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Objective To analyze the epidemiological characteristics and seasonal distribution of hand, foot and mouth disease (HFMD) in a suburban town in Shanghai from 2012 to 2018, and to provide a scientific basis for formulating effective prevention and control strategies. Methods The incidence data of a suburban town in Shanghai from 2012 to 2018 was collected through the Chinese disease prevention and control information system and analyzed by descriptive epidemiological methods. Results From 2012 to 2018, a total of 538 cases of hand, foot and mouth disease were reported in the suburban town in Shanghai, with an average annual incidence of 186.27/100,000. The difference in incidence between each year was statistically significant (χ2=107.95, P<0.05). The age of onset was mainly children under 5 years old. Peak incidence was from May to September. The main occupation was scattered children. HFMD outbreaks mainly occurred in nurseries and schools, accounting for 60.53% of the total number of outbreaks. Conclusion From 2012 to 2018, the incidence of HFMD in a suburban town in Shanghai had a certain seasonality. It is recommended to implement preventive measures against HFMD for key populations and key places before the high incidence period to reduce the occurrence of severe cases and epidemic situations.
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Objective To evaluate the value of barium esophagography and CT in the diagnosis of congenital pyriform sinus fistula (CPSF).Methods The preoperative radiographic data of 5 9 CPSF patients were analyzed retrospectively,which were confirmed by operation.5 5 patients underwent barium esophagography,and 5 7 patients underwent pre-and post-contrast CT scans.The images of barium esophagography and CT were analyzed and the positive diagnostic rates (PDR)between the two imaging modalities and among the different CT features were compared.Results Among the 5 9 patients,left fistula was found in 5 5 cases,right fistula was found in 2 cases and bilateral fistula in 2 cases.For the patients examined with barium esophagography,53 sinus tracts or fistulas from the pyriform in 52 patients(including 2 patients with bilateral fistula)were depicted.The other 3 patients had negative results.The overall PDR of barium esophagography was 93.0%(53/57).CT findings of CPSF included the narrowness of pyriform fossa,sinus tract or fistula in the neck,bubble sign medial to the superior pole of thyroid,low density in thyroid,thyroid morphologic change,and so on.For the 5 7 patients (including 2 patients with bilateral fistula)examined with CT.The PDR of narrowness of pyriform fossa was 44.1%(26/59),the PDR of sinus tract or fistula was 1 3.6%(8/5 9),the PDR of bubble sign medial to the superior pole of thyroid was 55.9%(33/5 9),the PDR of low density in thyroid was 1 6.9%(1 0/5 9),the PDR of thyroid morphologic change(defect sign of superior pole of thyroid)was 9 1.5%(54/5 9 ).And the total PDR of thyroid density or morphologic change was 94.9%(56/59).Conclusion Barium esophagography can be the main modality to diagnose CPSF because of its high PDR.Although the PDR of CT for direct sign(sinus tract or fistula)is not high,its PDR for indirect sign (thyroid density or morphologic change)is very high.So CT has great value for patients suspected of CPSF.
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Objective To introduce the Filial Values Index (FVI) scale and form Chinese FVI scale and evaluate reliability and validity of the scale. Methods Formed the Chinese FVI to investigate 98 caregivers for chronic heart failure patients. SPSS18.0 software was adopted to analyze the reliability and validity of the scale. Results The content validity of Chinese FVI scale was 0.89,and two common factors were extracted by exploratory factor analysis which could explained 68.91% of the total variance (P <0.01). The Cronbach α coefficient of the overall scale and each dimension was between 0.89-0.94, and the retest reliability was 0.97. Conclusions Chinese FVI scale had good reliability and validity, which can be used for evaluation of domestic caregivers filial piety values for chronic heart failure patients.
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Objective To explore the effect of posterior debridement, grafting and internal fixation for treatment of non-specific lumbar intervertebral infection. Methods Clinical data of 20 patients with non-specific lumbar intervertebral infection treated in General Hospital of Ningxia Medical University from October 2013 to June 2013 were retrospectively analyzed. There were 15 males and 5 females with an average age of 41 years (range, 36-51 years). All patients suffered from single lumbar inter-vertebral infection, including 3 cases at L2/3,4 at L3/4,10 at L4/5 and 3 at L5/S1. All 20 cases underwent one-stage posterior debride-ment, autogenous bone grafting and internal fixation, tissue samples in focus were collected for bacterial culture and pathological examination. The disease controlling statues were evaluated based on laboratory results of ESR and CRP. Imaging examinations were taken to evaluate the fusion of vertebral body. Clinical effects were evaluated using the visual analog scale (VAS) and the Jap-anese Orthopaedic Association scores (JOA) score of lumbar fumction. Results All patients underwent the surgery successfully. The surgery duration time was 90-160 min, average 125 min, and the blood loss was 200-700 ml, average 360 ml. Cerebrospinal fluid leakage occurred in one case. Postoperatively, all patients experienced significant reliefof back pain, improving in the func-tion of movement, and no fever. The lower back VAS score: average (5.35 ± 1.15) points before operation , average (2.76 ± 0.34) points one week after operation, and an average score of (0.85±0.65) points by the last follow-up time. JOA lumbar function score:all patients were effective after operation, the improvement rate was excellent in 65%(13cases), good in 25%(5 cases), and pass-able in 10%(2cases). Comparing with preoperation, the excellent and good rate was 90%. All patients ESR and CRP returned to normal levels at the last follow-up. Ordinary bacterial culture was positive in 8 cases and negative in 12 cases. The pathogens iden-tified were staphylococcus aureus (6 cases), Escherichia coli (2 cases) and staphylococcus epidermidis (2cases). All incisions achieved primary healing. All patients were followed up from 6-18 months (average,12 months), and the symptom of pain relieved significantly. No recurrent infection had happened. A solid bony fusion was found in all patients at 6-14 months (average, 8.5 months) after the surgery. Conclusion Posterior debridement, grafting and internal fixation are effective treatments for non-spe-cific lumbar intervertebral infection, can reduce the time of staying in hospital, this operation is safe and reliable.
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Objective To explore the effect of posterior debridement, grafting and internal fixation for treatment of non-specific lumbar intervertebral infection. Methods Clinical data of 20 patients with non-specific lumbar intervertebral infection treated in General Hospital of Ningxia Medical University from October 2013 to June 2013 were retrospectively analyzed. There were 15 males and 5 females with an average age of 41 years (range, 36-51 years). All patients suffered from single lumbar inter-vertebral infection, including 3 cases at L2/3,4 at L3/4,10 at L4/5 and 3 at L5/S1. All 20 cases underwent one-stage posterior debride-ment, autogenous bone grafting and internal fixation, tissue samples in focus were collected for bacterial culture and pathological examination. The disease controlling statues were evaluated based on laboratory results of ESR and CRP. Imaging examinations were taken to evaluate the fusion of vertebral body. Clinical effects were evaluated using the visual analog scale (VAS) and the Jap-anese Orthopaedic Association scores (JOA) score of lumbar fumction. Results All patients underwent the surgery successfully. The surgery duration time was 90-160 min, average 125 min, and the blood loss was 200-700 ml, average 360 ml. Cerebrospinal fluid leakage occurred in one case. Postoperatively, all patients experienced significant reliefof back pain, improving in the func-tion of movement, and no fever. The lower back VAS score: average (5.35 ± 1.15) points before operation , average (2.76 ± 0.34) points one week after operation, and an average score of (0.85±0.65) points by the last follow-up time. JOA lumbar function score:all patients were effective after operation, the improvement rate was excellent in 65%(13cases), good in 25%(5 cases), and pass-able in 10%(2cases). Comparing with preoperation, the excellent and good rate was 90%. All patients ESR and CRP returned to normal levels at the last follow-up. Ordinary bacterial culture was positive in 8 cases and negative in 12 cases. The pathogens iden-tified were staphylococcus aureus (6 cases), Escherichia coli (2 cases) and staphylococcus epidermidis (2cases). All incisions achieved primary healing. All patients were followed up from 6-18 months (average,12 months), and the symptom of pain relieved significantly. No recurrent infection had happened. A solid bony fusion was found in all patients at 6-14 months (average, 8.5 months) after the surgery. Conclusion Posterior debridement, grafting and internal fixation are effective treatments for non-spe-cific lumbar intervertebral infection, can reduce the time of staying in hospital, this operation is safe and reliable.
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The microbial transformation of buflomedil by Cunninghamella blakesleana AS 3.153 was studied, as well as a microbial model which can be used to mimic metabolism of buflomedil in mammal was established. Experiments were conducted to screen the capabilities of four strains of Cunninghamella species to transform buflomedil, in which C. blakesleana AS 3.153 was selected for a preparative biotransformation. Furthermore, the microbial model was established based on the transformation condition optimization. The parent drug and its metabolites produced by C. blakesleana AS 3.153 were detected by liquid chromatography-mass spectrometry method and three metabolites were identified while two of them were new found metabolites. Two major metabolites, para-O-desmethyl buflomedil and 12-C-oxidated buflomedil, were isolated by semi-preparative HPLC. Based on the comparison between different species, the microbial transformation of buflomedil by C. blakesleana AS 3.153 is more similar to the metabolism of buflomedil in human and Beagle dog than that in rat.
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Objective:To investigate the results of surgical treatment for multi-level spinal tuberculosis with focal debridement ,bone grafting and primary internal fixation.Method:27 cases of multi-level spinal tuberculosis treated by operation from January 1999 to January 2007 were reviewed retrospectively.3 vertebral bodies involved in 15 cases,4 vertebral bodies involved in 7 cases,5 vertebral bodies involved at least in 5 cases.Of these,there were 5 cases in thoracic vertebra,7 cases in lumbar vertebra,11 cases in thoracolumbar vertebra,4 cases in lumbosacral vertebra.11 cases showed neurological deficit before surgery,According to the Frankel classification,Frankel B in 1 case,Frankel C in 2,Frankel D in 8.The preoperative average Cobb angle of kyphosis was 35°±7° (range,26°-43°).The focal debridement,bone grafting and primary internal fixation were performed for all patients.Among these protocols, 16 cases underwent one staged posterior spinal internal fixation and anterior focal debridement,bone grafting.11 cases had anterior spinal internal fixation with focal debridement and bone grafting.All patients received anti-TB chemotherapy before and after operation.Anti-TB chemotherapy protocols consisting of combinations of rifampin,isoniazid,ethambutol and streptomycin were administered for 3 months which including 3 weeks before the operation and 3 months after the operation,followed by rifampin,isoniazid and ethambutol for a total of 9 months.The clinical outcomes were evaluated according to the criteria designed by WU Qiqiu et al.Result:The average surgical time was 240 minutes (range,150-300min),with the average intraoperative blood loss of 1000ml (range,600-1400ml),There was no complication such as nerve injury and cerebrospinal fluid leakage.The incision in 1 case presented sinus which had a secondary healing later on,others obtained primary healing.The average postoperative Cobb angle of kyphosis was 15°±5°(range,12°-20°).All cases were followed up for an average of 18 months(range, 14-48 months).The patients with paraplegia recovered to the normal in 8 months.Bony fusion was achieved in all cases with mean fusion period of 7 months(range,5-14 months) with no incidence of hardware failure.At the final follow-up,all patients had evidence of clinical heal and the solid bony fusion.Conclusion:Focal debridement,bone grafting and primary internal fixation is reliable in dealing with multi -level spinal tuberculosis.
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Objective To evaluate the biological activity of anti-Rh(D) antibodies in vitro. Methods The titres of plasma Anti-Rh (D) antibodies in the RH(-) patients uncorrectly infused RH(+) blood were detected by various methods. The anti-D antibodies were evaluated for their capacity to sensitize erythrocytes, trigger monocyte and K-cell mediated antibody-dependent cellular cytotoxicity (ADCC), mediate binding to monocyte and lymphocyte Fc gamma R, and stimulate phagocytosis by monocytes. The synergistic effect of anti-D antibodies in promoting hemolysis was detected by complement fixation test (CFT). Results The titre of plasma anti-D antibodies measured by micro-column gel indirect anti-globulin technique(MGIAT) was the highest compared with the other detection methods. When red cells were sensitized with anti-D antibodies, the binding and phagocytosis of red cells by monocytes and the lysis of red cells by monocytes or lymphocytes were great, and the hemolysis of red cells by alexin was great too. Conclusion Anti-Rh (D) antibodies had great biological activity in vitro, and MGIAT had the highest sensitivity for detecting anti-Rh(D) antibodies.