Objective:To research and design a negative pressure environment that can be applied in container type of biological isolation shelter,so as to meet the stable negative pressure environment and dynamic intelligent regulation of pressure difference in the container during multimodal transportation,especially under air freight conditions.Methods:The design specifications and research achievements of pressure differences of negative pressure isolation equipment for infectious diseases at home and abroad were comprehensively analyzed.And then,one kind of power-distributed ventilation system without air duct was designed to achieve.The preseted pressure redundancy,real-time monitoring of sensors and dynamic follow-up of pressure were used to realize stable and intelligent regulation of negative pressure within the container during air freight.Results:After testing,the pressure differences of each region of the"three regions and two channels"included clean region,buffer region,contamination region,medical staff passage and patient passage within container type of biological isolation shelter under the negative pressure environment could meet the preseted requirements.The values of pressure differences at the outside of room of clean region,the toilet of clean region,the toilet of clean region of the second dressing room of the buffer region,the contamination region of the first dressing room of the buffer region,the toilet of contamination region and the outside of the room of contamination region were respectively 34.2,38.8,-8.0,-31.7,-15.1 and-44.6.The conditions of the pressure differences within each region of container,which dynamically met the requirements of Biosafety Level-Ⅲ(BSL-3)laboratory,were tested through the sensors,and intelligent display and control equipment that deployed inside of container.Conclusion:The stable negative pressure environment and intelligent regulation for pressure difference in each region of the container can take container to have more high biosafety characteristics,which can effectively ensure the safe transportation of whole region for patients with severe infectious diseases,and the transport and treatment under air freight condition.

Objective:To understand the knowledge and skills of professional technicians in prevention and control of parasitic diseases in Shandong Province, and to provide a basis for further capacity building.Methods:On October 12 and 13, 2017, five professional technicians from each of 17 prefectures and cities in Shandong Province participated in the "Shandong Province Parasitic Diseases Prevention and Control Job Skills Competition in 2017". This competition included theoretical knowledge examination (written test) and operation skill examination (operation test). The written test included basic knowledge of parasites life history, pathogen, diagnosis, epidemic and prevention; the operation test included blood smear making, Kato-Katz thick smear making, microscopic examination of Plasmodium and Helminth eggs. The competition results of the competitors were statistically analyzed, and the pass rate, correct answer rate and accuracy of microscopic examination were calculated. According to the report of malaria cases from 2010 to 2017, 17 prefectures and cities in Shandong Province were divided into malaria classⅠreport area (≥100 cases) and malaria classⅡreport area (< 100 cases), and the competition results of the two types of areas were compared. Results:A total of 85 competitors in Shandong Province participated in the competition, including 19 males (22.35%) and 66 females (77.65%); the age was (34.67±6.04) years old, the youngest was 25 years old, and the oldest was 51 years old. The scores of written test and operation test were (67.06±12.73) and (59.31±14.23) points, respectively, and the difference between them was statistically significant ( t=4.949, P < 0.01). The pass rate of written test was 74.12% (63/85); the correct answer rates of morphology, life history, pathogenicity, diagnosis, epidemic and prevention were 71.76% (366/510), 71.61% (913/1 275), 67.94% (462/680), 71.18% (847/1 190), 66.91% (455/680) and 65.76% (1 062/1 615), respectively, there was statistically significant difference in the correct answer rates of different knowledge points (χ 2=18.185, P < 0.01). The pass rate of operation test was 55.29% (47/85); among them, the pass rates of blood smear making, Kato-Katz thick smear making, microscopic examination of Plasmodium and Helminth eggs were 98.82% (84/85), 98.82% (84/85), 70.59% (60/85) and 31.76% (27/85), respectively. Four Plasmodium species were examined, and the overall accuracy of microscopic examination was 61.41% (261/425), there was no statistically significant difference in the accuracy of microscopic examination between different Plasmodium species (χ 2=4.791, P > 0.05). Nine common Helminth eggs were examined, and the overall accuracy of microscopic examination was 47.29% (402/850), there was statistically significant difference in the accuracy of microscopic examination between different Helminth eggs (χ 2=180.064, P < 0.01). The scores [(28.27±3.74) and (23.20±3.39) points, n=30] of microscopic examination of Plasmodium and Helminth eggs in the malaria classⅠ report area were higher than those in the malaria classⅡreport area [(22.40±5.81) and (18.25±3.41) points, n=55], and the differences were statistically significant ( t=2.217, 2.860, P < 0.05). Conclusions:For professional technicians, the mastery of theoretical knowledge in prevention and control of parasitic diseases is better than operation skills in Shandong Province. So the training and assessment of prevention and control skills of parasitic diseases should be strengthened in areas with weak abilities.

Objective:To investigate the correlation between lipoprotein(a)[Lp(a)]levels and parameters for left ventricular structure in elderly hypertensive patients.Methods:A total of 65 patients aged ≥65 years diagnosed with essential hypertension were enrolled in this retrospective analysis.Left atrial diameter dilation(LAD)was measured to evaluate the degree of cardiac involvement.According to the existence of LAD, patients were divided into the negative group(n=43)and the positive group(n=22). The differences in levels of blood lipids including Lp(a)and LAD as well as other echocardiographic indexes between the two groups were compared, and their correlations were analyzed.Results:Compared with the negative group, the duration of hypertension, LAD, and Lp(a)level increased in the positive group( P<0.05). LAD was correlated with age, duration of hypertension, left ventricular end diastolic diameter and Lp(a)level.The Lp(a)level was correlated with age and LAD( P<0.05). Logistic regression analysis showed that duration of hypertension( OR=1.060, 95% CI: 1.008-1.116)and Lp(a)level( OR=6.394, 95% CI: 1.038-39.396)were independent risk factors for LAD.The area under the receiver operating characteristic(ROC)curve of Lp(a)for LAD was 0.665(0.524, 0.806). Conclusions:Laboratory testing for serum lipoprotein(a) levels will help assess the degree of cardiac involvement in patients with hypertension and has practical value for the risk assessment of cardiac remodeling in elderly hypertensive patients.

Objective:To investigate differences in the value of three chronic kidney disease epidemiology collaboration(CKD-EPI)estimation formulas in the evaluation of renal function damage in elderly patients with hypertension.Methods:A total of 58 patients with essential hypertension over 65 years of age were enrolled from November 2018 to March 2019 in this retrospective analysis.Patients with abnormal results in one or more items out of serum creatinine(Scr), blood urea nitrogen and urine protein were included in the hypertensive renal damage group(the positive group, n=25)and patients without abnormal results were included in the simple hypertensive group(the negative group, n=33). We measured Scr and cystatin c(Cys C)levels in fasting blood for each group.The estimated glomerular filtration rates(eGFR Scr, eGFR Cys C and eGFR Scr-Cys C)were calculated using the CKD-EPI formulas. Results:There was no statistically significant difference in gender, age, body mass index, grade of hypertension, onset time of hypertension, total cholesterol and triglycerides between the two groups( P> 0.05). There were significant differences in Cys C, eGFR Scr, eGFR Cys C and eGFR Scr-Cys C between the two groups( P<0.05). Spearman correlation analysis showed that Cys C was positively correlated with Scr( r=0.427, P<0.01), serum urate( r=0.266, P<0.05)and blood urea nitrogen( r=0.357, P<0.01)and was negatively correlated with eGFR Scr( r=-0.369, P<0.01), eGFR Cys C( r=-0.982, P<0.01)and eGFR Scr-Cys C( r=-0.845, P<0.01). Of the three formulas, eGFRScr-Cys C had the largest area under the receiver operating characteristic(ROC)curve(AUC)and its value was 0.707(0.565, 0.849). Conclusions:For the three estimation formulas, CKD-EPI Scr-Cys C has slightly better diagnostic efficiency than the others and may help improve the diagnosis of renal damage in elderly patients with hypertension.

Objective:To explore the difference between the prevalence of metabolic syndrome (MetS) and its influencing factors between rheumatoid arthritis (RA) patients and osteoarthritis (OA) patients.Methods:2 024 patients with RA were selected as the experimental group inthe First Central Hospital of Tianjin from January 1, 2014 to March 12, 2019. A total of 1 271 patients with OA who were treated at the same time served as the control group.Relevant indicators were measured, and correlation analysis was performed using logistic regression.Results:The prevalence of MetS in the past six years did not differ significantly inpatients with RA ( χ2=5.77, P=0.06) and OA ( χ2=1.11, P=0.57). MetS risk factors were more prevalent inpatients with OA, and the prevalence of MetS in patients with OA was also higher than patients with RA ( χ2=19.07, P<0.01). In logistic regression model, the prevalence of MetS was positively correlated with body weight {RA: 1.14[(95% CI(1.10, 1.18), P<0.01]; OA: 1.11[95% CI(1.07, 1.16), P<0.01]}, blood levels of triglyceride {RA:2.64[95% CI(1.58, 4.40), P<0.01] and OA: 2.91[95% CI(1.32, 6.43), P=0.01]}, and glucose {RA:1.67[95% CI(1.42, 1.97), P<0.01] and OA: 1.76[95% CI(1.31, 2.35), P<0.01]}, and negatively correlated with blood level of high-density lipoprotein cholesterol{RA: 0.09[95% CI(0.02, 0.32), P<0.01] and OA: 0.03[95% CI(0.01, 0.25), P<0.01]} in patients with RA and OA. MetS risk factors such as serum creatinine (Scr) only presented in RA patients 1.04 [ OR: 95% CI(1.01, 1.06), P<0.01]. Conclusion:The prevalence of MetS did not decrease in patients with chronic inflammatory arthritis in the past six years, and OA patients havea greater risk of MetS.

Objective:To examine the associations between serum magnesium (Mg) concentration and metabolic syndrome (MetS), diabetes (DM), hypertension (HTN), hyperuricemia (HU) in rheumatoid arthritis (RA) patients.Methods:From June 29, 2013 to February 29, 2019, 1 009 RA patients were collected at Tianjin First Central Hospital. The Mg concentration, clinical and laboratory indicators, living habits and medication were collected. The multivariate adjusted Logistic regression model was used to evaluate the relationship between Mg and MetS, DM, HTN, and HU.Results:Compared with the lowest quintile serum magnesium, In the MetS regression analysis, OR and 95% CI were 0.26 [95% CI(0.09, 0.76), P=0.01)], 0.17 [95% CI (0.06, 0.47), P<0.01], 0.27 [95% CI(0.09, 0.76), CI=0.01], and 0.22 [95% CI(0.09, 0.58), P<0.01], in second, third, fourth, and fifth (highest) quantiles of serum Mg, respectively, P for trend <0.01. In DM regression analysis, after adjusting for multiple potential confounders in Model 2, OR and 95% CI were 0.58 [95% CI (0.35, 0.96), P=0.03], and 0.51 [95% CI (0.29, 0.89), P=0.02], in third and fifth quantiles of the serum Mg, respectively, P for trend =0.01. But in model 3 this correlation disappears. HTN and HU were not associated with serum Mg ( P>0.05), P for trend >0.05. Conclusion:There was a negative correlation between serum Mg concentration and MetS in RA patients, But no correlation with HTN, HU. After adjusting the glomerular filtration rate, the negative correlation between serum Mg and DM also disappeared.

Objective:To understand epidemiological characteristics of imported cases of malaria in Shandong province and provide scientific basis for timely adjustment of prevention and control measures.Methods:The incidence data of malaria, case investigation data and case review data by Shandong Provincial Reference Laboratory for Malaria Diagnosis from 2017 to 2018 were collected. Software SPSS 18.0 was used for statistical analysis and software QGIS 2.18 was used for mapping.Results:A total of 442 imported cases of malaria were reported in Shandong from 2017 to 2018, and the main infection source was in Africa (97.96%, 433/442). All the 17 prefectures in Shandong reported imported malaria cases, mainly in Jining (88 cases), Yantai (65 cases), Weihai (46 cases), Qingdao (44 cases) and Dezhou (42 cases), accounting for 64.48% (285/442). The cases were distributed in 77.37%(106/137) of counties of the province. The cases were reported in every month without seasonal characteristics. The median ( M) of time interval between onset and the first medical care seeking was 2 days, and the interquartile range ( IQR) was 3 days. The M of time interval between the first medical care seeking and final diagnosis was 0 day, and the IQR was 3 days. The proportion of medical care seeking on onset day was only 27.83% (123/442). Only 69.68% (308/442) of cases were diagnosed with malaria in the first medical care seeking, and the diagnostic accuracy of medical institutions below the county level was lower than other medical institutions (all P<0.01). Only 51.13% (226/442) of cases were diagnosed with malaria in the first medical care seeking, the differences in the rates among medical institutions at different levels were not significant ( P>0.05). Conclusions:The imported malaria in Shandong was characterized by a large number of cases, multiple infection sources and wide area distribution during 2017-2018. The awareness of timely medical care seeking in the cases was low, meanwhile the awareness and ability of malaria diagnosis and treatment in primary medical institutions were still inadequate. It is necessary to adjust the prevention and control measures accordingly.

Objective To compare the effect of pressurized rapid intravenous drip of Shenfu and micro-pumping of dopamine on hypoperfusion in percutaneous coronary intervention (PCI) of acute inferior wall myocardial infarction.Methods A total of 80 patients with acute inferior wall myocardial infarction treated with emergency PCI in Chest Pain Unit of Yantaishan Hospital of Yantai City from May 2014 to May 2015 were enrolled. Then these patients were divided into observation group (n=40,pressurized rapid intravenous drip of normal saline and Shenfu) and control group (n=40,pressurized intravenous drip of normal saline with the same pressure combined with micro-pumping of Dopamine) according to random number table. Blood pressure and heart rate per five minutes were observed and recorded before intravenous drug,five to forty minutes after intravenous drug. Besides,the incidence rates of malignant arrhythmia,vomitting,TIMI grade three flows after intrqvenous drug and major adverse cardiovascular events after 30 days of a follow-up were also observed and recorded.Results Systolic pressure,diastolic pressure and mean arterial pressure of patients between two groups all met and maintained to the expectation after treatment with significant differences between two groups (P<0.05). The incidence rates of malignant arrhythmia,nausea and vomitting in observation group were lower than those in control group with significant differences (P<0.05). There was no statistically significant difference in the proportion of TIMI grade three flows and the incidence of major adverse cardiovascular events after 30 days of a follow-up (P>0.05).Conclusions When the hypoperfusion appears during PCI of acute inferior wall myocardial infarction,the pressurized rapid intravenous drip of Shenfu can improve hypoperfusion which is better than Dopamine in the effects of correcting hypotension and reducing the occurrence of adverse events.

OBJECTIVETo explore the optimal time of acupuncture intervention in the assisted reproduction.

METHODSOne hundred and twenty female mice and 60 male mice were collected. 20 female mice were selected in the natural period group and the rest 100 female mice were prepared as the model of controlled ovarian hyperstimulation (COH). The model mice were randomized into a COH group, a down-regulation group, a gonadotropins (Gn) start group, an injection of human chorionic gonadotropin (HCG) group and an embryo culture group, 20 mice in each one. The donor mice and receptor mice were subdivided in each group, 10 mice in each subgroup. One week before the experiment, vas deferens ligature was done in 30 male mice and the other 30 male mice did not receive ligature. In the down-regulation group, the Gn start group, the HCG injection group and the embryo culture group, electroacupuncture (EA) was applied to "Guanyuan" (CV 4), "Zhongji" (CV 3) and "Sanyinjiao" (SP 6) at the time points accordingly. EA stimulation was in the condition of continuous wave, 2 Hz and 1 mA. No inter-vention was given in the natural period group and the COH group. On the day of HCG injection, the donor mice and the non-ligatured male mice were put in the same cage of each group. The fertilized ovum was collected with the date of fertilization marked and was fostered in the incubator. At the ratio of 1:1, the receptor mice and ligatured mice were put in the same cage in each group. The vaginal plug was examined in the next morning. The pseudopregnancy was marked with the date of plug observed. In the 68th hour of embryo culture, the embryo of the donor was shifted to the receptor on the same day when the plug was observed. The clinical pregnancy rate and embryo imbed site number were observed. RT-PCR assay was adopted to determine the expression of insulin-like growth factor-1 (IGF-1) mRNA in endometrium.

RESULTSIn the COH group, the pregnancy rate, average imbed site number and endometrial IGF-1 mRNA expression were all significantly lower than those in the natural period group (all<0.01). After EA treatment, in the Gn group, the HCG injection group and the embryo culture group, the pregnancy rates were higher significantly than those in the COH group (<0.05,<0.01). In the HCG injection group, the average imbed site number and IGF-1 mRNA expression were increased apparently as compared with those in the COH group (both<0.01), better than those in the Gn group and the embryo culture group (all<0.01).

CONCLUSIONSIn the treatment with acupuncture combined with IVF-ET for infertility, the intervention of acupuncture on the day of HCG injection is the optimal time point. It increases the secretion of endometrial IGF-1 so as to improve the clinical pregnancy rate, the mean imbed site number and the embryo implantation.

Objective To understand the malaria epidemic situation and characteristics in Shandong Province in 2014,so as to provide evidences for taking targeted strategies and measures for malaria elimination. Methods The data of malaria epi?demic and malaria cases of Shandong Province in 2014 were collected from Information Management System for Infectious Dis?eases Report and Information Management System for Parasitic Diseases Control and Prevention. The epidemiological character?istics of malaria situation and the diagnosis and treatment of malaria cases were analyzed by Microsoft Excel 2007. Results A total of 150 malaria cases were reported in Shandong Province in 2014,which increased by 14.50% compared with that in 2013 (131 cases). All the cases were imported from other countries except one imported from Yunnan Province in China,and most of the imported cases were from Africa(142 cases,95.30%). All the cases were confirmed in Shandong Provincial Reference Labo?ratory and there were 121 cases(80.67%)infected with Plasmodium falciparum,16 cases(10.67%)infected with P. vivax,9 cases(6.00%)infected with P. ovale and 4 cases(2.67%)infected with P. malariae. The cases were mainly distributed in Tai’ an(40 cases,26.67%),Yantai(17 cases,11.33%),Weihai(13 cases,8.67%),Jining(11 cases,7.33%)and Heze(11 cases,7.33%)cities. Conclusions There have been no local malaria cases reported in Shandong Province in the continuous 3 years. However,the reported number of imported malaria cases shows an increasing trend in the province in recent years,and the species of infected Plasmodium are diverse. Imported malaria from other countries is the key of malaria control in Shandong Province at present.