Objective Toinvestigatetheclinicalvalueofhumanneutrophillipocalin(HNL)detectioninthedifferentialdiagnosis of bacterial and viral infections of elderly patients with acute respiratory infection .Methods 142 elderly patients with respiratory infection were divided the bacteria group (96 cases) and the virus group (46 cases) according to their infections ,42 healthy people in the corresponding period were enrolled as the control group .Enzyme-linked immunosorbent assay and highly sensitive dry chemi-cal particles enhanced immune turbidity assay were employed to detect their blood HNL and C-reactive protein(CRP) ,respectively , and virus-specific antibodies detection were performed simultaneously .Results Compared the blood HNL ,CRP levels and their positive rates of patients in bacteria group with those in the virus group ,control group ,respectively ,differences showed statistically significant(P<0 .01) ,while the differences of indicators listed above between the virus group and control group had no statistically significant(P>0 .05) .Antibiotic treatment before and 24 ,48 and 72 hours after ,the concentrations of HNL were (216 .8 ± 64 .1) , (192 .0 ± 41 .2) ,(158 .0 ± 54 .5) and (87 .0 ± 12 .4)μg/L ,respectively ,while those of CRP were (50 .9 ± 40 .9) ,(46 .2 ± 18 .3) , (39 .6 ± 9 .6) and (12 .6 ± 9 .8) mg/L ,respectively .Sensitivity ,specificity ,positive predictive value and negative predictive value of HNL detection were 90 .6% ,90 .9% ,91 .5% and 89 .9% ,respectively ,which were higher than those of CRP (88 .5% ,85 .2% , 86 .7% and 87 .2% ,respectively) ,with statistically significant difference(P<0 .05) .Conclusion NHL detection possesses impor-tant significance in differential diagnosis between bacterial and viral infections of elderly patients with acute respiratory infection .

ObjectiveTo investigate the current status of Kaschin-Beck disease in Shandong province, and to provide a scientific basis for decision-making in controlling the disease. Methods According to the National Monitoring Program of Kaschin-Beck disease requirements, historical serious villages of Kaschin-Beck disease in Qingzhou of Shandong province were selected annually; children aged 7 to 16 were chosen to receive clinical examination and children aged 7 to 12 were taken X-ray examination. Clinical and X-ray diagnosis was carried out according to the Diagnostic Criteria of Kashin Beck Disease(GB 16003-1995). Results From 1996 to 2010, in 53 diseased villages, three thousand three hundred and eighteen school children aged 7 to 16 were clinically diagnosed, and child Kaschin-Beck disease of degree Ⅰ and above were not detected; three thousand and ninety-one school children aged 7 to 12 were examined by X-ray, forty cases were found positive, and the total positive rate was 1.29％(40/3091 ). The year with the highest positive rate was 2002, and the rate was 3.49％(13/372) ; the positive rate was 0 in 1996 and 2008. The difference of the X-ray positive rate between each year was statistically significant(x2 =31.54, P ＜ 0.01 ). ConclusionsChild Kashin-Beck disease in Qingzhou is basically under control.Since etiology of Kashin-Beck disease is still unclear, surveillance of the disease still needs to be strengthened.

OBJECTIVETo analyze the characteristics of injuries between two types of Emergency Department (ED) in China.

METHODSWe selected 25 hospital EDs in the whole country as spots for investigation, and designed one special questionnaire to collect information, from 1st July, 2001 to 30th June, 2002.

RESULTSIn city hospitals (CIH), the proportion of injury to all diseases were 19.65%, and in country hospital (COH) it was 29.88%. The fatality rate of injuries was 1.29% in COH, which was higher than that of CIH's (P < 0.001). In COH, ambulance was more frequently used to treat injury patients than in CIH, but the average rescue time was not different. In cities, machinery was the leading cause (about 32.88%), but in country it was due to transpert (35.34%). Traffic accidents, suicide/homicide and unintentional drowning were the main causes of death. In CIH, the number of unintentional poisoning was almost twice as intentional, but in COH the patients due to poisoning suicide act were more than unintentional poisoning, with 2/3 of the poisoning causes were women. Patients due to chemical, drug and food poisoning accounted for 86.13% in CIH, while in COH the main causes were pesticidal, chemical and druggery (89.80%). In all poisons, pesticide was the leading cause for death.

CONCLUSIONIt's suggested that patients with injury be treated timely since the acute injury patients accounted for important part of ED's patients. The differences between CIH and COH were obvious, with better ability of treatment in CIH than in COH. More relevant measures were needed to improve the ability of acute treatment for injuries.

China ; epidemiology ; Emergency Medical Services ; statistics & numerical data ; Female ; Humans ; Male ; Poisoning ; epidemiology ; etiology ; mortality ; Sex Factors ; Surveys and Questionnaires ; Survival Rate ; Wounds and Injuries ; epidemiology ; etiology ; mortality

Objective To investigate the present status of Kaschin-Beck disease(KBD) in Qingzhou at present, and provide a scientific basis for decision-making in controlling the disease. Methods According to The National Technical Scheme for Endemic Disease Control in 2007, children aged 7 to 12 were chosen to receive clinical and X-ray examination in 3 villages of 2 towns in Qingzhou. Local adults aged 16 years and older were clinically diagnosed in 10 villages of 4 towns and divided into different groups according to the clinical degrees and their ages. The Diagnostic Criteria of Kashin Beck Disease(GB 16003-1995) was carded out by clinical and X-ray diagnosis. Results Two hundred and sixty school children aged 7 to 12 were clinically diagnosed, and the patients of I degree upwards of KBD were not detected. One hundred and ninety-eight school children aged 7 to 12 were examined by X-ray, and the detectable rate was 0(0/198). In 7099 adults aged 16 years old upwards clinically tested, 502 patients of degree I and higher of KBD were detected and the detectable rate was 7.07%(502/7099). The patients distributed mainly in the population aged 36 years old and older, accounting for 99.00% (497/502). Conclusions Although KBD in children have been controlled in Qingzhou, it is still serious in adults. So the monitoring of KBD should be carried on and prevention and control for KBD in adults should be strengthened.

OBJECTIVEThis study aimed to study the characteristics of injuries in the Emergency Departments.

METHODSAcute injuries of the Emergency Department attendants from Jury 1, 2001 to June 30, 2002 were selected.

RESULTS25,019 cases were sampled. Results showed that injured persons accounted for 17.46% of all emergent cases attending the above hospitals. 81.67% of the injuries were accidental. Sex ratio was 2.0. Young people aged 15-34 years accounted for 50.63% of all the injuries. The leading cause was mechanical injury, followed by traffic accidents and accidental falls. The leading occupation would include workers, followed by farmers and students. The fatality rate was 5.12 per thousand. The number of deaths for young people accounted for 79.69% of all deaths. The number of deaths for motor vehicle accidents took the first place and accounted for 46.88%. The characteristics due to mechanical injury and 11,151 cases of acute poisoning were analyzed.

CONCLUSIONTo develop a surveillance post on injuries in the Emergency Departments of general hospitals are not only necessary, urgent but feasible.

Accidental Falls ; statistics & numerical data ; Accidents, Occupational ; statistics & numerical data ; Accidents, Traffic ; statistics & numerical data ; Emergency Medical Services ; Emergency Service, Hospital ; statistics & numerical data ; Female ; Hospitals, General ; statistics & numerical data ; Humans ; Male ; Sex Factors ; Wounds and Injuries ; etiology

OBJECTIVEThis study aimed to develop an estimate of the actuality and characteristics of poisoning suicide attempted patients in emergency department (ED) in China.

METHODSWe selected 25 hospital EDs in whole country as the investigation spots, and designed one special questionnaire to collect information from the poisoning suicide attempted patients from 1st July, 2001 to 30th June, 2002.

RESULTSResults were based on 4060 cases hospitalized during the investigating period. In general frequency analysis, the ratio of male to female was 1:2.95. In all patients, 98.40% cases took poisons orally, and 93.57% cases occurred at home. The average age was 31.5 years old (min 8, max 93). The leading occupations of cases were farmers, unemployed house-wives, jobless, service people and students. The main types of poisons were druggery (54.29%) and pesticide (35.84%). 2044 cases (59.23%) were cured timely (in 1 hour). When comparing cases from rural hospitals (RHs) and urban hospitals (UHs): ratio of poisoning attempted suicides in RHs to all poisoning cases was higher than UHs with significant gender difference (P < 0.05). UHs number one cause of poisoning was druggery, but in RHs it was pesticide.

CONCLUSIONPoisoning attempted suicide was very serious in China. Farmers and women were among the high-risk groups. Druggery and pesticide were the primary poisons, suggesting that management enforcement was in urgent need.

Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Child ; China ; epidemiology ; Emergency Medical Services ; statistics & numerical data ; Female ; Hospitals ; statistics & numerical data ; Humans ; Male ; Middle Aged ; Occupations ; Poisoning ; classification ; epidemiology ; Sex Factors ; Suicide, Attempted ; statistics & numerical data ; Time Factors ; Treatment Outcome

Objective To evaluate the clinical outcome of autologous hemopoietic stem cell transplantation (AHSCT) for hematological malignancies. Methods Data of 61 patients with hematological malignancies who underwent AHSCT in Xiangya Hospital from April 1994 to August 2008 were retrospectively analyzed. There were 30 acute non-lymphoblastic leukemias (ANLL), 25 non-Hodgkin lymphoma (NHL), 3 Hodgkin lymphoma (HL), and 3 plasmacytoma. Mel 160 mg/m2 + Ara-C 2.0/2.5 g × 2 +Cy 1.8 g/m2 × 2, or TBI 8-10 Gy + Cy 1.8 g/m2 × 2 were mainly included in pretreatment regimens. Results All patients had rapid hemopoietic reconstitution. There was one patient who died of heart failure during the transplantation process. The rate of AHSCT related death was 1.6 %. The median follow up duration was 52(2-211) months. Forty-seven of 61 patients were still alive during the analysis. The probabilities of disease free survival (DFS) at 5 years were significantly different between these two groups: (77.5±5.5) % for AHSCT groups and (31.6±7.3) % for synchronous intensive chemotherapy groups(P ＜0.01). Conclusion AHSCT can be safely performed as an important treatment constituent for hematological malignancies.

OBJECTIVETo study hepatitis B virus (HBV) genotype and subtype distribution and its clinical significance in HBV-infected patients.

METHODSWe used type/subtype-specific primers and PCR to detect HBV genotype and subtype of 445 HBV-infected patients from Beijing, Changchun, Hanchuan Shenzhen, Qingyuan and Nanjing, including 7 acute hepatitis (AH), 36 asymptomatic HBV carriers (ASC), 352 chronic hepatitis (CH), 28 liver cirrhosis (LC), and 22 hepatocellular carcinoma (HCC) cases. Genotyping results were confirmed by PCR product sequencing.

RESULTSAmong 445 HBV-infected patients, the proportions of genotype B, C, and B/C were 32.6% (145/445), 53.7% (239/445), and 13.7% (61/445), respectively. In genotype C, 13 (5.4%) were subtype C1, 135 (56.5%) were subtype C2, and the remaining 91 (38.1%) were neither C1 nor C2. In genotype B, 100 (69.0%) were subtype Ba, 25 (17.2%) subtype Bj, and the other 20 (13.8%) were neither Ba nor Bj. In genotype B/C, 15 (24.6%) were Ba/C2, 8 (13.1%) Bj/C2, 6 (9.8%) Ba/C1, 3 (4.9%) Bj/C1, 11 (18.0%) Ba/neither C1 nor C2, 7 (11.5%) Bj/neither C1 nor C2, and 6 (9.8%) neither Ba nor Bj/neither C1 nor C2, 2 (3.3%) neither Ba nor Bj/C1, 3 (4.9%) neither Ba nor Bj/C2. The HBV genotype and subtype distribution we found exhibited significant differences in the various clinical types of HBV infection tested, and showed that genotype C was predominant among patients with liver cirrhosis (78.6%) and hepatocellular carcinoma (86.4%) while genotype B was predominant in asymptomatic carriers (72.2%). In addition, genotype and subtype distribution showed no significant differences between male and female patients, but genotype and subtype distribution showed significant differences in patients positive or negative with HBeAg.

CONCLUSIONSubtypes Ba and C2 are predominant in patients with hepatitis B from these 6 cities, and genotype C may be associated with the development of liver cirrhosis and hepatocellular carcinoma.

Genotype ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; virology ; Humans ; Liver Cirrhosis ; virology ; Liver Neoplasms ; virology ; Polymerase Chain Reaction

OBJECTIVETo study the incidence and spatiotemporal dynamic variation of hemorrhagic fever with renal syndrome (HFRS) in Shandong province.

METHODSAccording to surveillance data on HFRS epidemics and host animals, a 'contour area multifractal model' was estimated on the HFRS' incidence and multi-analysis model was applied to study spatiotemporal dynamic variation.

RESULTSThe process could be classified into 5 periods: 1st period (1974-1981) when HFRS was in completely natural focal state in Shandong, and the nature of focus was typical Apodemus type. 2nd period (1982-1986) indicated the process of expanding and merging of the Apodemus type focus in the southeastern part of Linyi district and the Rattus type focus was in the southern part of Jining city. 3rd period (1987-1990) indicated that through the expanding and merging of the two epidemic focuses,one mixed focus dominated by the Apodemus type had been formed in the hilly area of the southern and middle part of Shandong while another one dominated by the Rattus type in the Yellow River valley of the northwestern part of Shandong. 4th period (1991-1993) showed that the process of the spatial pattern of the mixed focus dominated by the Rattus type in Shandong. 5th period (1994-2004) referred to the spatial pattern of the mixed focus dominated by the Rattus became stabilized.

CONCLUSIONEvolution of the characteristics of HFRS focus in Shandong province experienced the following three processes: the simple Apodemus type and the simple Rattus type were seen separately to the mixed foci with the Apodemus type dominant and the Rattus dominant type coexisted and merged to the stable state of the mixed focus with Rattus as the dominant one.

China ; epidemiology ; Hemorrhagic Fever with Renal Syndrome ; epidemiology ; Humans ; Incidence

OBJECTIVETo investigate the feasibility and safety of percutaneous endoscopic gastrostomy (PEG) and percutaneous endoscopic jejunostomy(PEJ).

METHODSFrom June 1996 to April 2005, clinical data of 121 patients treated with PEG or PEJ were analyzed retrospectively.

RESULTSA total of 121 patients experienced 134 times of PEG or PEG plus PEJ, including 90 cases (103 times) treated with PEG and 31 patients treated with PEG plus PEJ. Thirteen patients treated with PEG had fistula replacement 6-10 months after PEG. All patients had quick nutrition recovery after fistula tube insert,therefore parenteral nutrition was not required. No severe complications occurred in all patients after 10 months of following-up. Four patients had subcutaneous infection around fistula 4-10 days after PEG.

CONCLUSIONPEG and PEJ are safe and new methods for gastrointestinal decompression and enteral nutrition, which can be substitutes for nasogastric tube.

Adult ; Aged ; Aged, 80 and over ; Endoscopy, Gastrointestinal ; methods ; Female ; Follow-Up Studies ; Gastrostomy ; methods ; Humans ; Jejunostomy ; methods ; Male ; Middle Aged ; Retrospective Studies