Objective: To design HBV DNA proficiency testing and system comparison samples with different concentration gradients, analyze their detection results in PCR detection systems, evaluate the nucleic acid detection capabilities of laboratories and differences between detection systems, and put forward suggestions for continuous quality improvement to participating laboratories. Methods: Three groups of randomly numbered proficiency testing samples (with HBV DNA reference concentrations of <2, 7.5, and 30 IU/mL respectively) were taken as the detection objects. Using nucleic acid test data from 11 provincial blood station laboratories as the source, the samples were grouped by detection system and laboratory successively, and statistical analysis was conducted. Results: Statistical analysis of the detection data of the three groups of samples based on detection systems and laboratories showed that from low to high concentration, the coincidence rate between the detection results of different detection systems and laboratories and the expected results showed an increasing trend: 38.89%, 85.90%, and 100.00%; the same system exhibited certain differences in performance among different laboratories. Conclusion: Through this proficiency testing and system comparison, it is found that there are certain differences in the detection capabilities of different laboratories and different nucleic acid test systems. Blood station laboratories should standardize processes, strengthen quality management and data analysis on the basis of being familiar with the detection performance of their detection systems, and at the same time strengthen the control of laboratory interference factors to continuously improve the nucleic acid detection capabilities of blood station laboratories.

Objective:To summarize the experience of 15 cases of balloon endovascular occlusion assisted aortic replacement.Methods:15 patients who needed reoperation after aortic surgery underwent endovascular balloon occlusion assisted aortic replacement by DSA guidance in the hybrid OR. Main inclusion criteria: The target vessel to be blocked cannot be directly blocked. Based on the last CTA before the operation, the diameter of the target vessel was measured, and the appropriate diameter balloon and the appropriate diameter balloon and the amount of contrast agent were selected. The vascular approach was selected according to the CTA.During the operation, the balloon was filled and fixed well, the distal invasive blood pressure waveform showed advection, and the pressure close to hydrostatic pressure as the complete blocking standard.Results:All 15 cases of balloon endovascular occlusion assisted aortic surgery were successful. After the operation, 14 target vessels normally without damage, and there was no vascular complication. One case after surgical three-branch stent surgery underwent the second thoracoabdominal aortic replacement operation. After the stent was blocked by the balloon, the new tissue in the stent fell off, and the celiac trunk and superior mesenteric artery were embolized for reoperation.Conclusion:Balloon endovascular occlusion technology expands the indications of aortic surgery and simplifies the operation, that is a safe and effective occlusion method. Whether the target vessel is suitable for balloon occlusion should be judged before the operation to avoid related complications.

Objective: To illuminate the epidemic characteristics of Yersiniosis among children in the central city of Beijing and the accuracy of current clinical diagnosis towards Yersiniosis. Methods: Etiological surveillance of diarrheal patients, a total of 3 493 cases, was performed in a children hospital in central area of Beijing from 2011 to 2018 continuously. Collected the epidemiological and clinical information of the cases, analyzed the clinical and etiological diagnosis for Yersiniosis and bacterial dysentery and compared the distribution of Yersiniosis cases with the different symptoms. Results: A total of 3 493 acute diarrhea cases distributed from the age of 6 months to 13 years old, M (P₂₅, P₇₅) was 1.50 (0.75, 3.17) years old. The 28 cases were isolated Yersinia enterocolitica (isolation rate of 0.80%) and they could be diagnosed as Yersiniosis by etiology. The isolation peaked in May and February. A total of 85.71% (24/28) of Yersiniosis cases were under 5-year old. The children of 3-4 age group had the highest isolation rate (1.52%) while the rate (0.18%) of 0-1 age group was the lowest (P=0.025). The Yersinia enteroclitica isolation rates of diarrheal patients with the symptoms including mucus feces, fever, white blood cell (WBC) and red blood cell (RBC) in feces were higher than the patients without these symptoms (P>0.05). The 9 of 28 Yersiniosis cases by etiology diagnosis were clinical diagnosed as bacillary dysentery. Conclusion The infants and young children under 5-year old were the main population of Yersiniosis adolescent patients under 14-year old. The typical symptoms characterized with mucus stool, fever, WBC and RBC by routine microscopic examination. The preliminary clinical diagnosis of Yersiniosis is easily confused with bacterial dysentery.

Objective: To investigate the clinical features of anti-signal recognition particle (SRP) antibody-positive patients with dermatomyositis/clinically amyopathic dermatomyositis (DM/CADM) . Methods: Clinical data were collected from 90 patients with DM/CADM, who were hospitalized at the Department of Dermatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from June 2015 to July 2017. Immunoblotting assay was performed to determine the serum level of anti-SRP antibody in these patients. Statistical analysis was carried out using t test and Chi-square test. Results: Of the 90 patients with DM/CADM, 11 (12.2%) were positive for serum anti-SRP antibody, including 6 with DM and 5 with CADM. Among 82 adult patients with DM/CADM, the prevalence of malignant tumors was significantly higher in the patients with anti-SRP antibody than in those without (7/9 vs. 31.5%[23/73], χ² = 7.394, P = 0.006) . The 11 patients with anti-SRP antibody had typical DM skin lesions, and their cutaneous dermatomyositis disease area and severity index (CDASI) was 18.1 ± 2.9. The prevalence of "angel wings sign" (aliform erythema on the trunk) was significantly higher in the patients with anti-SRP antibody than in those without (7/11 vs. 29.9%[20/67], Fisher′s exact test, P = 0.028) . The positive rate of antinuclear antibody was significantly higher in the patients with anti-SRP antibody than in those without (4/8 vs. 16.7%[13/78], χ² = 6.053, P = 0.014) . Magnetic resonance imaging of muscles of both thighs of the 10 patients with anti-SRP antibody (6 with DM and 4 with CADM) showed the presence of abnormal signals in the thigh muscle group in 8, swelling of the muscle group in 2, subcutaneous edema in 2, myofascial swelling in 1, and no abnormities in 2. No interstitial lung disease or myocardial involvement was observed in the patients with anti-SRP antibody. Conclusions The anti-SRP antibody-positive patients with DM/CADM showed a high prevalence of "angel wings sign" , and a high risk of malignant tumors. Early detection of the anti-SRP antibody in patients with DM/CADM is helpful to predict the occurrence of malignant tumors.

Objective To illuminate the epidemic characteristics of Yersiniosis among children in the central city of Beijing and the accuracy of current clinical diagnosis towards Yersiniosis. Methods Etiological surveillance of diarrheal patients, a total of 3 493 cases, was performed in a children hospital in central area of Beijing from 2011 to 2018 continuously. Collected the epidemiological and clinical information of the cases, analyzed the clinical and etiological diagnosis for Yersiniosis and bacterial dysentery and compared the distribution of Yersiniosis cases with the different symptoms. Results A total of 3 493 acute diarrhea cases distributed from the age of 6 months to 13 years old, M (P25, P75) was 1.50 (0.75, 3.17) years old. The 28 cases were isolated Yersinia enterocolitica (isolation rate of 0.80%) and they could be diagnosed as Yersiniosis by etiology. The isolation peaked in May and February. A total of 85.71% (24/28) of Yersiniosis cases were under 5?year old. The children of 3-4 age group had the highest isolation rate (1.52%) while the rate (0.18%) of 0-1 age group was the lowest (P=0.025). The Yersinia enteroclitica isolation rates of diarrheal patients with the symptoms including mucus feces, fever, white blood cell (WBC) and red blood cell (RBC) in feces were higher than the patients without these symptoms (P＞0.05). The 9 of 28 Yersiniosis cases by etiology diagnosis were clinical diagnosed as bacillary dysentery. Conclusion The infants and young children under 5?year old were the main population of Yersiniosis adolescent patients under 14?year old. The typical symptoms characterized with mucus stool, fever, WBC and RBC by routine microscopic examination. The preliminary clinical diagnosis of Yersiniosis is easily confused with bacterial dysentery.

Objective To illuminate the epidemic characteristics of Yersiniosis among children in the central city of Beijing and the accuracy of current clinical diagnosis towards Yersiniosis. Methods Etiological surveillance of diarrheal patients, a total of 3 493 cases, was performed in a children hospital in central area of Beijing from 2011 to 2018 continuously. Collected the epidemiological and clinical information of the cases, analyzed the clinical and etiological diagnosis for Yersiniosis and bacterial dysentery and compared the distribution of Yersiniosis cases with the different symptoms. Results A total of 3 493 acute diarrhea cases distributed from the age of 6 months to 13 years old, M (P25, P75) was 1.50 (0.75, 3.17) years old. The 28 cases were isolated Yersinia enterocolitica (isolation rate of 0.80%) and they could be diagnosed as Yersiniosis by etiology. The isolation peaked in May and February. A total of 85.71% (24/28) of Yersiniosis cases were under 5?year old. The children of 3-4 age group had the highest isolation rate (1.52%) while the rate (0.18%) of 0-1 age group was the lowest (P=0.025). The Yersinia enteroclitica isolation rates of diarrheal patients with the symptoms including mucus feces, fever, white blood cell (WBC) and red blood cell (RBC) in feces were higher than the patients without these symptoms (P＞0.05). The 9 of 28 Yersiniosis cases by etiology diagnosis were clinical diagnosed as bacillary dysentery. Conclusion The infants and young children under 5?year old were the main population of Yersiniosis adolescent patients under 14?year old. The typical symptoms characterized with mucus stool, fever, WBC and RBC by routine microscopic examination. The preliminary clinical diagnosis of Yersiniosis is easily confused with bacterial dysentery.

Objective: To analyze the etiological characteristics of infectious diarrhea among people under 5 years old in Dongcheng District, Beijing. Methods: The age, time of infection, clinical symptoms and laboratory test results of the cases who didn't used antibiotics within 3 days in the second maternal and child health care hospital were collected from 2012 to 2015, through the information management system of infectious disease monitoring technology platform. To compare the detection rate of virus and bacteria in children with different sex, time and age,and the difference of clinical characteristics between virus detection group and bacteria detection group by chi square test. Results: 1 977 cases of infectious diarrhea were collected, the median of the month age (P₂₅, P₇₅) was 14.19 (8.31, 23.15) months. The virus detection rate was 34.3% (679 cases); the bacterial detection rate was 14.6% (288 cases). The difference of virus detection rate in children with different months was statistically significant (χ²=72.38, P<0.001), the virus detection rate of 24-60 months (40.9% (188/460)) was the hightest, and the detection rate of 0-5 months (15.3% (48/314)) was the lowest. The difference of bacteria detection rate was also statistically significant (χ²=32.67, P<0.001), and the detection rate of 12-17 months (19.0% (81/426)) was the highest, the detection rate of 0-5 months (6.7% (21/314)) was the lowest. The proportion of vomit and water sample in the virus detection group was 22.2% (136 cases) and 73.3% (449 cases), respectively, which were higher than those in bacteria detection group (8.1% (18 cases) and 57.2% (127 cases)), the difference was statistically significant (χ² values were 125.92 and 19.60; P values were both<0.001); the proportion of mucus stool and fever was 0.8% (5 cases) and 14.0% (86 cases), respectively, which were lower than those in bacterial detection group (4.1% (9 cases) and 18.5% (41 cases)), and the difference was statistically significant (χ² values were 8.50 and 23.01; P values were 0.004 and <0.001). Conclusion The virus detection rate of infantile infective diarrhea is higher than that of bacteria in Dongcheng district of Beijing, and the clinical characteristics are significantly different.

Objective To investigate the influence of the hematoma involving the aortic arch in endovascular aortic repair of complicated type B intramural aortic hematoma. Methods A total of 69 patients[58men; mean age(58.1±8.9)years; range 38-77]underwent endovascular repair between February 2011 and June 2015 were retrospectively reviewed. Patients with hematoma involving about the left subclavian artery level were categorized as group A(n=28) and patients without hematoma involvement to the aortic arch were categorized as group B (n=41). Results All the patients were treated with coverd aortic stents. The success rate was 97.1％ with complete isolation of lesion in 67 patients. The average follow-up period was(19.6±14.1)months. During perioperative period, no procedure related deaths was recorded. Perioperative complications include paraplegia in 1case(1.4％) in group B and stent graft-induced new entry in 2 cases(2.9％) in group A. During the follow-up period 1 case in group A within 1 month and another 1 case in group B within 1 year developed new entries at proximal end of stents. 1 case (1.4％) in group B had asymptomatic type Ⅰ endoleak 2 years after TEVAR. Conclusions Type B aortic intramural hematoma with arch involvement is not a risk factor of stent-induced new entry in perioperative period after endovascular treatment and further studies are needed. Strict control of blood pressure is essential for the prevention of stent-related complications.

Objective: To compare the outcome of radiofrequency catheter ablation under local anesthesia/sedation (S) or general anesthesia(GA) in atrial fibrillation patients. Methods: Data of 498 patients with atrial fibrillation undergoing radiofrequency catheter ablation in our departmentfrom January 2014 to December 2015 were retrospectively analyzed. Two hundred and twenty patients assigned to the GA group, the other 278 patients to the S group. Patients were followed clinically every 3 months within one year after procedure. Immediate electrocardiogram was performed in patients with palpitation or choking sensation in chest. The end point of the study was recurrence of any atrial tachyarrhythmia lasting >30 seconds in device interrogation, 24-hour Holter monitoring or 12-lead electrocardiogram after a single procedure. After the ablation procedure, a blanking period of 3 months was allowed according to the guidelines. Procedure time, radiofrequency time, fluoroscopy time, the detection of paroxysmal supraventricular tachycardia, the success rate and the complications were compared between the two groups. Results: There was no difference in the baseline characteristics between the two groups, such as age, gender, BMI, complications, LVEF, LAD (all P>0.05). The duration of procedure ((117.8±51.7)minutes vs.(115.4±36.9)minutes, P=0.79), duration of fluoroscopy((12.5±11.2)minutes vs. (10.4±10.2)minutes, P=0.35), duration of radiofrequency((40.1±12.9)minutes vs. (48.6±44.3)minutes, P=0.48) were similar between the two groups (P>0.05). Compared with S group, discovery of the frequency of atrioventricular node reentrant tachycardia (AVNRT) was significantly lower in GA group (0 vs. 3.6%(10/278), P<0.01), but the difference disappeared with repeat electrophysiological examination when patients become conscious from GA(3.2%(7/220) vs. 3.6%(10/278), P=0.311). The difference of atrioventricular reentrant tachycardia (AVRT) was similar between the two groups(0.9%(2/220) vs. 0.7%(2/278), P=0.841). Compared with S group, reflection of vagus nerve was less in GA group (1.4%(3/220) vs. 8.6%(24/278), P=0.026). After following up of (356±92) days, freedom from atrial fibrillation/atrial flutter/atrial tachyarrhythmia was similar between the two groups(77.9%(162/208) vs. 79.9%(215/269), P=0.818). Conclusion General anesthesia is a promising method to atrial fibrillation ablation, in view of stable patient status and safety for the procedure. There is no difference in complications, recurrence of arrhythmia between the two groups, but detection rate of AVNRT is lower in GA group.