Myeloid neoplasms (MNs) belong to a group of hematological malignancies characterized by the abnormal biological functions of hematopoietic stem progenitor cells. The abnormal immune and hematopoietic microenvironment of patients with MN interact with malignant clonal hematopoietic stem cells, promoting the occurrence and development of their diseases. MN large granular lymphocyte proliferation (MN-LGLP) is a special and rare clinical phenomenon in this type of disease. Currently, research on this disease in domestic and international cohorts is limited. This study analyzes the clinical and laboratory characteristics of this type of patient and explores the impact of LGLP on the clinical characteristics and survival of patients with MN. Patients with MN-LGLP are prone to neutropenia and splenomegaly. The presence of LGLP is not a risk factor affecting the survival of patients with MN-LGLP. STAG, ASXL1, and TET2 are the most common accompanying gene mutations in MN-LGLP, and patients with MN-LGLP and STAG2 mutations have poor prognoses.

The authors systematically reviewed the progress of health human resources development, personnel management system and conceptual changes from 2011 to 2020 in China, and analyzed the status quo in this regard. The past 10 years have witnessed rapid progress of health human resources, namely better personnel management system and constant innovation in human development concepts. As required by the strategy of empowering the country with talents in the new era, as well as the overall promotion for the Healthy China initiative and the high-quality development of the health industry, higher requirements have been put forward for the quantity and quality, structural distribution and management innovation of health human resources. Therefore it is necessary to further expand the coverage of talents work and innovate talents policy, thus keeping the upgrade of the capability and competence of health talents.

Health manpower is key to the functioning of the health system. There exists a general need to strengthen health human resources in countries at large as they achieve universal health coverage. Through the systematic collection and sorting out of the declarations, initiatives, guidelines in the world and topics at the World Health Assemblies on health manpower-related issues since 2000, this paper summarized and analyzed the key issues and trends on health manpower planning, education and training, international migration, and compensation management, in order to provide reference for China′s health manpower management and practice.

Aim:Pertussis is a respiratory tract infection,the vaccine for which was introduced in the Expanded Programme on Immunization (EPI) in Guizhou Province of China (hereafter referred as Guizhou) in the 1980s.This vaccine rapidly decreased incidence rates of pertussis in the province,however,despite the wide high coverage of the diphtheria,tetanus and acellular pertussis (DTaP) combined vaccine,there has been a resurgence of pertussis since 2014.Even with this recent increase in disease transmission,risk factors for pertussis infection have not been evaluated in Guizhou.We aimed to provide information on pertussis risk factors and insight on designing targeted pertussis control policies and measures through this study.Methods:A 1∶2 matched retrospective case-control study was conducted between 2016 and 2017,involving infants and children younger than 6 years old and parents of the participants.The enrolled cases included clinical and laboratory confirmed pertussis cases according to the WHO-recommended pertussis definition.Controls were selected from children in the same neighborhood who were not diagnosed with pertussis prior to our investigation and did not exhibit any clinical manifestations of pertussis.Results:The household size[Matched odds ratio (ORm) =1.4,95％ confidence interval (CI):1.1-1.7]and house-hold members with antecedent cough (ORm =3.6,95％ CI:1.8-7.2) were significantly associated with their child's pertussis onset.The parents' occupations were significantly associated with their child's pertussis onset(ORm =9.4,95％ CI:1.6-54.8,for mother side;ORm =4.5,95％ CI:1.2-16.5,for father side),when they worked in the business and/or service industry.Having family members with a history of cough was an independent risk factor for pertussis[Adjusted odds ratio (AOR) =43.6,95％ CI:2.7-694.0].Besides,the parents' demographic characteristics and DTaP doses were not found to be independent factors.Conclusion:Household exposure is an important risk factor for pertussis infection in infants and young children and should therefore be considered as a major factor during formulation of pertussis control policies and measures.

Objective:To explore the clinical strategy of using adjacent tissue flaps to immediately repair large facial soft tissue defects after resection of lateral facial skin tumors in the elderly patients.Methods:The clinical data of the elderly patients with large soft tissue defects after resection of skin malignant tumors on the lateral facial region from July 2016 to June 2020 were reviewed by the Department of oral and maxillofacial surgery of Qilu Hospital of Shandong University and the Department of Oral and Maxillofacial Surgery of Xinjiang Uygur Autonomous Region People’s Hospital. All the soft tissue defects after tumor resection were larger than 3.0 cm×3.0 cm. The line drawn from the top of the helix to the lateral canthus was used as an anatomical marker. Twelve cases of type Ⅰ defects were located in the lower part, and 12 cases of type Ⅱ defects were located in the upper part. Type Ⅰ could be subdivided into two subclasses: Type Ⅰa, which was mainly located in the aesthetic unit of the buccal area. Submental artery island flap (SMAIF) was used to repair and restore its thickness and convexity. Type Ⅰb, the defects extended directly to the tragus, which was located in the aesthetic regions of the lateral and zygomatic subunits, cervicofacial or cervicothoracic rotation flaps were used to repair thinner tissue defects. For type Ⅱ, defects mainly located in the temporal and forehead regions abovethe dividing line, which were repaired by the cervicothoracic and forehead rotation flaps. Then, visual analogue scale (VAS) was used to evaluate patients’satisfaction about the incision design and aesthetic outcome 3 months after operation.Results:There were 24 patients (15 males and 9 females) included in this study with an average age of 68.6 years (range from 57-86 years) when the disease was at onset, including 69.7 years for males and 66.8 years for females. The average defect area after tumor resection was 37.1 cm 2 (5.0 cm×4.5 cm-8.5 cm ×7.0 cm). Six cases of type Ⅰa defect were repaired with SMAIFs. Three cases of type Ⅰb defect were repaired with the cervicofacial rotation flaps, and the other three cases of type Ⅰb were repaired with cervicothoracic rotation flaps. Twelve cases of type Ⅱ defect were repaired with cervicothoracic and forehead rotation flaps. Visual analogue scale (VAS) score was 9.3 on average (8.9-9.7) at 3 month after operation, and the patients were very satisfied with the incision design and the cosmetic outcome. No recurrences were found in patients with a follow-up period ranged from 10-43 months (average 27.1 months). Conclusions:One or more adjacent tissue flaps can be used for the immediate reconstruction of the lateral facial region soft tissue large defects. The line drawn from the top of the helix to the lateral canthus can be used as an anatomical marker. The selection of these flaps can be planned preoperatively based on the location and size of the defect or lesion. For elderly patients with relatively low malignant skin cancer, using adjacent tissue flaps to repair large lateral facial soft tissue defects could be the preferred treatment.

Objective:To explore the clinical strategy of using adjacent tissue flaps to immediately repair large facial soft tissue defects after resection of lateral facial skin tumors in the elderly patients.Methods:The clinical data of the elderly patients with large soft tissue defects after resection of skin malignant tumors on the lateral facial region from July 2016 to June 2020 were reviewed by the Department of oral and maxillofacial surgery of Qilu Hospital of Shandong University and the Department of Oral and Maxillofacial Surgery of Xinjiang Uygur Autonomous Region People’s Hospital. All the soft tissue defects after tumor resection were larger than 3.0 cm×3.0 cm. The line drawn from the top of the helix to the lateral canthus was used as an anatomical marker. Twelve cases of type Ⅰ defects were located in the lower part, and 12 cases of type Ⅱ defects were located in the upper part. Type Ⅰ could be subdivided into two subclasses: Type Ⅰa, which was mainly located in the aesthetic unit of the buccal area. Submental artery island flap (SMAIF) was used to repair and restore its thickness and convexity. Type Ⅰb, the defects extended directly to the tragus, which was located in the aesthetic regions of the lateral and zygomatic subunits, cervicofacial or cervicothoracic rotation flaps were used to repair thinner tissue defects. For type Ⅱ, defects mainly located in the temporal and forehead regions abovethe dividing line, which were repaired by the cervicothoracic and forehead rotation flaps. Then, visual analogue scale (VAS) was used to evaluate patients’satisfaction about the incision design and aesthetic outcome 3 months after operation.Results:There were 24 patients (15 males and 9 females) included in this study with an average age of 68.6 years (range from 57-86 years) when the disease was at onset, including 69.7 years for males and 66.8 years for females. The average defect area after tumor resection was 37.1 cm 2 (5.0 cm×4.5 cm-8.5 cm ×7.0 cm). Six cases of type Ⅰa defect were repaired with SMAIFs. Three cases of type Ⅰb defect were repaired with the cervicofacial rotation flaps, and the other three cases of type Ⅰb were repaired with cervicothoracic rotation flaps. Twelve cases of type Ⅱ defect were repaired with cervicothoracic and forehead rotation flaps. Visual analogue scale (VAS) score was 9.3 on average (8.9-9.7) at 3 month after operation, and the patients were very satisfied with the incision design and the cosmetic outcome. No recurrences were found in patients with a follow-up period ranged from 10-43 months (average 27.1 months). Conclusions:One or more adjacent tissue flaps can be used for the immediate reconstruction of the lateral facial region soft tissue large defects. The line drawn from the top of the helix to the lateral canthus can be used as an anatomical marker. The selection of these flaps can be planned preoperatively based on the location and size of the defect or lesion. For elderly patients with relatively low malignant skin cancer, using adjacent tissue flaps to repair large lateral facial soft tissue defects could be the preferred treatment.

Objective To investigate the molecular characteristics of H5 subtype avian influenza viruses (AIV) in Weining, Guizhou Province. Methods Nine representative strains were randomly select-ed from H5 subtype AIV that were identified by real-time PCR in Weining, Guizhou Province from 2015 to 2017. Nucleic acid was extracted from each sample and hemagglutinin (HA) genes were amplified and then sequenced. Homology, genetic evolution and the sites related to pathogenicity, receptor binding regions as well as potential glycosylation of H5 AIV were analyzed by bioinformation software. Results Homology analysis revealed that there was 96. 1%-99. 9% and 95. 7%-100% similarity among the nine strains in nu-cleotide and amino acid of HA gene, respectively. These strains belonged to two branches, H5-1 and H5-2. The cleavage site motifs were PLREKRRKR↓GLF for five strains in H5-1 branch and PQRERRRKR↓GLF for four strains in H5-2 branch, which made them high pathogenic. QSG and QRG at the key receptor bind-ing sites were found in H5-1 and H5-2 branch strains, respectively. They were responsible for receptor bind-ing specificity of AIV. Mutations of 138Q, 139G and 53K were all detected in the nine strains. 129K, 189T, 140K and 282V mutations were discovered in the five strains of H5-1 branch, while 189N, 140M and 282I mutations were found in the four strains of H5-2 branch. Results of the glycosylation motif analysis showed that six sites were conservative, but there was an addition of 124NHT site in two strains of H5-2 branch isolated in 2017. Conclusion Two high pathogenic H5 subtypes of AIV could be epidemic in Wein-ing, Guizhou Province during 2015 to 2017. Although H5 subtype AIV did not possess specific receptor binding regions like human influenza viruses, they were in continuous variation with an increase in glycosyla-tion motifs, which might enhance their virulence and pathogenicity to human beings. Hence, surveillance and study on the molecular properties of H5 subtype AIV should be strengthened.

Objective The clinical effect of the lateral femoral cutaneous artery flap for soft tissue defects of leg wounds. Methods From October 2007 to January 2016, VSD was firstly used to promote the growth of granulation tissue. When the growth of granulation tissue became satisfactory, flaps were designed based on the anatomical characteristics of the lateral femoral cutaneous artery. We repaired 20 cases of wound defects by cutting flaps that coincide with the recipient vessels. Result 20 cases were followed up for 6 to 24 months, 12 months on average. All flaps were survived and only one case had small area of necrosis flap which was healed by replacing medicines. In all cases, wounds were healed and flaps showed good color and good texture. The strength of quadriceps muscle was good and the extension of knee flexion was 0° to 150°. Conclusion To The lateral femoral cutaneous artery flap is used for soft tissue defects of refractory wounds on leg , flap donor sites are sutured directly, the treatment period is shorten and the method is safe and effective. The lateral femoral cutaneous artery flap is one of ideal choices for wound tissue defects.

OBJECTIVETo identify and characterize the Brucella strains from Guizhou province in 2010-2013.

METHODSA total of 12 strains of Brucella suspicious bacteria were isolated in Guizhou province from 2010 to 2013. Four strains (GZLL3, GZLL4, GZLL11 and SH2) were isolated from goat blood samples and eight strains (SH4, GZZY, GZSQ, GZZA, BR13001, BR13004, BR13005 and BR13006) were isolated from blood samples of patient 12 Brucella suspicious strains were identified and characterized using conventional methods. Brucella genus specific gene BCSP31-based PCR (BCSP31-PCR) was used to identify the genus of Brucella and IS711 insert sequence-based PCR (AMOS-PCR) was applied to identify the species of Brucella strains. Goats and patients originated Brucella strains were comparatively analysed using Pulse-field Gel Electrophoresis (PFGE).

RESULTSBoth of conventional methods and PCR identified the 12 Brucella suspicious strains as B. melitensis biotype 3. BCSP31-PCR identification results showed that a specific DNA bands (223 bp) were detected in all the 12 strains and positive control samples with no DNA band in negative samples. AMOS-PCR amplified a 731 bp-DNA bands in all the 12 strains, with 731 bp, 498 bp and 275 bp in M5, S2 and A19 strains, respectively, and no DNA band was detected in the negative control samples. PFGE analysis showed that 12 Brucella isolates from patients and goats showed consistent PFGE patterns with the digestion of restriction enzyme Xba I.

CONCLUSIONThe epidemic species/type of Brucella in both human and animal in Guizhou province was B. melitensis biotype 3 and goat was the main animal source of infection of brucellosis in Guizhou province.

Animals ; Bacterial Typing Techniques ; Brucella ; classification ; Brucellosis ; epidemiology ; China ; epidemiology ; DNA, Bacterial ; Goats ; Humans ; Molecular Typing ; Polymerase Chain Reaction

Objective To identify and characterize the Brucella strains from Guizhou province in 2010-2013. Methods A total of 12 strains of Brucella suspicious bacteria were isolated in Guizhou province from 2010 to 2013. Four strains (GZLL3, GZLL4, GZLL11 and SH2) were isolated from goat blood samples and eight strains (SH4, GZZY, GZSQ, GZZA, BR13001, BR13004, BR13005 and BR13006) were isolated from blood samples of patient 12 Brucella suspicious strains were identified and characterized using conventional methods. Brucella genus specific gene BCSP31-based PCR (BCSP31-PCR) was used to identify the genus of Brucella and IS711 insert sequence-based PCR (AMOS-PCR) was applied to identify the species of Brucella strains. Goats and patients originated Brucella strains were comparatively analysed using Pulse-field Gel Electrophoresis (PFGE). Results Both of conventional methods and PCR identified the 12 Brucella suspicious strains as B. melitensis biotype 3. BCSP31-PCR identification results showed that a specific DNA bands (223 bp) were detected in all the 12 strains and positive control samples with no DNA band in negative samples. AMOS-PCR amplified a 731 bp-DNA bands in all the 12 strains, with 731 bp, 498 bp and 275 bp in M5, S2 and A19 strains, respectively, and no DNA band was detected in the negative control samples. PFGE analysis showed that 12 Brucella isolates from patients and goats showed consistent PFGE patterns with the digestion of restriction enzyme Xba I. Conclusion The epidemic species/type of Brucella in both human and animal in Guizhou province was B. melitensis biotype 3 and goat was the main animal source of infection of brucellosis in Guizhou province.