Objective To analyze the predictive value of spermatic vein diameter in diagnosing occult oblique inguinal hernia in children.Methods A total of 93 children of oblique inguinal hernia were admitted to Hangzhou Linping District Maternal &Child Health Care Hospital from August 2021 to August 2023 as research objects,including 15 with 30 sides of bilateral dominant hernia and 78 with 78 sides of unilateral dominant hernia.Among them,21 with 21 sides of contralateral recessive hernia were found by laparoscopic exploration in unilateral dominant hernia.The 108 sides of dominant hernia were used as dominant hernia group and 21 sides of occult hernia group as recessive hernia group.According to different ages,the patients were divided into 1 to 3 years old group 60 cases,4 to 6 years old group 33 cases;Children with oblique inguinal hernia were divided into＜2 years group(68 cases)and ≥2 years group(25 cases).The color ultrasound diagnostic instrument uses a 7.5MHz linear transducer to measure the diameter of the spermatic vein in the inguinal region of the child using blood flow imaging with a signal displayed at 2mm/s.Receiver operating characteristic(ROC)curve analysis of the predictive value of spermatic vein diameter for the diagnosis of occult inguinal hernia in children.Results Compared with occult hernia group,diameter of spermatic cord was increased in dominant hernia group(P＜0.05).Compared with overt hernia group,diameter of spermatic cord in＜2 year group and ≥2 year group was smaller,and difference was statistically significant(P＜0.05).In prediction of disease diagnosis with different age and course of disease,sensitivity of 1 to 3 years old was lower than that of 4 to 6 years old,and specificity was higher.The sensitivity of ≥2 years group was lower than that of＜2 years group.The specificity was higher and difference was statistically significant(P＜0.05).Conclusion diameter of spermatic vein can be used to predict the diagnosis of occult oblique inguinal hernia in children with high sensitivity and specificity.

Objective To analyze the predictive value of spermatic vein diameter in diagnosing occult oblique inguinal hernia in children.Methods A total of 93 children of oblique inguinal hernia were admitted to Hangzhou Linping District Maternal &Child Health Care Hospital from August 2021 to August 2023 as research objects,including 15 with 30 sides of bilateral dominant hernia and 78 with 78 sides of unilateral dominant hernia.Among them,21 with 21 sides of contralateral recessive hernia were found by laparoscopic exploration in unilateral dominant hernia.The 108 sides of dominant hernia were used as dominant hernia group and 21 sides of occult hernia group as recessive hernia group.According to different ages,the patients were divided into 1 to 3 years old group 60 cases,4 to 6 years old group 33 cases;Children with oblique inguinal hernia were divided into＜2 years group(68 cases)and ≥2 years group(25 cases).The color ultrasound diagnostic instrument uses a 7.5MHz linear transducer to measure the diameter of the spermatic vein in the inguinal region of the child using blood flow imaging with a signal displayed at 2mm/s.Receiver operating characteristic(ROC)curve analysis of the predictive value of spermatic vein diameter for the diagnosis of occult inguinal hernia in children.Results Compared with occult hernia group,diameter of spermatic cord was increased in dominant hernia group(P＜0.05).Compared with overt hernia group,diameter of spermatic cord in＜2 year group and ≥2 year group was smaller,and difference was statistically significant(P＜0.05).In prediction of disease diagnosis with different age and course of disease,sensitivity of 1 to 3 years old was lower than that of 4 to 6 years old,and specificity was higher.The sensitivity of ≥2 years group was lower than that of＜2 years group.The specificity was higher and difference was statistically significant(P＜0.05).Conclusion diameter of spermatic vein can be used to predict the diagnosis of occult oblique inguinal hernia in children with high sensitivity and specificity.

Objective: To investigate the epidemiological characteristics of varicella outbreaks in primary and middle schools, and to establish a risk predictive model, so as to provide scientific guidance for the prevention of varicella outbreaks in schools. Methods: Based on a nested case-control study, primary and middle schools in 4 districts of Shanghai (Yangpu District and Jingan District) and Hangzhou (Xiaoshan District and Linping District) from January to December 2023 were selected to observe the status of varicella outbreaks. Associated factors of varicella outbreaks were investigated and used for establishing the predictive model, which was evaluated by the Hosmer-Lemeshow(H-L) goodness of fit test, receiver operating characteristic (ROC) curve, Calibration curve, decision curve analysis (DCA). Results: A total of 98 varicella outbreaks were included, with 195 schools without varicella outbreaks during the same period as controls. Eight factors, including the availability of warm water in restroom, availability of hand soap in restroom, average class size, duration of student attendance at school per day, presence of a fulltime school doctor, hesitancy of the school principal towards varicella vaccination, and rates of first and second doses of varicella vaccination, were identified as potential factors for school varicella outbreaks, with statistically significant differences (χ2/Z=10.01, 20.49, 17.43, 9.74, 32.17, 6.60, 2.20, 3.39, P<0.05). The 8 variables above were employed to construct a risk predictive model, and Hosmer-Lemeshow goodness of fit test yielded a χ2 value of 5.863 (P>0.05); the area under the ROC curve (AUC) was 0.846 (95%CI=0.799-0.893); Calibration curve analysis indicated good consistency between predicted and actual values of the model. DCA demonstrated favorable predictive performance of the model over a wide range. Conclusions The predictive model for school varicella outbreaks demonstrates satisfactory accuracy and efficacy. It suggested to make good use of this prediction model and take relevant measures to reduce the risk of varicella transmission in schools.

To analyze the epidemiological characteristics of human infection with avian influenza A(H7N9) virus from 2013 to 2016 in Xiaoshan,China,we collected the epidemiological data of human A(H7N9) cases as well as the results of environmental monitoring and analyzed it by case study,descriptive epidemiological method,and statistical analysis.Results showed that a total of 22 cases were confirmed,including 12 deaths.All the cases occurred in winter and spring,and most of them had been exposed to live poultry,and with the underlying condition of chronic diseases.Chi-square test showed that the ratio of cases with chronic diseases in death group was higher (P=0.01).The environmental monitoring result showed there were distinctive seasonal differences of positive rate with peaks in winter and spring and nadirs in autumn and summer.Positive rates for the samples from external environmental monitoring were consistent with the distribution of the case onset.Due to rise of environmental monitoring positive rate,we should be alert to the occurrence of new cases,especially in rural areas where live poultry fairs still exist and among people with occupational exposure.We should further improve ability to prevent and control this disease.

Objective To investigate the clinicopathological characteristics and immunopheotype of diffuse large B-cell lymphoma (DLBCL) in order to improve diagnosis and therapy efficacy. Methods The clinical, immunophenotypical and histopathological features of 22 cases of DLBCL patients were studied retrospectively. The expressions of CD20, CD30, CD10, bcl-6, MUM-1, Ki-67 and CD3o of all patients, and CD5,CyclinD1, Lysozyme,AE1/3 and PLAP of patients with differential cancer, seminoma, anaplastic large cell lymphoma and blastic variant of mantle cell lymphoma were detected by EnVision Immunohistochemical technique. Results All patients were primary systemic DLBCL. All of 22 patients, 14 males and 8 females,average 48(21-71) years old, were primary DLBCL, including 13 cases of germinal centre B-cell-like(GCB) (7 cases of intra-node and 6 extra-node) and 9 cases non-GCB (6 intra-node and 3 extra-node). Conclusion The favorable diagnosis of DLBCL may be achieved by combination of clinical histological and immunological features.

Objective To study the expression and significance of Ki-67 in gastrointestinal stromal tumors(GIST) with CD117 immunoreactive. Methods The expression of Ki-67 was detected by SP method in 25 cases of high risk GISTS, 18 cases of moderate GISTS and 33 cases of extremely low and low risk GISTS,which were compared with the follow-up results. The relationship between Ki-67 index (LI) and risk degree was analyzed. Results Forty patients with moderate and high risk GIST were followed-up, including 26 alive,12 die of GIST and 2 die of other causes. Compared with patients of extremely low and low risk GIST, Ki-67 LI＞5 % was correlated with moderate and high risk cases (P ＜0.01), meanwhile Ki-67 LI was positively correlated with tumor sizes of ＞5 cm and tumor mitotic cell count ＞5/50 HPF, but was not with locations(P ＞0.05). Conclusion Ki-67 LI＞5 %, tumor size＞5 cm and tumor mitotic cell count＞5/50 HPF are risk indicator for GIST with CD117 immunoreactive.

Objective To investigate the clinicopathology characteristics, immunopheotypic of anaplastic large cell lymphoma (ALCL) in order to improve its diagnostic and therapeutic accuracy. Methods The clinical, immunophenotypic and histopathologie features of 19 cases ALCL were retrospectively studied. The expression of CD30, ALK, CD43, CD45RO, EMA and TIA-1 was detected using EnVision immunohistochemical technique. Results All patients were primary systemic ALCL. Among the 19 patients, 11 were males and 8were females. The age ranged from 2 to 71 years, average age 26 years old. It shows a broad morphologic spectrum of the tumor cell and the hallmark cells characterized by sheets of large lymphoid cells withchromatin-poor horseshoe-shaped nuclei containing multiple nucleoli were encountered in all ALCL variants. 16patients (84.2 %) showed B-symptoms, and extranodal involvement was present in 14 (73.7 % ).Immunohistochemical study showed that the tumor cells expressed CD30 (100 %), ALK (78.9 %), EMA(52.6 %), TIA-1 (73.7 %) and 2 cases (10.5 %) neither expressed ALK, nor EMA,TIA-1.17 cases were reached the correct diagnosis according to combination of clinic, histological and immunological features.Conclusion The correct diagnosis of ALCL may be reached by combination of clinic, histological and immunological features according to WHO classification. Immunohistoehemical staining for CD30, ALK, EMA and TIA-1 is useful in making a correct diagnosis.

Objective To study the clinicopathological characteristics of hepatobiliary cystic neoplasms(cystadenoma and cystadenocarcinoma)in order to improve its diagnostic and therapeutic accuracy.Methods A retrospective analysis was done on the clinical materials of 9 cases of cystic biliary tumors hospitalized in the People's Hospital of Rizhao City from May 1993 to May 2007.All cases were confirmed by operation and pathologic biopsy.Results Six cases were biliary cystadenoma with muhilocular cyst.The other three cases were biliary cystadenocarcinoma,two with single cyst and one with multilocular cyst.Of the three cystadenocarcinorna,two cases had mural nodules and one case had papillary excrescences and cystic wall thickening.Irregular thickening of internal sept.was shown in the multilocular cyst cases.Two had calcification.Enhancement of the wall.internal septa and nlasses were seen in all the malignant tumors on CT scans. Metastatic lymph node was found in one cage. Conclusion There were no special clinical characteristics in difierentiation between hiliary cystadenoma and cystadenocarcinoma. Single cyst, mural nodules and papillary excrescences,irregular thickening of cystic wall and internal septa,coarse calcification and metastatic lymph node increase the likelihood of the diagnosis of the malignant tumors.But the diagnostic differentiation between cystadenoma and cystadenocarcinoma depends on pathology.

Objective To study the expression of Galectin-3,CK19 and Ki-67 in the papillary thyroid carcinoma and papillary thyroid hyperplasia and to find the differential diagnostic makers. Methods A total of 200 cases, including 100 with papillary thyroid carcinoma and 100 papillary thyroid hyperplasia by Immunohistochemistry. Results The positive rates for Galectin-3,CK19 and Ki-67 in the papillary thyroid carcinoma were 100 %, 97 % and 93 %, which were significantly higher than those in the papillary thyroid hyperplasia (13 %, 31 %, 1 %) (P

BACKGROUNDTo detect quantitatively HCMV DNA in peripheral blood leukocytes to monitor the status of HCMV infection, evaluate the effectiveness of antiviral treatment with ganciclovir (GCV) combined with intravenous immunoglobulin (IVIG) and find out the relationship among the HCMV DNA levels, the state of infection and the clinical outcome.The long-term goal of the study was to establish a molecular diagnostic standard for HCMV infection in children.

METHODS45 cases of suspected HCMV-infected children were examined by PCR, ELISA and fluorescent quantitative (FQ)-PCR, respectively. Twenty five HCMV hepatitis cases of the 45 were randomly assigned to a treated group or a control group. Both groups were treated with prednisone, glucurone, Luminal and Xiaoyanlidanpian. But the treated group was given with GCV+IVIG in addition. Each infant of the two groups was checked with FQ-PCR at the five time points.

RESULTSThe positive rates of PCR, ELISA and FQ-PCR were 60.00%, 33.33% and 66.67%,their sensitivities were 84.38%, 46.88% and 93.75%, respectively. There was no significant difference in viral DNA copy numbers between the two groups before being treated (P>0.05), but there was significant difference between HCMV hepatitis and normal infants (P<0.001). Although viral load of both groups decreased in both groups, the viral load of the treated group decreased more significantly. The level of HCMV DNA fell to 103 copies/ml at second time point while that of the control group fell to the same level after third time point. The differences between the two groups at each time point were statistically significant (P<0.001). The results of 135 person times testing indicated that 103 copies/ml of FQ-PCR can be taken as a critical value for prediction of active HCMV infection.

CONCLUSIONSFQ-PCR may be one of the effective methods for diagnosis of HCMV disease; it can offer a key index in the diagnosis of HCMV active infection; dynamic detection of HCMV viral load can play a role not only in monitoring antiviral therapy, but also in evaluating the development and prognosis of HCMV disease.

Antiviral Agents ; therapeutic use ; Cytomegalovirus ; isolation & purification ; Cytomegalovirus Infections ; diagnosis ; drug therapy ; DNA, Viral ; blood ; Ganciclovir ; therapeutic use ; Humans ; Infant ; Infant, Newborn ; Polymerase Chain Reaction ; methods ; Sensitivity and Specificity ; Treatment Outcome