Relationship between cadmium exposure and pulmonary function level and chronic obstructive pulmonary disease / 中华劳动卫生职业病杂志

Objective: To analyze the levels and distribution characteristics of blood cadmium and urinary cadmium in American adults, to analyze the relationship between blood cadmium and urinary cadmium and pulmonary function dose response, and to explore the effect of this index on the risk of chronic obstructive pulmonary disease. Methods: In March 2022, 3785 patients from 2007 to 2012 in NHANES database were selected as the subjects. Collect demography data such as gender and age, and test data such as lung function, blood cadmium concentration and Urine cadimium concentration. The relationship between blood and urine cadmium levels and lung function and pulmonary function and chronic obstructive pulmonary diease (COPD) was analyzed by Mann-Whitney U test or Kruskal-Wallis H test, multivariate linear regression and restricted cubic spline method. Results: The geometric mean of blood cadmium and urine cadmium in American adults was 0.37 g/L and 0.28 g/L, FEV(1) and FEV(1)/FVC among different cadmium exposure groups was statistically significant, and there was a negative linear dose-response relationship between serum Cd and urine Cd concentrations and FEV(1)/FVC levels (P(overall)<0.001, P(non-linear)=0.152; P(overall)<0.001, P(non-linear)=0.926). Compared with the lowest quartile concentration (Q1), the highest quartile blood cadmium concentration (Q4) (OR=1.934, P(trend)=0.000) and urinary cadmium concentration (OR=1.683, P(trend)=0.000) may increased the risk of chronic obstructive pulmonary disease. Conclusion: There is a negative correlation between blood cadmium, urinary cadmium levels and lung function in American adults, and cadmium may increase the risk of chronic obstructive pulmonary disease.

Epidemiological and etiological characteristics of Vibrio parahaemolyticus strains causing foodborne disease outbreaks in Guangdong Province from 2017 to 2020 / 中华预防医学杂志

Objective: To study the epidemiological and pathogenic characteristics of Vibrio parahaemolyticus isolated from outbreaks cases in Guangdong Province, 2017-2020. Methods: Epidemiological characteristics of 87 outbreak events caused by Vibrio parahaemolyticus were analyzed. Strains were serotyped, and then analyzed by pulsed-field gel electrophoresis (PFGE). Results: The food-borne disease outbreak caused by Vibrio parahaemolyticus was found in 16 cities. 44.8% (39/87) and 37.9% (33/87) of the outbreaks occurred in hotels, restaurants and school canteens, respectively. Improper food processing and storage (40.2%, 35/87) and cross contamination caused by indiscriminate raw and cooked food (25.3%, 22/87) were the main causes of food-borne disease outbreaks of Vibrio parahaemolyticus. The main serotypes of patient derived strains were O3:K6 (87.5%) and O4:KUT (22.5%). The similarity value between O3:K6 type isolates was 65.5%-100.0%, and the PFGE pattern similarity value of O4:KUT type isolates was 66.5%-100.0%. Conclusion: Outbreaks caused by Vibrio parahaemolyticus are widely distributed in Guangdong province. It is necessary to strengthen the publicity and education on the correct handling of food in hotels, restaurants, schools, and unit canteens. O3:K6 and O4:KUT serotypes are the main serotypes of the outbreak. There is genetic diversity among the epidemic strains.

Reinforcement of sterols production through directed storage and transportation in yeast: a review / 生物工程学报

Sterols, a class of cyclopentane poly-hydrophenanthrene derivatives, are the predominant membrane constituent of eukaryotes. These substances have a variety of biological activities and have been widely used in food and pharmaceutical industries. The presence of endogenous ergosterol biosynthetic pathway in Saccharomyces cerevisiae cells make it an ideal chassis for the de novo synthesis of sterol and its derivatives. Most recently, the rational modification of organelles provides a novel strategy for the directed transportation and storage of target products and the ultimate enhanced product synthesis. This review summarizes the phenotypic responses of S. cerevisiae cells upon different physiological stimulations and the underlying molecular mechanisms. Reinforcement of sterol production through directed storage, transportation, and excretion of sterols offers a novel strategy for breaking the limitation of de novo biosynthesis of sterols in yeast.

Kinetic Characteristics of Neutralizing Antibody Responses Vary among Patients with COVID-19 / 生物医学与环境科学（英文）

Objective@#The coronavirus disease 2019 (COVID-19) pandemic continues to present a major challenge to public health. Vaccine development requires an understanding of the kinetics of neutralizing antibody (NAb) responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).@*Methods@#In total, 605 serum samples from 125 COVID-19 patients (from January 1 to March 14, 2020) varying in age, sex, severity of symptoms, and presence of underlying diseases were collected, and antibody titers were measured using a micro-neutralization assay with wild-type SARS-CoV-2.@*Results@#NAbs were detectable approximately 10 days post-onset (dpo) of symptoms and peaked at approximately 20 dpo. The NAb levels were slightly higher in young males and severe cases, while no significant difference was observed for the other classifications. In follow-up cases, the NAb titer had increased or stabilized in 18 cases, whereas it had decreased in 26 cases, and in one case NAbs were undetectable at the end of our observation. Although a decreasing trend in NAb titer was observed in many cases, the NAb level was generally still protective.@*Conclusion@#We demonstrated that NAb levels vary among all categories of COVID-19 patients. Long-term studies are needed to determine the longevity and protective efficiency of NAbs induced by SARS-CoV-2.

Reproductive characteristics and habitat factors of Acanthopanax giraldii / 中国中药杂志

The growth parameters,clonal propagation parameters and sexual reproduction parameters of Acanthopanax giraldii population were systematically investigated and analyzed by means of population ecology in this study. The correlation among the above mentioned parameters and the correlation among canopy density,topography and soil fertility factors were analyzed. It is clear that there was a significant correlation among the clonal ramets,the fruit production capacity of the cluster and the new shoot production capacity of the A. giraldii. Sexual reproduction and clonal reproduction played an important role in the continuation of the population. Illumination was the key ecological factor that determined growth type. The increase in canopy density changed the population from " group clonal growth" to " guerrilla clonal growth",and the higher stand closure degree and low-strength herb layer competition was a necessary condition for seed germination and colonization. Under the background of natural forest protection and sustainable development of resources,the reproductive characteristics of wild A. giraldii resulted in the decrease of its recoverable quantity.

The preliminary analysis of the endoscopic holistic rhinoplasty—report of 52 cases / 中华整形外科杂志

Objective@#To analyze the clinical effect of the endoscopic holistic rhinoplasty in order to improve its clinical application and safety.@*Methods@#The patients with external nasal deformities and complained nasal congestion were assessed before operation and undergoing endoscopic holistic rhinoplasty from January 2015 to June 2017. Therefore, the internal nasal plasty and external nasal plasty were performed simultaneously, so as to correct the abnormalities of internal and external nasal structures, restore nasal ventilation function, and achieve the purpose of external nose cosmetology. The nasal congestion, visual analog scale, rhinomanometry and acoustic rhinometry and patient satisfaction were used to assess the efficacy. SPSS 21.0 was used for statistical analysis. Paired sample t test was used for preoperative and postoperative comparison, and P<0.05 was taken as statistically significant difference.@*Results@#All the patients were followed up from one month to one year without complications. Postoperative nasal obstruction VAS score (1.63±0.76) was significantly lower than preoperative(6.35±0.65) (t=6.315, P<0.001). The minimum nasal cross-sectional area was (0.38±0.29) cm2 preoperatively and (0.52±0.14) cm2 postoperatively, which was significantly higher than that before the operation (t=9.732, P<0.001). Postoperative nasal volume (9.21±3.23) cm3 was significantly higher than preoperative (6.44 ± 1.04) cm3 (t=9.559, P<0.001), and postoperative nasal resistance (0.26 ± 0.07) kPa·s/L was lower than preoperative (0.65±0.21) kPa·s/L(t=7.524, P<0.001). The postoperative satisfaction survey result were very satisfactory in 41 cases (78.85%), accounted satisfaction in 11 cases (21.15%).@*Conclusions@#The application of the endoscopic holistic rhinoplasty has a good clinical effect and a high degree of satisfaction.

Stem cell models for commercialization / 中国组织工程研究

BACKGROUND: Stem cells are the potentially immortal cells capable of self-renewal, which are essential to the mystery of human development and aging, and are also the core of research for regenerative medicine. OBJECTIVE: To summarize the biological characteristics of embryonic stem cells, adult stem cells and induced pluripotent stem cells, to review the clinical and commercial applications in stem cell therapy and drug screening, and to analyze the problems and prospects in stem cell industry. METHODS: We searched relevant articles about stem cell models in PubMed and CNKI databases during 1995 to 2017 on internet, and took"stem cells, embryonic stem cells, adult stem cells, induced pluripotent stem cells, stem cell therapy, drug screening" as the keywords in English and Chinese, respectively. RESULTS AND CONCLUSION: According to the origin, stem cell models are divided into three types: embryonic stem cells, adult stem cells and induced pluripotent stem cells. Different types of stem cells have their unique biological advantages. Embryonic stem cells can generate all somatic cell types, but the application is limited by ethical disputes. As for adult stem cells, there are the most extensive and in-depth, studies as the well as the most prevalent and mature applications. Induced pluripotent stem cells have similar characteristics as embryonic stem cells, and furthermore their use avoids source restriction, moral and ethical controversies, bringing new opportunities for stem cell application. Stem cell-based cell therapy has shown successful achievement. There have been a few commercial products about adult stem cells-based cell therapy; in the meanwhile both embryonic stem cells and induced pluripotent stem cells are making their way into clinical trials. In addition, pluripotent stem cells hold great promise for the specific drug screening because they enable scientists to establish a variety of cell and disease models in vitro.

Observation of systemic adverse reactions by specific immunotherapy and analysis of risk factors in allergic rhinitis / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the systemic adverse effects of specific subcutaneous immunotherapy (SCIT) in patients with allergic rhinitis (AR) and explore the possible risk factors.@*Methods@#A retrospective study was conducted on AR patients who underwent SCIT from January 2014 to January 2017 in Department of Otorhinolaryngology, the First Affiliated Hospital of Chongqing Medical University. For patients with adverse reactions, the detailed medical history during treatment was reviewed.@*Results@#A total of 1608 injections were performed on 102 patients, there were 12 cases / 21 times systemic adverse events, including systemic urticaria, angioedema and Grade Ⅰ systemic adverse reactions. There were 3 cases of grade Ⅳ adverse reactions. Systemic adverse reaction was prone to an initial treatment phase where the dose and concentration of the injection were increasing. Meanwhile, it was more common in young patients aged 20-40 years old and easy to occur in May and June. About the possible risk factors, the most common one was obvious local adverse reactions (17/21), followed by prolonged injection interval (9/21), the recent exposure to a large number of allergens (7/21) and strong positive skin prick results (7/21).@*Conclusions@#The systemic adverse effects, which were induced by SCIT, mainly included systemic urticaria, angioedema and Grade Ⅰ systemic adverse reactions. Systemic adverse reaction was prone to an initial treatment phase where the dose and concentration of the injection were increasing.

Clinical analysis of 258 cases of nasal-sinus benign and malignant tumors / 重庆医学

Objective To analyze the clinical features of 258 cases of nasal-sinus benign and malignant tumors to improve the accuracy of clinical diagnosis.Methods The clinical data of 258 patients with nasal-sinus tumor confirmed by pathology were retrospectively analyzed and the clinic differences between benign and malignant tumors were compared.Results The clinic manifestations of sinonasal neoplasm were varied.The incidences of epistaxis or blood in the tears,headache,facial numbness or pain,eye pain or epiphora were significantly higher in the benign tumors group than in the malignant tumors group (P＜0.05).Among 196 patients undergoing surgery,the coincidence rates of preoperative and postoperative paraffin sections were similar in the two groups (P＞0.05).Among 63 surgical patients with malignant tumors,the coincidence rate of 232 incised-margin frozen sections and postoperative paraffin sections was 98.70％ (229/232).Among 34 cases,the coincidence rate of frozen sections and postoperative paraffin sections was 91.18％0 (31/34),in which 6 cases were immediately intraoperative frozen,and 66.67％ (4/6) of the cases that changed into malignancy from benignity were not consistent with the preoperative diagnosis of paraffin sections.Conclusion The sinonasal tumors are lacking specificity in clinical manifestations,but rapid intraoperative frozen section examination is helpful to improve the diagnosis rate;continuously frozen pathological examination should be performed in malignant tumor margins.

The factors influence the use of angiotensin-converting enzyme inhibitors/ angiotensin receptor blockers (ACEI/ARB) in patients with acute myocardial infarction in Gansu, Ningxia, Qinghai and Xinjiang from 2001 to 2011 / 中华急诊医学杂志

Objective To investigate the rate of employing angiotensin converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) therapy in patients with acute myocardial infarction (AMI) in Gansu,Ningxia,Qinghai and Xinjiang provinces from 2001 to 2011,in order to determine the factors affecting the use of ACEI/ARB.Methods The original data of this study were obtained from the China PEACE,a national retrospective study of AMI to evaluate clinical outcome of coronary heart disease from 31 provinces.A part of these data was selected from 8 cooperative hospitals (2 hospitals were tertiary class and 6 hospitals were secondary class) from Gansu,Ningxia,Qinghai and,Xinjiang provinces for further analyses.The clinical data of AMI patients in 2001,2006 and 2011 were collected to analyze the use of ACEI/ARB therapy in each of these years.Binary logistic regression analysis was used to identify factors influencing the use of ACEI/ARB.Results Of 311 eligible patients included,300 were categorized into Class Ⅰ AMI and 11 into Class Ⅱ a AMI according to Chinese guidelines.From 2001 to 2011,there wassignificant change in the use of ACEI/ARB in term of percentage in patients with Class Ⅰ AMI (69.57％,82.19％ and 60.77％,P =0.033),but such change did not occur in patients with Class Ⅱa AMI (40％,0％ and 60％,P =0.525).Among three specific years,the percentage of ACEIs employed was noticeably higher than that of ARBs.Binary logistic regression analysis showed that patients with hypertension (OR =2.3,95％ CI:1.3-4.1),heart failure (OR =1.95,95％ CI:1.7-5.8),smoking indulgence (OR =2.0,95％ CI:1.2-3.6) were more likely to be treated with ACEI/ARB,and patients with prior stroke (OR=0.3,95％CI:0.1-0.8),systolic blood pressure ＜90 mmHg (OR =0.1,95％CI:0-0.5)were less likely to be treated with ACEI/ARB.Conclusiorns In underdeveloped areas such as Gansu,Ningxia,Qinghai and Xinjiang provinces,the overall proportion of rational and necessary use of ACEI/ARB use in patients with AMI during hospitalization is still low.The rational use of ACEI/ARB lags behind the advance of medical condition progress,economic development and information availability,especially in patients with a history of stroke,low blood pressure.Patients with hypertension,heart failure,smoking indulgence were more likely to get ACEI/ARB therapy.The main reasons of this phenomenon were attributed to firstly the thorough understanding of standard medication guide to coronary heart disease to be lacking among some professionals,secondly,the side effects of these drugs to be unnecessary worried about among certain of doctors,and thirdly,low awareness of the pathogenesis of AMI disease and the lack of concerning for patients to be existent.

The factors influence the use of angiotensin-converting enzyme inhibitors/ angiotensin receptor blockers (ACEI/ARB) in patients with acute myocardial infarction in Gansu, Ningxia, Qinghai and Xinjiang from 2001 to 2011 / 中华急诊医学杂志

Objective To investigate the rate of employing angiotensin converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) therapy in patients with acute myocardial infarction (AMI) in Gansu,Ningxia,Qinghai and Xinjiang provinces from 2001 to 2011,in order to determine the factors affecting the use of ACEI/ARB.Methods The original data of this study were obtained from the China PEACE,a national retrospective study of AMI to evaluate clinical outcome of coronary heart disease from 31 provinces.A part of these data was selected from 8 cooperative hospitals (2 hospitals were tertiary class and 6 hospitals were secondary class) from Gansu,Ningxia,Qinghai and,Xinjiang provinces for further analyses.The clinical data of AMI patients in 2001,2006 and 2011 were collected to analyze the use of ACEI/ARB therapy in each of these years.Binary logistic regression analysis was used to identify factors influencing the use of ACEI/ARB.Results Of 311 eligible patients included,300 were categorized into Class Ⅰ AMI and 11 into Class Ⅱ a AMI according to Chinese guidelines.From 2001 to 2011,there wassignificant change in the use of ACEI/ARB in term of percentage in patients with Class Ⅰ AMI (69.57％,82.19％ and 60.77％,P =0.033),but such change did not occur in patients with Class Ⅱa AMI (40％,0％ and 60％,P =0.525).Among three specific years,the percentage of ACEIs employed was noticeably higher than that of ARBs.Binary logistic regression analysis showed that patients with hypertension (OR =2.3,95％ CI:1.3-4.1),heart failure (OR =1.95,95％ CI:1.7-5.8),smoking indulgence (OR =2.0,95％ CI:1.2-3.6) were more likely to be treated with ACEI/ARB,and patients with prior stroke (OR=0.3,95％CI:0.1-0.8),systolic blood pressure ＜90 mmHg (OR =0.1,95％CI:0-0.5)were less likely to be treated with ACEI/ARB.Conclusiorns In underdeveloped areas such as Gansu,Ningxia,Qinghai and Xinjiang provinces,the overall proportion of rational and necessary use of ACEI/ARB use in patients with AMI during hospitalization is still low.The rational use of ACEI/ARB lags behind the advance of medical condition progress,economic development and information availability,especially in patients with a history of stroke,low blood pressure.Patients with hypertension,heart failure,smoking indulgence were more likely to get ACEI/ARB therapy.The main reasons of this phenomenon were attributed to firstly the thorough understanding of standard medication guide to coronary heart disease to be lacking among some professionals,secondly,the side effects of these drugs to be unnecessary worried about among certain of doctors,and thirdly,low awareness of the pathogenesis of AMI disease and the lack of concerning for patients to be existent.

A primary analysis on CT and MRI features of common malignant sinonasal tumors / 实用医学杂志

Objective To explore the imaging characteristics of common malignant sinonasal tumors for improving the diagnostic accuracy of the disease. Methods Radiological and clinical data of 78 patients with sino-nasal malignant tumors confirmed by pathological examination were retrospectively analyzed. Results Sinonasal malignant tumors lacked imaging specificity. Most of CT showed uneven soft tissue densities with unclear boundary and destruction of bone which invaded the soft tissue outside of the cavity including orbit or intra-cranium. There was moderate to remarkable enhancement of the lesion. T1WI in MR demonstrated homo-and hypo-intense signal , while T2WI revealed homo- and hyper-intense signal ,and post contrast MR imaging displayed heterogeneous con-trast enhancement. There was no significant statistical difference between CT and MRI in the detection rate of ma-lignant tumors(P > 0.05),but CT in combination with MRI improved the positive rate of detection(P < 0.05). Conclusions The imaging of sinonasal malignant tumors is complicated and lacks specificity. For complicated si-nonasal malignant tumors,enhanced CT in combination with MRI should be used to determine the nature and limi-tation of the tumor,and its relationship with the surrounding structures,resulting in improvement of the diagnostic accuracy of the disease.

Association of hemoglobin with ankle-brachial index in general population

OBJECTIVES: Previous studies have demonstrated that both low and high hemoglobin concentrations are predictive of adverse cardiovascular outcomes in various populations. However, an association of hemoglobin with the ankle-brachial index, which is widely used as a screening test for peripheral arterial disease, has not yet been identified. METHODS: We examined 786 subjects (236 women and 550 men) who received routine physical check-ups. The ankle-brachial index and several hematological parameters, including the hemoglobin level, hematocrit and red blood cell count and other demographic and biochemical characteristics were collected. Univariate and multivariate linear regression analyses were performed to assess the relationships between the ankle-brachial index and the independent determinants. Receiver operating characteristic curve analysis was conducted to calculate the cut-off level of hemoglobin for detecting a relatively low ankle-brachial index (less than 20% of all subjects, which was 1.02). RESULTS: The hemoglobin level, hematocrit and red blood cell count were correlated with the ankle-brachial index in the males (r=-0.274, r=-0.224 and r=-0.273, respectively, p<0.001 for all), but these associations were not significant in the females. Multivariate linear regression analysis revealed that the independent determinants of the ankle-brachial index included age, total cholesterol, high-density lipoprotein cholesterol and the white blood cell count for the females and age, hypertension, total cholesterol and hemoglobin (β=-0.001, p<0.001) for the males after adjusting for confounding factors. Receiver operating characteristic curve analysis revealed that the cut-off level of hemoglobin for predicting a low ankle-brachial index was 156.5 g/L in the males. CONCLUSIONS: A high hemoglobin concentration was independently correlated with a low ankle-brachial index in the healthy males, indicating that an elevation in this level may be associated with an increased atherosclerosis risk.

The diagnostic value of circulating microRNAs for middle-aged (40–60-year-old) coronary artery disease patients

OBJECTIVE: Circulating microRNAs have been recognized as promising biomarkers for various diseases. The present study aimed to explore the potential roles of circulating miR-149, miR-424 and miR-765 as non-invasive biomarkers for the diagnosis of coronary artery disease in middle-aged (40–60-year-old) patients. METHODS: Sixty-five stable coronary artery disease patients (49–57 years old), 30 unstable coronary artery disease patients (49–58 years old), and 32 non-coronary artery disease patients (49–-57 years old) who were matched for age, sex, smoking habits, hypertension and diabetes were enrolled in this study. Total RNA was isolated from plasma with TRIzol reagent. Circulating miRNA levels were measured by quantitative real-time polymerase chain reaction. RESULTS: Circulating miR-149 levels were decreased 4.49-fold in stable coronary artery disease patients (1.18 ± 0.84) and 5.09-fold in unstable coronary artery disease patients (1.04 ± 0.65) compared with non-coronary artery disease patients (5.30 ± 2.57) (p<0.001). Circulating miR-424 levels were reduced 3.6-fold in stable coronary artery disease patients (1.18 ± 0.60) and 5-fold in unstable coronary artery disease patients (0.86 ± 0.54) compared with non-coronary artery disease patients (4.35 ± 2.20) (p<0.001). In contrast, circulating miR-765 levels were elevated 3.98-fold in stable coronary artery disease patients (6.09 ± 2.27) and 5.33-fold in unstable coronary artery disease patients (8.17 ± 2.77) compared with non-coronary artery disease patients (1.53 ± 0.99) (p<0.001). Receiver operating characteristic curve analysis revealed that the respective areas under the curve for circulating miR-149, miR-424 and miR-765 were 0.938, 0.919 and 0.968 in stable CAD patients and 0.951, 0.960 and 0.977 in unstable coronary artery disease patients compared with non-coronary artery disease patients. CONCLUSION: Our results suggest that circulating miR-149, ...

Comparison of curriculum and degree conferment in higher medical education between Germany and China / 中华医学教育探索杂志

The higher medical education in China starts late and needs further exploration and improvement.While in Germany,it is elite education with a long history.Compared with China,in curriculum setting,Sociology,Medical health security,Humanities and Social Sciences and Organ system classification courses are more emphasized,and in terms of degree,it only has Doctor degree but with higher quality in Germany.Higher medical education in China will also take the path of the elite education.We can learn from the German medical education development experience and pay attention to solving the lack of the curriculum by supplementing social medicine and medical health security,increase the autonomy of the instructors in the training process,strengthen the medical students' social responsibility,and improve the quality of higher medical education in China.

One case report of primary sphenoid sinus tuberculosis / 临床耳鼻咽喉头颈外科杂志

We report a case of primary sinonasal tuberculosis in a 23-year old man. He had a half-year history of headache and eye pain on the left side, and found the neoplasm of nasopharynx 15 days ago. Previously denied history of tuberculosis and contact history. After be admitted to hospital, twice biopsy from neoplasm of na- sopharynx were both of chronic inflammation. Coronal CT scan of the lesion when admission found the left parasellar region and the left sphenoid sinus soft tissue density increased, about 20 mm X 32 mm X 34 mm, left inferior wall between sella bone defects, and bone sclerosis, plain CT value was about 34 HU, the lesion protruded downward left the nasopharynx. Eight days after he was admissioned in hospital of sphenoid sinus biopsy showed granulomatous inflammation and tuberculosis diagnosis was considered. Review of the lesion is partial absorbed after 11 months of anti-tuberculosis treatment and now is still in follow-up.

Application of European position paper on rhinosinusitis and nasal polyps in clinical teaching for Otorhinolaryngology postgraduates / 中华医学教育探索杂志

Rhinosinusitis is a popular disease in otorhinolaryngology.A guideline document,European position paper on rhinosinusitis and nasal polyps (EPOS) developed on the basis of evidencebased medicine was used in clinical teaching.Theoretical teaching was promoted by reading and understanding EPOS.Meanwhile,EPOS was used in clinical practices of preclinical ward round,case analysis and independent bed charge,which laid a solid foundation to help otorhinolaryngology postgraduates fully grasp the theoretical knowledge of rhinosinusitis and nasal polyps,improve clinical practice abilities and develop standardized philosophy of diagnosis and treatment finally.

Analysis of the brucella pathogen and its molecular genotype in Guangdong province / 中国地方病学杂志

Objective To analysis the etiology and molecular classification of brucella strains isolated in Guangdong province in 2010.Methods The strains of 19 brucella were verified and identified by some methods including traditional biology phenotype confirmation,PCR amplification and pulsed field gel electrophoresis (PFGE).Results On phenotype level,4 strains were brucella melitensis biovar 1,2 strains were brucella suis biovar 3,and the rest were brucella melitensis biovar 3,which were specific B genes positive strains,and the PFGE typing similar values ranging from 67.9％ to 100％.In addition to the four strains from Zhuhai for the outbreak,the homology was 100％,and the rest were sporadic cases.Conclusions Brucella cases,in Guangdong province,are highly sporadic and dispersed outbreaks.Compared with a few years ago,it shows species diversification,and brucella melitensis biovar 3 is still the dominant serotype.PFGE can be used to distinguish the three species of brucella,but it can't effectively distinguish the allotypes.

Surveillance and analysis on the pathogenic features of Salmonella in Guangdong province in 2010 / 中华预防医学杂志

<p><b>OBJECTIVE</b>In order to better understand the nature of Salmonella infection in diarrheal patients in Guangdong province, the study analyzed the serum types, antibiotic resistance and molecular determinants of the isolated Salmonella strains.</p><p><b>METHODS</b>In year 2010, 8405 diarrhea patients from 16 surveillant hospital in Guangzhou, Zhongshan, Dongguan, Zhuhai, Maoming, Yangjiang and Jiangmen cities in Guangdong province, were recruited in the study. A total of 8405 fecal specimen were collected and subjected to Salmonella isolation and culture. The isolated Salmonella strains were further analyzed via serotyping, antimicrobial susceptibility testing, and PFGE. The χ(2) test was applied to compare the differences between the isolated Salmonella strains in different seasons and districts. BioNumerics software was used to analyze the PFGE results in order to determine the correlation between different Salmonella strains.</p><p><b>RESULTS</b>The positive rate of the surveillant Salmonella in Guangdong province was 3.58% (301/8405) in 2010; with the gender ratio at 1.34:1 (166/124). Salmonella infection was found in all age groups, and most in infants, accounting for 57.48% (173/301). The isolated rates of Salmonella were separately 3.48% (61/1751), 4.97% (134/2695), 3.08% (73/2370) and 2.08% (33/1589) in the four seasons; and the difference was statistically significant (χ(2) = 27.29, P < 0.01). The isolated rates of Salmonella in different regions were as follows: Zhuhai 15.43% (25/162), Maoming 7.53% (18/239), Dongguan 6.51% (39/599), Yangjiang 3.64% (14/385), Zhongshan 3.03% (70/2309), Guangzhou 2.90% (126/4349) and Jiangmen 2.49% (9/362). The difference between regions was statistically significant (χ(2) = 100.75, P < 0.01). Except one strain of the isolated Salmonella cannot be serotyped, the other 300 strains were divided into 42 serotypes, of which Salmonella typhimurium and Salmonella enteritidis were dominant, account for 45.18% (136/301) and 10.96% (33/301) respectively. Although over 85% of Salmonella were sensitive to cephalosporin, ACSSuT resistance patterns (defined as resistance to at least ampicillin, chloramphenicol, streptomycin, sulfamethoxazole and tetracycline) reached 34.88% (105/301), the highest resistant rate was found in serotype Salmonella typhimurium, as high as 65.44% (89/136). 136 strains of Salmonella typhimurium were divided into 51 PFGE types, showed great genetic diversity. 33 strains of Salmonella enteritidis were divided into 18 PFGE types. The strains with same PFGE pattern may have different drug-resistant patterns, and vice versa.</p><p><b>CONCLUSION</b>Salmonella typhimurium and Salmonella enteritidis were the dominant serotypes causing infectious diarrhea in Guangdong province. Cephalosporin was the primary choice in clinical medicine. However, Salmonella typhimurium was resistant to drug most seriously in Guangdong province. There was no significant correlation between Salmonella resistance patterns and PFGE type.</p>

Etiologic detection and epidemiological analysis of one suspected case of diphtheria in Guangdong province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To clarify the diagnosis of one suspected case of diphtheria in Guangdong province by epidemiological analysis and etiologic detection.</p><p><b>METHODS</b>On July 6th 2010, the corynebacterium diphtheria was detected from the nasal secretions of one nasopharyngeal carcinoma patient in a college-town hospital in Guangzhou City, Guangdong Province. The patient and the close contacts were asked to participate in the epidemiological survey; and their nasopharyngeal swabs (3 samples) and the nasal secretions of the patient (1 sample) were collected. The bacteria of the samples were isolated and cultured by blood plate and agar loefflera. The smears of positive strains were dyed and identified by BioMerieux API Coryne biochemical card. Gene tox of β-Corynebacteriophage, Corynebacterium diphtheriae was tested by PCR method, the aliphatic acid was analyzed by gas chromatography method and the Corynebacterium diphtheriae (CMCC 38009) was selected as positive control.</p><p><b>RESULTS</b>The patient had not gone out, neither had been visited. The patient denied history of vaccines or the immunizations. From the survey on patient's family members and close contacts, no similar symptoms had been found. One strain of Corynebacterium diphtheriae was isolated from the patient's nasal secretions, Gram positive and shape diversified. After cultured by agar loefflera and Gram-dyed and Neisser-dyed, one end or both two ends of the strain showed typical metachromatic granule. API Coryne was identified to Corynebacterium diphtheriae mitis/belfanti (99.4%). The result of gas chromatography method also indicated Corynebacterium diphtheriae. No Corynebacterium diphtheriae was isolated from the nasopharyngeal swabs, neither of the patient nor of the close contacts. The gene tox of β-Corynebacteriophage, Corynebacterium diphtheriae was negative according to the PCR test.</p><p><b>CONCLUSION</b>The isolated Corynebacterium diphtheriae did not produce toxin as there was no biological structure gene of toxin. The patient was a health carrier of nontoxic Corynebacterium diphtheriae.</p>