellosis from December 2016 to December 2017 in Heilongjiang Agricultural Reclamation Bureau General Hospital were selected to analysis the general characteristics,clinical symptoms,laboratory examination results,diagnosis and treatment effect.Healthy subjects undergoing health check-up at the same period were randomly selected as control group for laboratory blood biochemical test.Results A total of 396 patients were included in the brucellosis group,including 298 males and 98 females,with an average age of (43.6 + 15.6) years old,ranged from 1 to 75 years old.The control group included 125 cases,including 83 males and 42 females,with an average age of (41.7 ±+ 18.0) years old,ranged from 7 to 71 years old.There were no significant differences in age and gender between the two groups (t =1.083,x2 =3.789,P ＞ 0.05).The patients of ＞ 14-64 years old of age had the highest incidence (90.15％,357/396).The patients were mainly rural residents (76.01％,301/396) and the majority of them were farms (50.51％,200/396).The onset time was mainly from March to June of the year (47.73％,189/396).Clinical symptoms were fever,joint or muscle pain and hyperhidrosis,which accounted for 91.16％ (361/396),76.26％ (302/396) and 44.19％ (175/396),respectively.The levels of C-reactive protein (CRP),seropropane alanine aminotransferase (ALT),aspartate transaminase (AST),γ-glutamyl transpeptadase (γ-GT),alkaline phosphatase (ALP),α-hydroxybutyrate dehydrogenase (HBDH),and lactate dehydrogenase (LDH) in patients with brucellosis were significantly higher than those in the control group (t =4.956,2.746,4.019,3.272,7.008,3.728,3.409,P ＜ 0.01 or 0.05),while total protein (TP) and albumin (ALB) levels were reduced (t =-7.252,-8.601,P ＜ 0.01).After treatment,the test results of CRP,ALT,AST,γ-GT,TP,ALB,ALP,HBDH and LDH were compared with those before the treatment,and the differences were statistically significant (t =2.291,4.393,3.382,2.608,-7.516,-4.710,3.509,4.585,4.473,P ＜ 0.01 or 0.05).Conclusions The patients with brucellosis in Heilongjiang Province are mainly male farmers,and the onset time is mostly concentrated in March-June.The clinical manifestations of brucellosis are varied,clinicians should strengthen discrimination and prevent misdiagnosis.Medicines for brucellosis might be cautiously used in clinical trial,and changes in liver function and myocardial enzyme activity should be monitored.

Objective To analyze influencing factors of paclitaxel coated ballon(PCB)on long-term restenosis in patients with severe subpatellar artery lesions in type 2 diabetes mellitus(T2DM),and to construct a prediction model.Methods A total of 268 T2DM patients with severe infra-popliteal artery disease and received PCB treatment were selected.Patients were followed up for 1 year after treatment.Patients with target vessel restenosis were included in the observation group,and the other patients were included in the control group.Clinical data of two groups were analyzed.Multivariable Logistic regression analysis was used to analyze influencing factors of long-term restenosis in T2DM patients with severe infra-knee arterial disease,and a nomogram prediction model was constructed.Results A total of 260 patients(97.00%)completed the follow-up,and the incidence of restenosis was 13.85%(36/260).Both univariate and multivariate Logistic regression analysis showed that age,coexisting coronary heart disease,Trans-Atlantic Inter-Society Consensus(TASC)Ⅱ classification,Fontaine staging,glycosylated hemoglobin(HbA1c)and low density lipoprotein cholesterol(LDL-C)were independent influencing factors for the occurrence of long-term restenosis in T2DM patients with severe infra-popliteal artery disease(P<0.05).The risk factor with the highest score in the constructed nomogram prediction model was HbA1c,followed by age,LDL-C,TASCⅡ classification,Fontaine stage and coronary heart disease.According to the column chart,the total score was 210 points,and the probability of long-term restenosis was 90%.The discrimination of the nomogram model was 0.866,with a Brier score of 0.081 and a calibration slope of 0.733.When the risk threshold was 0.15 to 1.0,the net benefit rate of long-term restenosis in T2DM patients with severe infra-popliteal artery disease was greater than that of individual evaluation.The smaller the risk threshold,the greater the net benefit rate.The benefit was the best when the threshold reached 0.23.Conclusion The influencing factors for long-term restenosis in T2DM patients with severe subknee artery disease treated by PCB include age,combined coronary heart disease,TASCⅡ grade,Fontaine stage,HbA1c and LDL-C.The prediction model based on the above influencing factors has important value in predicting long-term restenosis in patients.

Objective:To investigate the clinical significance of six serological methods for diagnosis of brucellosis.Methods:Totally 160 cases of brucellosis patients were selected as the case group and 235 cases of health medical examiners were selected as the control group from January to June 2018 in Heilongjiang Agricultural Reclamation Bureau General Hospital. Six methods were used for detection of brucellosis, including Rose Bengal plate agglutination test (RBPT), fluorescence polarization assay (FPA), indirect enzyme linked immunosorbent assay (iELISA), cysteine agglutination test, standard tube agglutination test (SAT), and anti-globulin test (Coomb's). The consistency of the 4 preliminary screening methods (RBPT vs FPA, iELISA, cysteine agglutination test), and 2 diagnosis methods (SAT vs Coomb's) was compared, and the sensitivity, specificity, rates of missed diagnosis and misdiagnosis were analyzed. Results:In the preliminary screening methods, the consistency of RBPT with FPA and iELISA was relatively consistent (Kappa = 0.872, 0.784), and the consistency with cysteine agglutination test was generally consistent (Kappa = 0.543). In the diagnosis methods, the consistency between SAT and Coomb's was relatively consistent (Kappa = 0.861). The sensitivity of FPA, iELISA, cysteine agglutination test and Coomb's was 91.03%, 75.00%, 56.41% and 80.14%, respectively. The specificity was 95.81%, 100.00%, 98.74% and 100.00%, respectively. The rates of missed diagnosis were 8.97%, 25.00%, 43.59% and 19.86%, respectively. The rates of misdiagnosis were 4.19%, 0, 1.26%, and 0, respectively.Conclusions:FPA and iELISA have high sensitivity and specificity, and are suitable for clinical promotion. The combined detection of multiple serological methods will reduce the probability of misdiagnosis and missed diagnosis of brucellosis, thereby improving the diagnostic level of brucellosis.

Objective: To analyze the epidemiologic and clinical features of preschool children with brucellosis, and improve awareness of brucellosis and level of diagnosis. Methods: In-patients treated for brucellosis in preschool children from December 2016 to November 2018 in Heilongjiang Agricultural Reclamation Bureau General Hospital were retrospectively analyzed for epidemiology, clinical feature, laboratory data, treatment and prognosis. Results: There were 29 males and 16 females among the 45 preschool children brucellosis cases, with an average age of (3.7 ± 1.6) years old, ranged from 6 months to 6 years old. The patients of > 3-6 years old of age had the highest incidence (64.44%, 29/45). The patients were mainly rural residents (97.78%, 44/45). The onset time was mainly from March to June of the year (46.67%, 21/45). Clinical symptoms were mostly fever and joint pain, which accounted for 97.78% (44/45) and 57.78% (26/45), respectively. And lymph node enlargement and hepatosplenomegaly were also commonly seen, which accounted for 42.22% (19/45) and 35.56% (16/45). After treatment, the test results of patients with alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase isoenzyme (CK-MB), α-hydroxybutyrate dehydrogenase (HBDH) and lactate dehydrogenase (LDH) were compared with those of before the treatment, the differences were statistically significant (t=4.774, 2.970, 2.229, 5.664, 5.805, P < 0.05). Before the treatment, 36 patients (80.00%, 36/45) had positive blood culture, which turned negative after the treatment. Conclusions The epidemiologic and clinical features of preschool children with brucellosis are not typical. In the epidemic area of the disease and multiple seasons, for children with unexplained fever, the clinician should inquire about the epidemiological history and combine the clinical feature, consider the possibility of brucellosis, and strive for early diagnosis and treatment.