Objective:To analyze the epidemiological characteristics of COVID-19 caused by 2019-nCoV Delta variant (B.1.617.2) in Gansu province, and provide evidence for the prevention and control of COVID-19.Methods:The information of COVID-19 cases, including demographic characteristics, epidemiological history, onset date, diagnosis date, exposure place, detection way and infection source, in Gansu from 17 October to 25 November, 2021 were collected. Software Excel 2016,SPSS 22 and ArcGIS 10.7 were used for data process and analysis.Results:As of November 25, 2021, a total of 146 COVID-19 cases had been reported in Gansu and the epidemic affected 10 counties (districts) in 5 cities. The epidemic of COVID-19 in Gansu had three stages: imported case stage,imported-local case stage and local case stage. The age of cases ranged from 1 to 87 years,and the cases in age group 18-59 years accounted for 59.59% (87/146). The male to female ratio of the cases was 1∶1.12 (69∶77). The cases were mainly people engaged in business services (17.12%, 25/146),retirees (15.75%, 23/146),students (13.70%, 20/146),the jobless and unemployed (12.33%, 18/146). In 3 epidemic stages, the cases aged 18-59 years accounted for 44.44%,54.41% and 70.00% respectively,showing an upward trend,and there were differences among different populations (trend χ2=23.24, P<0.001). Also, the incubation period of the cases tended to decrease, and severe cases accounted for 33.33% (6/18), 19.12% (13/68) and 3.33% (2/60) respectively, showing a downward trend. Community screening (25.34%, 37/146) and close contact screening were the main ways to detect cases,the cases detected by close contact screening in 3 epidemic stages accounted for 50.00% (9/18), 66.18% (45/68) and 86.67% (52/60) respectively. The epidemic had obvious case clustering in confined places,and the main exposure modes were living together (24.66%), working/studying together (11.64%), taking same transportation (9.59%) and dining together (9.59%). Conclusions:The COVID-19 epidemic in Gansu was caused by 2019-nCoV Delta variant from imported cases. The virus was mainly transmitted through travel, sharing transportation, dining together and home contact. The characteristics of COVID-19 epidemic in Gansu changed with time, the case's clinical symptoms were not obvious and the incubation period became shorter. The infections mainly occurred in group aged 18 years and above.

Objective:To investigate the isolation rate, antimicrobial resistance phenotype, and molecular type characteristics of Klebsiella pneumoniae from infectious diarrhea outpatients in Tai’an. Methods:A total of 866 stool samples were collected from infectious diarrhea cases in sentinel hospitals in 6 counties of Tai’an from 2013 to 2017. The strains were isolated from stool samples of the cases and identified by biochemical test. Micro broth dilution method was used to detect the drug resistance of the strains. The molecular typing was conducted by using pulsed field gel electrophoresis (PFGE).Results:The detection rate of Klebsiella pneumoniae in the stool samples was 7.97 % (69/866), with significant differences among the 6 counties ( χ2=39.627, P=0.000). Sixty- eight out of the 69 strains were resistant to 15 antibiotics with resistance rate 98.55 %(68/69). The resistance to ampicillin (AMP) was highest (84.06 %) (58/69), followed by sulfamethoxazole (SOX) (72.46 %)(50/69). There were 40 drug resistance profiles, and the predominant resistance profile was AMP-SOX detected ( n=10). The multi-drug resistant (MDR) strains accounted for 33.33 % (23/69). The 69 strains could be divided into 65 PFGE patterns, and no predominant PFGE pattern or cluster was observed. Conclusions:Klebsiella pneumoniae was detected in the stool samples of diarrhea- syndrome outpatients, indicating the risk for community-acquired infection; the strains were resistant to multiplex antibiotics, with wide drug-resistance profiles and high multi-drug resistance rates. The PFGE patterns were diverse, which showed no correlation with drug resistance profiles. Our study indicated that it necessary to strengthen the surveillance and detection of Klebsiella pneumoniae from diarrhea outpatients, which could facilitate the prevention of the emergence and spread of drug resistance strains and the protection of susceptible population.

Objective To evaluate the methodological quality of the systematic evaluation literature of Shenfu injection in the treatment of heart failure with AMSTAR 2 statement.Methods Searching includes Chongqing VIP Database,China Knowledge Network Database,China Biomedical Literature Database.Wanfang Database,PubMed Database,Cochrane library database,search time limit from database construction to Dec 31 st,2017.Two evaluators independently screened the literature based on inclusion and exclusion criteria,and applied the AMSTAR 2 statement list to evaluate all the systematic review literatures included.Results A total of 9 articles were included in the study,and the average reporting rate is 43.75％.The low-reporting domains focused on the review protocols prior to the research,the types of the included studies,the list of excluded documents,the evaluation and causes of bias of risks and heterogeneity,and reports on funds and conflicts of interest.Conclusions The average reporting rate is low overall,indicating that the current reports of the systematic review has defects,which affects the credibility of the systematic review and the use of evidence.For the determination of clinical decision-making,it is recommended that researchers should follow the AMSTAR 2 statement to improve the methodological or reporting quality.

Objective To investigate the importance of conditional control on the results of binary Logistic regression analysis.Methods 664 male patients diagnosed with CHD and 400 healthy controls who visited the Department of Cardiology at People's Hospital of Yuxi City in Yunnan province from October 2010 to March 2013were enrolled consecutively in this case-control study, and 14 physiological and biochemical indexes[including:age,UA,TC,TG,HDL-C,LDL-C,APOA1,APOB100,Lp(a),HCY, TBIL,DBIL,IBIL,γ-GT]were collected.The correlations and differences in mathematical model results between physiological,biochemical indexes and CHD were compared by binary Logistic regression analysis under different statistical analysis strategies and then the model was analyzed by the ROC curve.Results (1)With no conditional control,all of the 14 physiological and biochemical indexes were directly inputted in the binary Logistic regression analysis,and after 11 steps regression analysis,11 indexes[age,UA,TG, HDL-C,LDL-C,APOA1,APOB100, Lp(a), HCY, DBIL, γ-GT]were retained.Because of the self-correcting ability of the binary Logistic regression analysis, relatively satisfactory results can be obtained. However,someof the resultsarehard to explain.(2)According to the application conditions of Logistic regression analysis,after performing the normality test, difference analysis and correlation analysis of these indexes, using condition analysis and control, considering the distribution characteristics of the indexes, excluding internal confounding factors among variables,9 more independent indexes[age,UA,TC,lnTG, lnLp(a),lnHCY,HDL-C,LDL-C and TBIL]were selected for Logistic regression analysis.After 7 steps regression analysis,7 indexes[age, UA, HDL-C, lnTG, lnLp(a), lnHCY and lnTBIL]were finally selected,and the area under the curve is 0.927.Conclusion When the binary Logistic regression analysis was used to confirm risk factors and establish risk assessment models for complex diseases, it is better to adopt strict conditional control to improve the reliability and validity of the analysis.

Objective To investigate the effect of Chinese rhubarb and ephedra prescription on the pulmonary function and blood pressure rhythm in patients with chronic obstructive pulmonary disease (COPD) in remission stage. Methods One hundred and fifty-two patients with COPD were admitted to Harrison International Peace Hospital from March 2014 to December 2016, and they were divided into a western medicine control group (72 cases) and a rhubarb and ephedra prescription group (80 cases) by random number table method, the conventional therapy was given to both groups, and in the rhubarb and ephedra group, additionally Chinese rhubarb and ephedra prescription (rhubarb 6 g, ephedra 5 g, agrimony 15 g, licorice 15 g) was applied, one dose orally taken daily, once 1/2 dose, 2 times a day, the therapeutic course being 3 months. The blood gas analysis, pulmonary function, 6-minute walking distance (6MWD) were detected, and modify medical research committee (mMRC) questionnaire for dyspnea score, the change of ambulatory blood pressure level monitoring and clinical effect were observed before and after treatment for 1, 2, 3 months. Results Compared with those before treatment, the blood gas indexes, the arterial partial pressure of oxygen (PaO2), arterial blood oxygen saturation (SaO2), and pulmonary function indexes, the percentage of one second forced expiratory volume (FEV1) in predictive value (FEV1%), the ratio of FEV1/forced vital capacity (FEV1/FVC) and 6MWD levels in both groups were continuously increased after treatment, while the arterial partial pressure of carbon dioxide (PaCO2) and mMRC score were persistently decreased after treatment in the two groups. After treatment for 2 months, compared with before treatment, the statistical differences appeared in the western medicine control group, while in the rhubarb and ephedra group, the statistical differences turned up after 1 month of treatment. After 3 months of treatment,the PaO2, SaO2, FEV1%, FEV1/FVC and 6MWD in the rhubarb and ephedra group were significantly higher than those in the western medicine control group [PaO2(mmHg, 1 mmHg = 0.133 kPa): 95.42±14.88 vs. 88.28±13.38, SaO2:0.97±0.02 vs. 0.96±0.02, FEV1%: 77.35±11.57 vs. 72.63±10.66, FEV1/FVC (%): 71.01±9.47 vs. 69.28±10.04, 6MWD (m): 318.0±40.1 vs. 306.6±35.7], PaCO2and mMRC were obviously lower in the rhubarb and ephedra group than those in the western medicine control group [PaCO2(mmHg): 40.35±7.58 vs. 43.57±7.85, mMRC score: 1.09±0.65 vs. 1.23±0.69], the differences of the two groups were statistically significant (all P < 0.05). After 3 months of treatment, in the western medicine control group, the percentage of patients with abnormal blood pressure rhythm was reduced to 44.4% (32/72), while in the rhubarb and ephedra group, was decreased to 32.5% (26/72), and the decrease amplitude of the rhubarb and ephedra group was greater than that of the western medicine control group (P > 0.05). The ratio of blood pressure morning peak in the rhubarb and ephedra group was significantly lower than that in the western medicine control group [23.8% (19/80) vs. 31.9% (23/72), P < 0.05], and the total effective rate in rhubarb and ephedra group was significantly higher than that in the western medicine control group [92.5% (74/80) vs. 73.6% (53/72), P < 0.05]. Conclusion Chinese rhubarb and ephedra prescription can improve indexes of blood gas analysis, pulmonary function and blood pressure rhythm in COPD patients in remission phase, and its clinical efficacy is significant.

Objective To observe the clinical efficacy of Tanreqing combined with cefoperazone sulbactam for treatment of patients with chronic obstructive pulmonary disease (COPD) and explore its mechanism. Methods One hundred and twenty eligible COPD patients admitted to the Harrison International Peace Hospital in Hengshui of Hebei Province from June 2015 to August 2017 were selected, their diagnostic criteria were in accordance with the diagnostic guidelines for COPD (in 2007 revision edition) and they were divided into an experimental group and a control group according to the random number table method, with 60 patients in each group. Both groups had the same routine treatment, such as continuous nasal catheter low flow oxygen inhalation, expel phlegm and relieve asthma, and electrolyte disturbance correction. In the control group, cefoperazone sulbactam intravenous drip was given on the basis of conventional treatment; and the experimental group was additionally given Tanreqing intravenous drip on the basis of treatment in the control group. Both groups received 1 course of treatment for 7 days. According to the clinical symptoms, imagelogy, laboratory indexes, the therapeutic effect was evaluated, and the levels of interleukin-2 (IL-2) and tumor necrosis factor-α (TNF-α) in serum were detected by enzyme linked immunosorbent assay (ELISA). Results After treatment, the levels of IL-2 in serum were significantly higher than those before treatment in both groups (μg/L: control group was 15.5±2.8 vs. 12.7±1.5, experimental group was 18.2±3.2 vs. 11.6±1.3, both P < 0.05), while the levels of TNF-α in serum were decreased compared with those before treatment in both groups (μg/L: control group was 23.8±2.1 vs. 26.9±6.2, experimental group was 20.1±4.3, 27.6±3.7, both P < 0.05). After treatment, the concentration of IL-2 in the serum of the experimental group was significantly higher than that of the control group (μg/L: 18.2±3.2 vs. 15.5±2.8, P < 0.05), and TNF-α level was significantly lower than that of the control group (μg/L: 20.1±4.3 vs. 23.8±2.1, P < 0.05). After 1 course of treatment, the clinical efficacy in the experimental group was significant, and its total effective rate was higher than that in the control group [93.3% (56/60) vs. 86.7% (52/60), P < 0.05], and no adverse reactions were observed during the course of treatment in both groups. Conclusion The therapeutic effect of Tanreqing combined with cefoperazone sulbactam for treatment of patients with COPD is obvious, and it can increase the concentration of IL-2 and reduce the concentration of TNF-α in serum.

Objective To investigate the effects of butylphthalide combined with shuxuening on cognitive function and activity of daily living (ADL) of patients with vascular dementia (VD).Methods A prospective research method was conducted, one hundred and one light and moderate VD patients admitted to Harrison International Peace Hospital from July 2014 to November 2016 were enrolled, and they were divided into a control group (49 cases) and an observation group (52 cases) according to random number tables. The two groups were given routine basic treatment, the control group received Shuxuening injection once a day for 2 courses (2 weeks as a course), while the observation group was additionally treated by butylphthalide capsule 0.2 g on the basis of the control group treatment. Before the treatment and 1 and 2 courses after treatment, the cognitive function was evaluated by mini-mental state examination (MMSE) and Hastgawa Dementia Scale (HDS), ADL was evaluated by ADL scale; the efficacy and adverse reactions were observed.Results The MMSE, HDS and ADL scores were increased gradually after treatment in the two groups, reached the highest degree after 2 courses of treatment, and the degrees of increase in the above indicators in observation group were more significant than those in the control group (MMSE score: 27.92±3.51 vs. 23.88±3.31, HDS score: 20.13±2.33 vs. 17.68±2.42, ADL score: 82.14±6.68 vs. 68.17±5.79, allP < 0.05). The total effective rate of observation group was significantly higher than that in the control group [86.5% (45/52) vs. 75.5% (37/49), P < 0.05], and the incidence of adverse reactions was lower than that in the control group [1.9% (1/52) vs. 4.1% (2/49)], being no significant difference between the two groups in adverse reaction (P > 0.05).Conclusions Polybutylene phthalate capsule combined with shuxuening injection can significantly improve the cognitive function and quality of life of patients with vascular dementia,and the clinical efficacy is safe and reliable.

Objective To investigate the effect of rhubarb and ephedra prescription on the pulmonary function and blood pressure circadian rhythm in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods One hundred and enghty six patients with AECOPD admitted to Department of Integrated Medicine of Harrison International Peace Hospital from December 2013 to Auguest 2016 were enrolled, and they were divided into a control group 90 cases and an experimental group 96 cases by random number talbe method. The patients in control group were treated with conventional therapy, while those in the experimental group were treated with the conventional therapy and additionally rhubarb and ephedra prescription (including rhubarb 6 g, ephedra 5 g, agrimony 15 g, licorice 15 g), taken orally 2 times a day, the therapeutic course in the two groups being 2 weeks. The diference of blood gas analysis, pulmonary function indexes, dyspnea score (mMRC) and ambulatory blood pressure monitoring were compared before and after treatment in the two groups.Results Compared with before treatment, the pH value, arterial partial pressure of oxygen (PaO2), forced vital capacity (FVC), one second forced expiratory volume (FEV1), FEV1/FVC of the two groups were significantly increased after treatment, while the arterial partial pressure of carbon dioxide (PaCO2) and mMRC score were significantly lowered, and the changes in the experimental group were more significant than those in the control group [pH: 7.40±0.04 vs. 7.37±0.03, PaO2 (mmHg, 1 mmHg = 0.133 kPa): 81.09±12.54 vs. 76.27±12.20, PaCO2 (mmHg): 48.01±8.27 vs. 51.91±8.37, FVC (L): 2.37±0.39 vs. 2.13±0.45, FEV1 (L): 2.08±0.38 vs. 1.87±0.41, FEV1/FVC: (69.01±12.04)% vs. (64.02±11.81)%, mMRC: 2.02±0.76 vs. 2.40±0.87, allP < 0.05 orP < 0.01]. Based on the percentage of blood pressure circadian value difference, the blood pressure circadian rhythm was divided into dipper type, non dipper type, super dipper type and anti dipper type, 24.2% patients were of dipper type and 75.8% patients were of non dipper, super dipper and anti dipper types. There was no significant difference in daytime systolic blood pressure (dSBP) between patients with super dipper and dipper types (P > 0.05),and the dSBP (mmHg) in patients with non dipper type was significantly higher than that in patients with dipper, super dipper and anti dipper types (131.55±5.08 vs. 117.78±4.47, 118.26±4.24, 113.37±3.97, allP < 0.05); the daytime diastolic blood pressure [dDBP (mmHg)] of anti dipper, non dipper type, dipper type, super dipper type increased in turn (respectively, 63.27±2.80, 70.24±3.82, 73.98±2.61, 82.96±4.52, allP < 0.05); the night SBP (nSBP) of anti dipper type was the highest (127.38±4.98) mmHg, and the nSBP of super dipper type was the lowest (89.07±3.81) mmHg; the night DBP (nDBP) of dipper type was lower than that of non dipper, anti dipper and super dipper types (mmHg: 63.57±1.37 vs. 68.86±2.12, 67.15±1.56, 67.89±2.04, allP < 0.05). After treatment, the proportion of patients with dipper type [66.7% (64/96) vs. 54.4% (49/90)], no dipper type [11.5% (11/96) vs. 8.9% (8/90)], and super dipper type [5.2% (5/96) vs. 2.2% (2/90)] in experimental group was significantly higher than that in the control group, the proportion of patients with anti dipper type [16.7% (16/96) vs. 34.4% (31/90)] in experimental group were significantly lower than those in the control group (allP< 0.05).Conclusion The Rhubarb and ephedra prescription can obviously improve the blood gas analysis indexes, pulmonary function and blood pressure rhythm in patients with AECOPD.

We investigated the serotype,drug resistance features,molecular types,and homology of Salmonella in diarrhea in Tai'an City,and provided scientific evidences for warning,control and clinical treatment.The 31 Salmonella strains isolated from stool specimens of diarrhea in Tai'an were identified by serotyping.Broth dilution technique was used to test the sensitivity of 31 strains of Salmonella to 16 antibiotics.Pulsed field gel-electrophoresis (PFGE) was used for molecular typing and cluster analysis.Results showed that 31 strains of Salmonella were divided into 10 kinds of serotype.S.enteritidis (11/31) was the predominant serotype.All 31 strains of Salmonella were sensitive to cefoxitin and imipenem.The drug resistance rates of the 31 strains of Salmonella were 77.42 ％ (24/31) to sulfafurazole.The 31 strains of Salmonella were divided into 17 patterns by PFGE,with 100％ similarity for each pattern.All the results suggest that there are more serious problems in multiple drug resistance.The genetic variation of S.enteritidis is relatively conservative.Early warning and control on S.enteritidis are exposed to reinforce.

Objective To explore the etiology and epidemiological characteristics of fever and rash syndrome a mong children under the age of five years in Northwest China from 2009 to 2015.Methods Descriptive epidemiological analysis was conducted based on the monitoring data in sentinel hospitals,which was from the information management system of national infectious disease monitoring from 2009 to 2015 in Gansu,Qinghai,Inner Mongolia and Xinjiang.Results The results showed that the major pathogens of fever and rash syndrome among children under the age of five years were enterovirus,measles virus,varicella-zoster virus (VZV) and rubella virus.The major pathogens among children in the age group of 0-years and in the age group of 1-5 years were measles virus and enteroviruses,respectively.Among the positive cases of enterovirus,the positive detectable rates of human enterovirus 71 (EV71) and coxsackie A16 (CA16) were 47.18％ and 45.59％,respectively.The incidences of enterovirus and measles virus infection were mainly concentrated on May to July and March to May,respectively.Conclusions The major pathogens of fever and rash syndrome among children under the age of five years in Northwest china were enterovirus and measles virus with seasonal epidemic characteristics.Therefore,the prevention and control of measles and hand-foot-mouth disease should be strengthened.