Surveillance on the adverse events following immunization in Dazu District of Chongqing， 2016‒2020 / 上海预防医学

ObjectiveTo determine the incidence and characteristics of adverse events following immunization （AEFI） in 2016‒2020 in Dazu District of Chongqing， and evaluate the AEFI surveillance information system and provide scientific evidence for vaccine safety. MethodsDescriptive epidemiological analysis was performed on the cases collected by the AEFI surveillance system. Incidence and coverage of AEFI were then presented. ResultsA total of 319 AEFI cases were reported in 2016‒2020. Reported incidence of AEFI was determined to be 24.64/105 doses. The proportion of timely reporting AEFI within 48 hours was 94.04% and that of timely investigation within 48 hours was 98.41%. The proportion of completing the AEFI survey was 100.00% and that of AEFI classification was 99.69%. The male to female ratio was 1.28∶1. Majority of the AEFI cases were less than 1 year old （64.26%， 205/319）， from April to September （68.97%， 220/319）， and reported at 0‒1 day post-immunization （89.34%， 285/319）. Moreover， the reported incidence differed significantly between time periods （χ2=32.481，P<0.05） and time intervals from vaccination to occurrence of AEFI （χ2=961.408， P<0.05）. Coverage of reporting AEFI at county level reached 100％. In addition， non-severe AEFI cases accounted for 98.43% （314/319） and no death case was reported. General events， such as fever， redness， and scleroma， accounted for 80.56% （257/319）， whereas rare adverse events accounted for 15.99% （51/319）. The reported incidence of NIP vaccines was highest in the diphtheria tetanus acellular pertussis combined vaccine， followed by measles and rubella combined attenuated vaccine and diphtheria tetanus combined vaccine. Clinical diagnosis of rare adverse events was mainly allergic rashes. ConclusionThe AEFI surveillance information system in Dazu District of Chongqing achieves efficient monitoring of AEFI. It has proven that the vaccines are generally safe and immunization strategies may be continuously implemented. Furthermore， the sensitivity of AEFI surveillance should be improved through multiple approaches.

Serum IL-32 level in children with bacterial pneumonia and its relationship with disease severity / 中国基层医药

Objective:To investigate the serum interleukin-32(IL-32) level in children with bacterial pneumonia and its relationship with the severity of the disease.Methods:From January 2019 to December 2019, 300 children with bacterial pneumonia in Taizhou Cancer Hospital were selected as the pneumonia group, and 300 healthy children in our hospital were selected as control group.The serum levels of IL-32, IL-6, IL-8 and tumor necrosis factor-α(TNF-α) were measured by double antibody sandwich enzyme-linked immunosorbent assay.Results:The serum levels of IL-32[(212.46±16.74)ng/L], IL-6[(0.29±0.06)μg/L], IL-8[(0.41±0.08)μg/L] and TNF-α[(1.15±0.11)μg/L] in the pneumonia group were higher than those in the control group[(116.51±14.52)ng/L, (0.07±0.02)μg/L, (0.09±0.03)μg/L, (0.14±0.03)μg/L](all P<0.05). The serum levels of IL-32[(128.76±15.42)ng/L], IL-6[(0.15±0.04)μg/L], IL-8[(0.16±0.05)μg/L] and TNF-α[(0.29±0.06)μg/L] in children with pneumonia during recovery were lower than those in early stage[(212.46±16.74)ng/L, (0.29±0.06)μg/L, (0.41±0.08)μg/L, (1.15±0.11)μg/L](all P<0.05). The levels of serum IL-32[(232.16±16.02)ng/L], IL-6[(0.37±0.08)μg/L], IL-8[(0.54±0.09)μg/L], TNF-α[(1.42±0.15)μg/L] in the severe pneumonia group were higher than those in the non-severe pneumonia group[(184.26±16.31)ng/L, (0.23±0.05)μg/L, (0.26±0.06)μg/L, (0.79±0.12)μg/L](all P<0.05). There were positive correlation between serum IL-32 level and IL-6( r=0.602), IL-8( r=0.624), TNF-α( r=0.593) levels in children with pneumonia(all P<0.05). Conclusion:The serum IL-32 level is elevated in children with bacterial pneumonia.The serum IL-32 level can reflect the therapeutic effect, severity and inflammatory response of children with bacterial pneumonia.

Clinical research of determination of infection status of children with lower respiratory infection according to sputum properties and the accuracy of the choice of antibiotics / 中国基层医药

Objective:To explore the accuracy of determination of the pathogen in children with lower respiratory infection according to sputum properties and the selection of corresponding antibiotics.To analyze the relationship between children's age, length of hospital stays and sputum culture positive rate.Methods:From March 2015 to November 2016, 300 children with lower respiratory infection in the Seventh Affiliated Hospital of Guangxi Medical University were selected.The isolated sputums through the nasal cavity were cultured, the sputum properties and antibiotics used at the beginning and 3-4 days later(after sputum culture) were recorded.Results:The sputum culture showed that 110 of 300 cases with lower respiratory infection were positive.Main pathogens were streptococcus pneumoniae, E.coli, staphylococcus aureus, klebsiella pneumoniae subspecies.Compared with the children with positive sputum culture, for white phlegm sputum and yellow phlegm sputum, the children with sputum culture negative had higher accuracy of antibiotic use(white phlegm sputum: 64.4%, yellow phlegm sputum: 57.1%), the difference was statistically significant (χ 2=36.04, P<0.01). The bacteria positive rate and multiple resistance rate had no statistically significant differences in length of treatment time prior to admission(all P>0.05). However, the bacteria positive rate (hospital stay ≤7 d: 24.7%, hospital stay>7 d: 48.1%, χ 2=17.66) and multiple resistance rate (hospital stay≤7 d: 13.9%, hospital stay>7 d: 35.1%; χ 2=5.40) had statistically significant differences in the length of hospitalization(all P<0.05). The bacteria positive rates in different age groups were as follows: 1-6 months: 48.1%, >6-36 months: 28.3%, >36 months: 25.0%.Compared with the two others, the positive rate of 1-6 months was higher and had statistically significant difference (χ 2=13.64, P<0.05). Conclusion:Accuracy of antibiotics use has a certain relationship with sputum color or properties and the result of sputum culture, for white phlegm sputum and yellow phlegm sputum, the accuracy of antibiotics use is higher.Once identified pathogen, sensitive antibiotics should be adopted.Probably, bacteria positive rate and multiple resistance rate have a certain relationship with the length of hospital stay and age.

Application value of atomization inhalation combined with montelukast in the treatment of cough after infantile infection / 中国基层医药

Objective To investigate the clinical value of atomization inhalation combined with montelukast in the treatment of infantile cough after infection.Methods From September 2015 to August 2017,300 children with post-infection cough in Taizhou Tumor Hospital were randomly divided into two groups,with 150 cases in each group.The control group was treated with montelukast,and the observation group was given atomization inhalation combined with montelukast.The clinical effect,symptom improvement time,adverse events and parents' satisfaction were observed.Results The total effective rate of the observation group was 97.33％,which was higher than 86.67％ in the control group(P ＜0.05).The improvement time of cough and expectoration of the observation group [(3.02 ± 0.45)d,(2.11 ± 0.71)d] was better than those of the control group(all P ＜ 0.05).The incidence rate of adverse events in the observation group(3.33％) was lower than that in the control group(P ＜0.05).The total satisfactory rate of parents in the observation group was 96.00％,which was obviously higher than that in the control group(P ＜ 0.05).Conclusion The effect of atomization inhalation combined with montelukast on children's cough after infection is good,it can effectively control the condition and relieve the symptoms such as cough,and the safety is higher.The risk of adverse reactions is low.

Expression of TLR4 signal pathway and pIgR in SE-induced inflammation response / 中国兽医学报

To observe the effect of pIgR on Salmonella Enteritidis induced inflammation in jejunum and ileum in Chicken,7 day Hyline chickens were taken orally with Salmonella Enteritidis (SE) and killed after 1 d,3 d,7 d and 14 d.The mRNA expression of Toll-like receptor 4(TLR4),MyD88,TRAF6,NF-κB and pIgR was detected by real-time RT-PCR and pIgR protein level was detected by Western blot.The results showed that TLR4 signaling pathway was activated and mR-NA level of the pIgR in jejunum and ileum was enhanced (P＜0.01) and protein level of the pIgR in jejunum and ileum was up-regulated by SE.The study proved that TLR4 signal pathway on mucosal cell surface of jejunum and ileum was activated and expression of pIgR was up-regulated and gut mucosal immunity of chicken was strenghtened.

Predictive value of abnormal second-trimester maternal serum triple screening markers for adverse pregnancy outcomes / 中华妇产科杂志

Objective To investigate the predictive value of abnormal multiples of the median (MoM) of second trimester maternal serum triple screening (STMSTS) markers for adverse pregnancy outcomes.Methods 16 000 singleton pregnancies at 15+0 to 20+6 weeks' gestation who underwent STMSTS between July 2010 and January 2013 in the First Hospital of Jilin University were recruited.Maternal serum AFP,free β-hCG (F-β-hCG) and unconjugated estriol (uE3) levels were measured using time-resolved fluoroimmunoassay,and then convened to MoM.LifeCycle 3.2 software was used to calculate risk,and a risk value greater than 1 in 270 or 1 in 350 was considered as high risk for trisomy 21 syndrome (Down syndrome,DS) and trisomy 18 syndrome (Edwards syndrome,ES),respectively.MoM of AFP more than 2.5was considered high risk for open neural tube defect (ONTD).Amniocentesis and karyotyping,ultrasound screening were advised for high risk women.AFP,F-β-hCG higher than 2.0 MoM or uE3 lower than 0.5MoM was considered as abnormal,respectively.The MoM of STMSTS marker between women with adverse pregnancy outcome and with normal outcome was compared.Results (1) The median MoM of AFP,F-β-hCG and uE3 was 0.91 MoM,0.94 MoM and 1.05 MoM,respectively.Of the 16 000 pregnant women,there was no statistical difference in the median MoM of triple screening marker at different weeks of gestation (P＞0.05).The positive rate of DS,ES and ONTD in women ≤35 years old (n=14 972) was 4.03％ (603/14 972),0.36％(54/14 972) and 0.29％(44/14 972) respectively.And in women＞35 years old(n=1 028),the positive rate was 24.51％ (252/1 028),1.95％ (20/1 028) and 0.78％ (8/1 028),respectively.There was a statistically significant difference of positive rate between the two groups(P＜0.05).(2) 9 cases of DS,1 case of ES and 1 ease of ONTD were found in the high risk group,and 2 cases of DS in the low risk group.The detection rate of DS,ES and ONTD was 9/11,1/1 and 1/1 respectively; and the positive predictive value was 1.05％(9/855),1.35％(1/74) and 1.92％(1/52),respectively.(3)The incidence of adverse outcome (group 1) was 1.49 ％(239/16 000).7 760 pregnant women in this study were healthy during pregnancy,so were their fetuses (group 2).There were significant differences in the age at delivery,body weight and markers' MoM of STMSTS between the two groups(P＜0.01).(4) In group 1,the rate of abnormal MoM of AFP or F-β-hCG was 7.95％(19/239) and 23.85％ (57/239),and the abnormal rate of MoM of uE3 was 4.18％(10/239).The rate of two abnormal MoM of markers was 5.02％(12/239); the rate that all three MoM were abnormal was 0.84％(2/ 239).However,in group 2,the rate of two abnormal MoM of markers was 0.14 ％(11/7 760); and the rate that all three MoM were abnormal was 0.There was a significant difference of abnormal MoM of maternal serum marker between the two groups (P＜0.01).Conclusions There is a relationship between abnormal marker of STMSTS and adverse outcomes.STMSTS show a high value in the detection of DS,ES and ONTD.

Preliminary study of cervical spinal cord in patients with amyotrophic lateral sclerosis using MR diffusion tensor imaging / 中华放射学杂志

Objective To determine whether normal-appearing cervical spinal cord in patients with amyotrophic lateral sclerosis (ALS) has abnormal changes based on the quantitative measurement in healthy volunteers. Methods Conventional MRI and axial DTI were obtained in 16 patients with ALS (ALS group) and 16 age-matched control subjects (normal group) . ADC, fractional anisotropy (FA) and relative anisotropy(RA)imagcs were obtained on workstation (AW4. 2). ROIs (5 mm × 5 mm) were placed in anterior funicalus, posterior funiculus, and bilateral lateral corticospinal tracts (LCTs), respectively, at the same slice (C3). Independent-sample t test was used for comparison of parameters between the two groups. Correlations between DTI parameters of ALS and ALS course, Norris score, and ALSFRS were carried out separately by Pearson correlation analysis. Results FA and RA values of bilateral LCTs were decreased significantly. FA/RA values of left LCT were 0.762±0.089 and 0.762±0.107 in ALS group, while they were 0.863±0.098 and 0.890±0.105 in control group, respectively. FA/RA values of right LCT were 0.751±0.065 and 0.772±0.082 in ALS group, and they were 0.843±0.118 and 0.863±0.134 in control group, respectively, they were decreased significantly (t = 2.575、4.195、2.246、2.218, P < 0.05). There were no significant differences (t = - 1.319, - 1.087, P > 0.05) between ADC values of left and right CSTs in ALS group [(0.744±0.162) × 10~(-3), (0.767±0.141) × 10-~(3) mm~2/s] and control group [(0.640±0.149) ×10~(-3), (0.643±0.168) ×10~(-3) mm~2/s)]. FA, RA and ADC values of ALS patients in anterior funiculus were 0.637±0.113, 0.622±0.138, (0.950±0.354)×10~(-3) mm~2/s, in control group they were 0.670±0.117, 0.656±0.136, (0.865±0.238) × 10~(-3) mm~2/s, there were no significant differences (t = 0.854, - 0.704, - 1.155,P > 0.05). FA, RA and ADC values of ALS patients in posterior funieulus were 0.886±0.073, 0.920±0.100, (0.613±0.137)×10~(-3) mm~2/s, in control group they were 0.906±0.078, 0.914±0.135, (0.636±0.224) × 10~(-3) mm~2/s, there were no significant differences (t = 1.655, - 0.148, - 1.360; P > 0.05). No significant correlation existed between FA and RA values and disease course, Norris and ALSFRS score (P > 0.05), in left and right LCTs. Conclusion DTI with SE-EPI technique is simple and sensitive to detect the pathological changes of the cervical spinal cord in ALS patients. DTI can reveal the abnormalities which are "normal appearing" on conventional T_2WI.

Corticospinal tract degeneration in amyotrophic lateral sclerosis: a diffusion tensor imaging and fibre tractography study

<p><b>INTRODUCTION</b>Motor neuron damage and cortical spinal tract (CST) degeneration in amyotrophic lateral sclerosis (ALS) are difficult to visualise and quantify on conventional magnetic resonance imaging (MRI).</p><p><b>CLINICAL PICTURE</b>We studied 8 ALS patients and 12 normal volunteers using diffusion tensor imaging (DTI) and fibre tractography using fibre assignment by continuous tracking (FACT) to study the fibres of the CST and the posterior thalamic radiation (PTR), a nonmotor tract.</p><p><b>OUTCOME</b>Fibre tractography was successfully performed in all normal volunteers and all patients except 1. The fibre bundles of the CST, but not the PTR, were significantly reduced (P <0.05) in patients compared to normal volunteers.</p><p><b>CONCLUSION</b>Fibre tractography can visualise axonal degeneration in the CST and may provide supplementary information about upper motor neuron disease in ALS patients.</p>

Blood oxygenation level dependent functional MRI study on the changes of motor cortex in patients with amyotrophic lateral sclerosis / 中华放射学杂志

Objective To study the changes of motor cortex in patients with amyotrophic lateral sclerosis(ALS)while executing sequential finger tapping movement by using blood oxygenation level dependent(BOLD)functional MRI.Methods Fifteen patients with definite or probable ALS and 15 age and gender matched normal controls were enrolled in the BOLD study,and all the subjects were right-handed with no other diseases or any recent medication history.A 3.0 T MR scanner was employed and gradient echo EPI(GRE-EPI)sequence was used to acquire the functional images.Subjects executed sequential finger tapping movement at a frequency of 1-2 Hz during a block design task.fMRI data were analyzed by using statistical parametric mapping(SPM)2.Volume of activated brain areas was compared with the use of a Student's t-test.Results Bilateral primary sensorimotor cortex(PSM),bilateral posterior aspect of premotor area(PA),bilateral supplementary motor area(SMA),contralateral inferior lateral premotor area (ILPA),bilateral parietal region(PAR),and ipsilateral cerebellum showed activation in both ALS patients and normal controls when executing the same motor task.The activation areas in bilateral PSM and bilateral posterior aspect of PA(right hand ipsilateral activation:ALS(924.5±141.1)mm3,control(829.9±98.4)mm3,P=0.05;right hand contralateral activation:ALS(9143.8±702.8)mm3,control(8638.8±506.4)mm3,P＜0.05;left hand ipsilateral activation:ALS(1162.5±357.4)mm3,control(902.5±184.2)mm3,P＜0.05;left hand contralateral activation:ALS(8255.2±870.2)mm3,control (5934.6±616.4)mm3,P＜0.05),bilateral SMA(right hand bilateral activation:ALS(6564.3±720.6)mm3,control(4710.7±416.3)mm3,P＜0.05;left hand bilateral activation:ALS(6970.5±961.8)mm3,control(3688.9±672.3)mm3,P＜0.05),and ipsilateral cerebellum(right hand ipsilateral activation:ALS(2720.0±1154.2)mm3,control(254.3±84.4)mm3,P＜0.05;left hand ipsilateral activation:ALS(4794.4±1237.0)mm3,control(1689.0±719.6)mm3,P＜0.05)were significantly larger in ALS patients than in normal controls.Extra activation areas including ipsilateral ILPA,contralateral cerebellum and bilateral posterior limb of internal capsule were only detected in ALS patients.Conclusions Similar activation areas were seen in both groups while executing the same motor task,but the activated areas were more prominent in ALS group.The increased activation areas in ALS patients may represent neural reorganization.while the extra activation areas in ALS patients may indicate functional compensation.

Imaging measurement of brain function when ankle dorsiflexion and planter flexion / 中国康复理论与实践

@#ObjectiveTo measure cortical areas involved ankle dorsiflexion and planter flexion.MethodsSix-health subjects performed ankle dorsiflexion and planter flexion. While, functional MRI at 1.5 T was made.ResultsWhen ankle dorsiflexion, the excited cortical areas included bilateral primary motor cortex (MⅠ) and primary somatosensory cortex (SⅠ), but area on contralateral side bigger than that on ipsilateral side, as well as chief visual cortexes and vermis of cerebellum. Inhibited areas included area 19, area 20 and area 39. When ankle planter flexion, the excited areas included contralateral secondary motor area (MⅡ) and striate body, ipsilateral supplementary motor area (SMA) and limbic system. Inhibited areas included bilateral upper middle precentral gyrus and postcentral gyrus, superior parietal lobule, inferior parietal lobule and prefrontal cortex.ConclusionThere is a great difference in the brain function images respectively in ankle dorsiflexion and planter flexion.

Mapping cortical areas associated with Chinese word processing using functional magnetic resonance imaging / 中华医学杂志(英文版)

<p><b>OBJECTIVES</b>To identify the cortical areas engaged during Chinese word processing using functional magnetic resonance imaging (fMRI) and to examine the reliability and reproducibility of fMRI for localization of functional areas in the human brain.</p><p><b>METHODS</b>FMRI data were collected on 8 young, right-handed, native Chinese speakers during performance of Chinese synonym and homophone judgment tasks on two different clinical MRI systems (1.5 T GE Signa Horizon and 1.5 T Siemens Vision). A cross correlation analysis was used to statistically generate the activation map.</p><p><b>RESULTS</b>Broca's area, Wernicke's area, bilateral extrastriate, and ventral temporal cortex were significantly activated during both the synonym and homophone activities. There was essentially no difference between results acquired on two different MRI systems.</p><p><b>CONCLUSIONS</b>FMRI can be used for localizing cortical areas critical to Chinese language processing in the human brain. The results are reliable and well reproducible across different clinical MRI systems.</p>

The display of fMRI of brain activities following low-frequency electrical stimulation of common peroneal nerve / 中华物理医学与康复杂志

Objective To evaluate the usefulness of functional magnetic resonance imaging (fMRI) as a noninvasive method in recording the activities of the human brain as excited by low frequency current(LFC) stimulator. Methods The right common peroneal nerves of 6 healthy volunteers were stimulated with LFC (NMR-II stimulator). The activities of the brain were then recorded and evaluated during the scanning by the fMRI technique. Data obtained during the study were dealt with with the software SPM99. Results In both cerebral hemispheres, the area where the postcentral and superior temporal gyrus, inferior parietal lobule met were excited, and so were the operculum at both sides. Postcentral gyrus, superior parietal and paracentral lobule, and the precuneus in the left cerebral hemisphere, as well as the superior occipital gyrus and the superior parietal lobule in the right hemisphere,were involved as the excited areas. Conclusion fMRI is a useful tool for recording and evaluating the brain activities excited by LFC.

Preliminary study on the mechanism of reading recovery in a pure alexia by using functional MRI / 中华放射学杂志

Objective To observe the changes of the brain function during reading recovery by using functional MRI (fMRI),and to provide the experimental data in elucidating the mechanism on the recovery of reading and language function.Methods fMRI was performed in a native Chinese patient with pure alexia on the 45 th and 130 th day after the onset,respectively.Three kinds of Chinese characters were presented during the scan and the patient was asked to make the judgement weather he could recognize the characters or not.The brain activation maps were acquired after postprocessing,and the activated location and volume were compared between the first and second experiments.Results In both experiments,Broca area,Wernicke area,and the right extrastriate were significantly activated,while the left extrastriate around the lesion was markedly activated only in the second experiment,and the volume of activation in the right extrastriate in the second experiment was about 3 times as large as that in the first experiment.Conclusion The left extrastriate cortex is one of the key areas responsible for reading function in the brain.The recovery of reading function can be compensated in contralateral corresponding cortical area,or it can be the result of reorganization in ipsilateral peri-lesion cortex.Both mechanisms may simultaneously play important roles in reading recovery.

Preliminary assessment of amyotrophic lateral sclerosis by using MRI and MR diffusion tensor imaging / 中华放射学杂志

Objective To describe the characteristic MR findings in the brain in patients with amyotrophic lateral sclerosis (ALS), and to assess the diagnostic value of conventional MR imaging and fractional anisotropy (FA) of diffusion tensor imaging (DTI). Methods Conventional MR imaging was performed in 14 clinically proved ALS patients and 12 age-matched normal controls. Contrast enhanced MR images were acquired in 2 patients. Axial and coronal DTI scans were performed in 10 patients and 12 normal controls with SE-EPI sequence. The b value was 1 000 s/mm 2, the number of diffusion sensitive gradient direction was 25. For quantitative assessment of the corticospinal tract (CST), FA value of bilateral CST was measured at the level of posterior limb (PL) of the internal capsule (IC) and the cerebral peduncle of the midbrain, respectively, and statistical analysis was performed. Results Focal slight low signal intensity on T 1WI and high signal intensity (hyperintense to gray matter) on T 2WI was demonstrated in 6 ALS cases (42.9%) in bilateral PL of the IC, and the high signal was longitudinally continuous from the PL to the cerebral peduncle on T 2WI coronal plane, corresponding to the course of CST. In another 8 ALS cases (57.1%), the focal slight low signal intensity on T 1WI and slight high signal intensity (isointense to gray matter) on T 2WI was revealed in bilateral PL of the IC. No abnormal contrast enhancement was detected in the 2 cases. In control group, the focal slight low signal intensity on T 1WI and slight high signal intensity (isointense to gray matter) on T 2WI was demonstrated in all 12 subjects in bilateral PL of the IC. FA values of the patient group were significantly lower than that of the control group at the level of the PL of the IC (F=7.38, P