Abstract On August 11, 2022, Tongxiang Center for Disease Control detected a case of brucellosis, and the case was not engaged in related work. Case finding and risk factor investigation were immediately conducted to trace the source of infection. It was revealed that the case sold aquatic products at a farmer's market and frequently picked up goods at a seafood warehouse adjacent to a lamb slaughtering site. There was a potential risk of infection due to indirect contact with slaughtered lambs or contaminants. Serological tests were conducted on 9 employees of the slaughtering site and 48 residents nearby, and the brucellosis cases diagnosed in hospitals in the same area were searched. A total of 11 brucellosis cases were identified, including 9 confirmed cases and 2 asymptomatic infections. There were 2 cases of slaughtering workers and 9 cases of non-occupational individuals from the surrounding area of the slaughtering site. Brucella melitensis biovar 3 were isolated from a slaughtering worker and a non-occupational individual. The slaughtered lambs primarily came from northern regions such as Inner Mongolia and Heilongjiang. It was concluded that it was a cluster caused by Brucella melitensis biovar 3 and spread through direct or indirect contact with imported infected lambs or contaminated environments from a lamb slaughtering site. It is suggested to strengthen the quarantine of imported sheep, legally shut down non-compliant lamb slaughtering sites, implement designated slaughtering and enhance occupational protection.

Objective:To understand the current status of nurses' awareness and needs for the Employee Assistance Program (EAP), as to provide basis for the hospital to formulate EAP.Methods:Using the purpose sampling method, 352 ICU nurses from the Nanjing Drum Tower Hospital Affiliated of Nanjing University Medical School were selected as the research subjects from December 2019 to January 2020. Finally, 350 valid questionnaires were obtained. Use the EAP demand questionnaire to investigate the ICU nurses' awareness and demand for EAP.Results:Among the 350 nurses in the intensive unit, 214 cases (61.14%) had never understood EAP, only 8 (2.29%) had understood and experienced the EAP, and 332 cases (94.86%) believed that the hospital′s implementation of EAP was a benefit provided to nurses. The top two service requirements were: "Relief of work pressure" and "mental health consultation", and hope to receive mixed-mode EAP services; in ICU and CCU, nurses hope EAP can help resolve work-family conflicts; in EICU, they need to provide Specific job skills training services.Conclusions:ICU nurses have insufficient cognition of EAP and urgently need to obtain EAP implementation knowledge; at the same time, it is necessary to formulate an implementation plan that meets ICU nurses′ needs for EAP, that is, to relieve work pressure and carry out psychological counseling to ensure that EAP is launch successfully in ICU nurses.

OBJECTIVE: To investigate the association of atrial fibrillation (AF) with hemorrhagic transformation (HT) in patients with ischemic stroke treated by intravenous thrombolysis. METHODS: Clinical data of 3272 patients treated by intravenous thrombolysis from 71 hospitals in Zhejiang Province during June 2017 and December 2018 were retrospectively reviewed. Intracranial HT was defined as intracranial hemorrhage suggested by imaging examination 24 hours after intravenous thrombolysis. Patients were dichotomized into HT group (=533) and non-HT group (=2739). The association of AF and HT was analyzed by univariate analysis and binary logistic regression. RESULTS: Compared with the non-HT group, the HT group were older, had longer onset to needle time (ONT), higher baseline National Institute of Health Stroke Scale (NIHSS) score, higher baseline glucose level, and higher AF rate (<0.05 or <0.01). Binary logistic regression analysis revealed that AF was independently associated with HT (=2.527, 95%:2.030-3.146, <0.01). CONCLUSIONS AF is independently associated with the occurrence of HT in ischemic stroke patients treated with intravenous thrombolysis.
Antifibrinolytic Agents ; adverse effects ; pharmacology ; Atrial Fibrillation ; complications ; Brain Ischemia ; complications ; drug therapy ; Humans ; Retrospective Studies ; Stroke ; complications ; drug therapy ; Thrombolytic Therapy ; adverse effects ; Treatment Outcome

OBJECTIVE: To evaluate the quality of methodology and reporting of Meta-analyses on acupuncture treating ischemic stroke in China. METHODS: The domestic literature of systematic reviews (SRs) on acupuncture treating ischemic stroke was retrieved from CBM, VIP, CNKI and WANFANG databases. The quality of methodology and reporting was measured by A Measurement Tool to Assess Systematic Reviews (AMSTAR) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). RESULTS: Seven studies involving 6 papers in Chinese and 1 paper in English were chosen from 402 papers. The deficiencies of methodology mainly contained incomplete retrieval strategy, less attention to the publication bias and the heterogeneity, etc. The shortages of reporting was on retrieval strategy reporting, the studies features and the risk of bias reporting and evidence strength level reporting, etc. CONCLUSION At present the quality of methodology and reporting of SRs on acupuncture treating ischemic stroke in China has flaws, which needs improvement.
Acupuncture Therapy ; Brain Ischemia ; therapy ; China ; Humans ; Publication Bias ; Stroke ; therapy

Objective To explore the impacts of natural ovulation cycles and stimulation cycles on the outcome of intrauterine insemination (IUI) in order to improve the clinical effects of IUI. Methods 176 women received 384 stimulation cycles. According to different ovulation stimulation protocols , the women were divided into six groups including natural cycle (NC) group, clomiphene citrate (CC) group, letrozole (LE) group;human menopausal gonadotrophin (HMG ) group, CC + HMG group, and LE + HMG group. The pregnancy rate between nature cycles and ovarian hyperstimulation cycles was compared. Results The pregnancy rate was 9.33%in the nature cycle group and 13.27% in the stimulation cycle group, with a significant difference (P < 0.05);and it dif not differ significantly among the stimulation cycle groups (P > 0.05). Conclusions Use of ovulation-induction medications is one of the important factors affecting the pregnancy rate of intrauterine insemination. There are no differences in the outcome of IUI among different ovulation stimulation protocols.

Objective To explore the signaling pathway of apoptosis induced by Paclitaxel (PTX) in leukemia cells and the chemosensitizing effect of adding short hairpin RNA(shRNA) on PTX,which targets the silencer of death domains(SODD).Methods After being treated with PTX,the expressions of SODD,B-cell lymphoma/leukemia-2 (Bcl-2),nuclear factor kappa B (NF-κB) and Caspase-3 proteins in Jurkat cells were determined by Western blot ;the shRNA-SODD vectors were constructed and transfected into Jurkat cells by electroporation,and then G418 was used to select the stable tranfected cell line expressing the shRNA-SODD recombinant plasmids.The incidence of cell apoptosis induced by PTX was determined by flow cytometry labeled with propidium iodide.Results During the process of inducing apoptosis of Jurkat cells,PTX could significantly down-regulate the expressions of SODD and Bcl-2 proteins,degrade Caspase-3 and activate NF-κB.The apoptotic sensibility of Jurkat cells transfected with shRNA-SODD to PTX was significantly increased compared with the control group,and the difference was statistically significant (F =10.35,P ＜ 0.05).Conclusions PTX can effectively induce apoptosis of Jurkat cells.Perhaps,SODD/Bcl-2 represents a specific apoptotic signaling pathway of PTX in leukemia cells and this apoptotic signaling pathway is Caspase-3-dependent,in which the function of NF-κB is to modulate the correlative apoptotic factors.Inhibiting the expression of SODD through transfecting shRNA-SODD vectors can significantly increase the apoptotic sensibility of leukemia cells to PTX.

Objective To investigate the surgical treatment strategies and prognostic factors of cT4bM0 primary rectal cancer.Methods The clinical data of 53 patients with cT4bM0 primary rectal cancer who were admitted to the First Hospital of Peking University from January 2000 to December 2010 were retrospectively analyzed.All the patients received en-bloc multivisceral resection and postoperative chemotherapy.The survival and prognostic factors were analyzed.The patients were followed up via out-patient examination,phone call or mail,and the follow-up was ended till December 2012.The survival curve was drawn using the Kaplan-Meier method,and the survival was analyzed using the Log-rank test.Uni-and multivariate analysis were done using chisquare test and COX's proportional hazard model.Results Of all the 53 patients,20 received posterior pelvic exenteration (PPE),20 received total pelvic exenteration (TPE),3 received low anterior resection (LAR) +local resection of ballder,2 received LAR + ovariectomy,2 received LAR + local resection of ureter,1 received LAR + local resection of posterior vaginal wall,1 received LAR + vesiculectomy and vesectomy,3 received abdominoperineal resection (APR) + local resection of posterior vaginal wall,1 received APR + sacrectomy.R0 resection was achieved in all the patients.No intraoperative death was observed,and the incidence of postoperative complication was 9.4％ (5/53).The results of postoperative pathological examination showed that 2 patients were with well-differentiated adenocarcinoma,41 with moderate-differentiated adenocarcinoma,and 10 with poorly differentiated adenocarcinoma.Twenty-four patients were with lymph node metastasis.Four patients were in TNM stage Ⅰ,25 in TNM stage Ⅱ and 24 in TNM stage Ⅲ.Fifty-three patients were followed up postoperatively,and the median time for follow-up was 33 months (range,4-116 months).The overall 5-year survival rates was 57.3％.The 5-year survival rate for patients with or without lymph node metastasis were 77.1％ and 30.4％,respectively,with significant difference between the 2 groups (x2 =7.374,P ＜ 0.05).The 5-year survival rates of patients with malignant infiltration and inflammatory adhesion mere 51.0％ and 68.5％,with no significant difference (x2=1.148,P ＞0.05).The 5-year survival rates of patients with malignant infiltration and inflammatory adhesion in stage Ⅱ were 74.6％ and 85.7％,with no significant difference between the 2 groups (x2=0.118,P ＞ 0.05).The 5-year survival rates of patients with malignant infiltration and inflammatory adhesion in stage Ⅲ were 28.8％ and 37.5％,with no significant difference between the 2 groups (x2 =0.959,P ＞ 0.05).The results of univariate analysis showed that lymph node metastasis and TNM stage were the risk factors influencing the prognosis of patients with cT4bM0 primary rectal cancer (x2=6.468,6.596,P ＜ 0.05).The results of multivariate analysis showed that lymph node metastasis was the independent risk factor (RR =3.797,P ＜ 0.05).Conclusions En-bloc multivisceral resection should be the first surgical treatment choice for patients with cT4bM0 primary rectal cancer,and lymph node metastasis is the independent risk factor.Under the same N stage,the prognosis of patients with malignant infiltration or inflammatory adhesion is similar if R0 resection is achieved.

ObjectiveTo explore the clinical diagnosis and surgical treatment of primary retroperitonealneurilemoma(schwannoma). MethodsClinicaldataof 47patientsof primary retroperitoneal schwannoma admitted and surgically treated from January 1995 to December 2009 were retrospectivelly reviewed.ResultsAs diagnosed by pathology there were 36 cases of Benign schwannoma,with a median age at onset of 41years, among those 11 patients were symptomatic, and 25 were asymptomatic. There were 11 malignant 11 cases, the median age was 38 years, among those 6 patients were symptomatic, and 5 were asymptomatic. The positive diagnostic rate of preoperative CT and MRI were 36. 2％ ( 17/47 ) and 58. 3％ ( 7/12 ) respectively. Immunohistochemically positive rates of S-100 were 100％ and 81.8％(9/11) in benign and malignant group respectively.All cases underwent surgical treatment. Surgical resection rates for benign and malignant groups were 100％ and 90. 9％(10/11)respectively. There was no perioperative death, Overall 5-year survival rates were 100％ and 45.5％ for benign and malignant tumors groups respectively. In benign group 2 cases recurred, in malignant group 4 cases recurred, and 3 had distant metastasis.ConclusionsPrimary retroperitoneal schwannomas are less common. It is difficult to make an accurate preoperative diagnosis. Surgery is the most effective therapy.Prognosis is good for benign and poor for malignant retroperitoneal neurilemomas.

In order to investigate the inhibitory effects of all trans-retinoitc acid (ATRA) on differentiation and apoptosis of Walker-256 hepatocellular carcinoma cells and the therapeutic effects of ATRA combined with transarterial chemoembolization (TACE) on rat Walker-256 transplanted hepatocarcinoma, Walker-256 hepatocarcinoma cell lines were treated with ATRA at different concentrations. After culture for 48 h, the inhibitory rate of cell proliferation was determined by MTT assay; the changes of Fas and Bcl-2 mRNA expression were determined by RT-PCR, and the expression levels of Caspase3 and Caspase8 proteins were detected by Western blot. Twenty-seven Wistar rat models of hepatocarcinoma were set up successfully by implanting Walker-256 cell lines. The tumor volume at the 11th day after implantation (V(preoperation)) was measured by magnetic resonance imaging (MRI). The 27 rats were randomly and equally divided into three groups, and the therapy scheme was performed as follows: group A (ATRA 0.1 mg+mitomycin 0.05 mL+lipiodol 0.05 mL+gelfoam powder 0.025 mg); group B (mitomycin 0.05 mg+lipiodol 0.05 ml+gelfoam 0.025 mg; group C (0.9% NaCl 0.2 mL). After another 11 days, MRI was performed once again to measure the tumor volume (V(postoperation)). The expression of factor and Ki VIII -67 in the tumor tissues was detected by immunohistochemistry. The results showed that ATRA could suppress proliferation of Walker-256 cell lines. After treatment of Walker-256 cell lines with ATRA, the expression of Fas mRNA was significantly up-regulated and the Bcl-2 mRNA was significantly down-regulated by ATRA at the concentration of 10 mumol/L as compared with the control group (P<0.05). After treatment with 10 mumol/L ATRA for 48 h, the Caspase3 and Caspase8 were significantly activated as compared with the control group (P<0.05). Significant difference existed in growth rate among the three groups (P<0.01) and between either two groups (P<0.05). The expression rate of factor VIII and Ki-67 was gradually increased from group A, group B to group C. The study suggests that ATRA could inhibit the proliferation of Walker-256 cells and the effectiveness of the combined therapy (ATRA+TACE) for treating transplanted hepatoma of rats is superior to that of TACE alone.