OBJECTIVES: To investigate the clinical treatment outcomes and the changes of the outcomes over time in extremely preterm twins in Guangdong Province, China. METHODS: A retrospective analysis was performed for 269 pairs of extremely preterm twins with a gestational age of <28 weeks who were admitted to the department of neonatology in 26 grade A tertiary hospitals in Guangdong Province from January 2008 to December 2017. According to the admission time, they were divided into two groups: 2008-2012 and 2013-2017. Besides, each pair of twins was divided into the heavier infant and the lighter infant subgroups according to birth weight. The perinatal data of mothers and hospitalization data of neonates were collected. The survival rate of twins and the incidence rate of complications were compared between the 2008-2012 and 2013-2017 groups. RESULTS: Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of severe asphyxia and smaller head circumference at birth (P<0.05). The mortality rates of both of the twins, the heavier infant of the twins, and the lighter infant of the twins were lower in the 2013-2017 group compared with the 2008-2012 group (P<0.05). Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of pulmonary hemorrhage, patent ductus arteriosus (PDA), periventricular-intraventricular hemorrhage (P-IVH), and neonatal respiratory distress syndrome (NRDS) and a higher incidence rate of bronchopulmonary dysplasia (P<0.05). CONCLUSIONS There is a significant increase in the survival rate over time in extremely preterm twins with a gestational age of <28 weeks in the 26 grade A tertiary hospitals in Guangdong Province. The incidences of severe asphyxia, pulmonary hemorrhage, PDA, P-IVH, and NRDS decrease in both the heavier and lighter infants of the twins, but the incidence of bronchopulmonary dysplasia increases. With the improvement of diagnosis and treatment, the multidisciplinary collaboration between different fields of fetal medicine including prenatal diagnosis, obstetrics, and neonatology is needed in the future to jointly develop management strategies for twin pregnancy.
Bronchopulmonary Dysplasia/epidemiology* ; Female ; Gestational Age ; Humans ; Infant ; Infant, Extremely Premature ; Infant, Newborn ; Pregnancy ; Respiratory Distress Syndrome, Newborn/epidemiology* ; Retrospective Studies ; Treatment Outcome

The culture of schistosomiasis control is specific in the history of Chinese culture. Broadly speaking, the culture of schistosomiasis control is a summary of specific social mood, social consciousness and material culture created by Chinese populations during the progress of schistosomiasis control since the founding of the People’s Republic of China. Narrowly speaking, the culture of schistosomiasis control is the spiritual culture that is jointly created and nurtured by schistosomiasis control workers since the founding of the People’s Republic of China. The spiritual features of Chinese schistosomiasis control culture are characterized by the patriotism and care about the people, the matter-to-fact attitude, the pioneering and enterprising spirit, and the spirit of sacrifice and dedication. The ultimate goal of the research on the culture of schistosomiasis control is to facilitate the achievement of the strategic goal of Healthy China 2030 as scheduled, accelerate the progress towards elimination of schistosomiasis, and to promote the sustainable development of schistosomiasis control in China.

This paper describes the current epidemic characteristics and endemic status of schistosomiasis, analyzes the main challenges of schistosomiasis control and proposes the emphasis and interventions for future schistosomiasis control activities in Hunan Province, so as to provide insights into the elimination of schistosomiasis in Hunan Province.

Objective To evaluate the safety of influenza vaccine and 23-valent pneumococcal polysaccharide vaccine (PPV23) immunized alone or in combination in elderly people and to raise the awareness of vaccine safety among the elderly. Methods From October 2014 to September 2015,454 eld-erly people who were over 60 years old and immunized with influenza vaccine and PPV23 alone or in combi-nation were recruited in this study and divided into five groups. Local and systemic reactions occurred within one month after vaccination were recorded. Results (1) Incidences of adverse reactions among all subjects and people vaccinated with influenza vaccine alone,domestic PPV23 alone,imported PPV23 alone,domes-tic PPV23 combined with influenza vaccine and imported PPV23 combined with influenza vaccine were 10.13%,5.35%,11.63 %,9.52%,17.24% and 12.63%,respectively. Local reaction,injection site pain and mild reaction were the common reactions to vaccination. All reactions occurred within seven days and most of them occurred within 30 minutes to one day after vaccination(82.61%). All subjects recovered within seven days and most of them recovered within one day (84.78%). (2) Compared with the people immunized with domestic or imported PPV23 or influenza vaccine alone,those immunized in combination had higher incidences of reactions to vaccination. Among the three single vaccination groups, domestic PPV23 group had the highest incidence of reactions,followed by imported PPV23 and influenza vaccine groups,but no significant difference was found among them(P>0.05). The incidence of responses to influenza vaccine combined with domestic PPV23 was higher than that to influenza vaccine combined with imported PPV23, but no significant difference was found between them (P>0.05). (3) In each group,women,people aged≥70 years or with chronic diseases had a higher incidence of responses to vaccination than men,people aged 60 to 69 years or without chronic diseases,respectively (P>0.05). Conclusion Immunization with influ-enza vaccine and PPV23 alone or in combination is safe and tolerable in elderly people regardless of gender, age,or whether they are suffering from chronic diseases or not. Both domestic and imported PPV23 have the feature of good safety.

BACKGROUND:The research and application of platelet-rich plasma in tissue regeneration and restoration have always been an issue of concern in the medicine and bioengineering fields.OBJECTIVE:To analyze the effects of platelet-rich plasma in combination with tendon stem cells on histomorphology change and matrix metalloproteinase 1 expression of the tendon tissues in a rabbit model of Achilles tendinopathy.METHODS:Forty New Zealand white rabbits were randomly divided into model group (n=32) and blank control group (n=8).In the model group,the animals were injected about 2 cm distant to the attachment point of the left calcaneus with prostaglandin E2 (once a week,for totally 4 weeks) to make the animal model of tendinopathy.The rabbits in the blank control group were injected the equal amount of normal saline.After 4 weeks,model rabbits were randomly divided into four subgroups:combination group,tendon stem cell group,platelet-rich plasma group and model control group,with eight rabbits in each group.Platelet-rich plasma and tendon stem cells,alone or in combination,and normal saline were injected into the corresponding group,twice with an interval of 3 weeks.At 6 weeks after injection,the tendon tissue was collected and stained for histological examination and detection of matrix metalloproteinasa 1 expression.RESULTS AND CONCLUSION:(1) Hematoxylin-eosin staining:the tendon fibers in the combinationgroup were intact and arranged orderly;in the tendon stem cell group,the tendon fibers were almost arranged orderly despite some fractured fibers;in the platelet-rich plasma group,fiber breakage and loose fiber structure were observed;in the model control group,there were no intact tendon fibers,with the presence of inflammatory cell filtration.(2) Masson staining:The tendon fibers in the combination group had slight wave-shaped changes but the fibers were not cut off;in the tendon stem cell group,the tendon fibers were slightly in disorder,but with the intact structure,and obvious inflammatory cell filtration was observed;in the platelet-rich plasma group,fiber breakage,reduced collagen fibers and inflammatory cell filtration were obviously observed;in the model control group,there were no intact tendon fibers,and inflammatory cell filtration was clearly visible.(3) The expression of matrix metalloproteinase 1:Compared with the blank control group,the expression of matrix metalloproteinase 1 was significantly higher in the other groups except the combination group (P ＜ 0.05).There was no significant difference in the expression of matrix metalloproteinase 1 between the combination group and blank control group (P ＞ 0.05).To conclude,the combination of platelet-rich plasma and tendon stem cells can inhibit the vicious cycle of degeneration of collagen and extracellular matrix,reduce the expression of matrix metalloproteinase 1 in tenocytes,and delay inflammation responses and degeneration due to tendinopathy.

Objective To explore the strategy and countermeasures of Oncomelania hupensis snail control and evaluate the effect in inside-embankment areas of lake-type schistosomiasis endemic area,for providing the effective method for controlling and interrupting the schistosomiasis transmission. Methods The data of schistosomiasis epidemic and its control and preven-tion were collected in Junshan District,Hunan Province,and the effect of snail control countermeasures were evaluated and the trend of indexes of snails was drafted in the inside-embankment areas of Junshan District,Hunan Province from 1998 to 2007. Results The area with snails in the inside embankment areas of Junshan District decreased by 98.43%,from 1496.66 hm2 in 1998 to 23.48 hm2 in 2017. The occurrence rate and average density of of living snails decreased from 20.61%and 0.45 snail/0.1 m2 in 2003 to 2.06%and 0.03 snail/0.1 m2 in 2017. The highest area with schistosome infected snails was found in 2001 and the total area was 79.36 hm2,however,no infected snails were found since 2007. The total fiscal investment for schistosomiasis pre-vention and control was 398.857 million RMB in Junshan District,including molluscicide(81.7709 million RMB)and environ-ment reform(213.5 million RMB)respectively. Conclusion The comprehensive measures,mainly including the combination of molluscicide and environment reform have gotten a significant effect in snail control and elimination in the inside-embankment areas,but the snail surveillance still need to be strengthened in the historic areas with snails.

The selection of the prosthetic material determine the success or failure of hip arthroplasty. Currently, the metals, ceramics, polymer composites and carbon materials are the main prosthetic materials of artificial hip joint. They have some progresses in biocompatibility, elastic modulus,mechanical properties, useful life, but they still can't reach the ideal standard of design. In this essay, we mainly review the characteristics and applications of the current artificial hip joint materials through its classification in order to provide a reference for choosing appropriate hip joint materials in clinic and increasing characteristic of materials. We consider the polymer composites has more advantages such as biocompatibility, mechanical properties, corrosion resistance and price, even if it has shortages in abrasion resistance. As the researches of polymer composites are main focus on abrasion resistance, articular surface and strength,and its performances are increased fast, it has a wide prospect in future.
Animals ; Hip Dislocation ; surgery ; Hip Prosthesis ; standards ; utilization ; Humans

Objective To evaluate the risks of vaccination operation in order to provide scientific basis for policy makings of vaccination operation.Methods The risk matrix and analytic hierarchy process approach were used to evaluate the risks of vaccination operation,including the possibility,severity,risk weight,and risk level.Results Seven items for the first level and thirty one items for the second level vaccination risk factors were determined.In the first level,E level risk (Extremely serious risk ) was vaccination implementation risk,and H level risk (high risk ) was the risks of pre -notification and health education and risks of vaccine and cold chain management.Vaccination implementation risk accounted the largest weight (weight coefficient=38.95%).In second level,E level risk was three inspection and seven verification before vaccination,and H level risk were personnel professional quality,personnel responsibility,pre -inspection,informed before vaccination, vaccination route, site and dose, vaccination operation, post vaccination notification and retention,and three inspection and seven verification before vaccination,accounted the largest weight (weight coefficient=10.14%).The weight of the logical consistency of the test results were satisfactory (consistency ratio<0.1 ).Conclusion The integrated application of risk matrix and analytic hierarchy process in risk assessment of vaccination operation helps to further regulate vaccination services and has application and promotion value.

OBJECTIVETo evaluate the clinical value of endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) biopsy for diagnosis of PET-CT positive mediastinal lymph nodes.

METHODSOne hundred and twenty-six patients with lung cancer undergoing both PET-CT scanning and EBUS-TBNA biopsy in the First Affiliated Hospital of Guanzhou Medical College from July 2008 to August 2010 were included in this study. There were 89 male and 37 female patients with a mean age of 56.3 years (range 34 to 81 years). (18)FDG-PET was considered positive in mediastinal nodes if the PET-CT reported hypermetabolic activity consistent with malignant disease (standardized uptake value > 2.5). All of the patients were clinically followed up.

RESULTSAmong the 126 patients, 185 stations of lymph nodes were punctured. The mean diameter of the nodes was 13.6 mm and the range was 6 - 23 mm. There were no procedural complications. The diagnostic accuracy, sensitivity, and specificity of EBUS-TBNA were 95.7%, 95.7%, and 100%, respectively.

CONCLUSIONSEBUS-TBNA is a minimally invasive, highly effective and accurate, practical and safe procedure for diagnosis of PET-CT positive mediastinal lymph nodes.

Adult ; Aged ; Aged, 80 and over ; Biopsy, Needle ; methods ; Bronchoscopy ; Endosonography ; Female ; Humans ; Lung Neoplasms ; diagnosis ; pathology ; Lymph Nodes ; diagnostic imaging ; pathology ; Lymphatic Metastasis ; diagnosis ; pathology ; Male ; Mediastinum ; diagnostic imaging ; pathology ; Middle Aged ; Positron-Emission Tomography ; Sensitivity and Specificity ; Tomography, X-Ray Computed

Adult ; Aged ; Aged, 80 and over ; Colles' Fracture ; therapy ; Combined Modality Therapy ; External Fixators ; Female ; Humans ; Male ; Manipulation, Orthopedic ; methods ; Middle Aged