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Based on the requirements of first-class undergraduate talents training in pharmacy in the new era, this paper summarizes and analyzes the law, current situation and actual situation of pharmaceutical talents training in TCM colleges and universities in China, and discusses the reform and practice of first-class pharmaceutical talents training in terms of talent training mode reform, teaching staff construction, curriculum system optimization, teaching mode innovation, quality assurance system construction and innovation and entrepreneurship education in combination with the construction experience of national first-class undergraduate specialty construction point in the pharmacy of Guangzhou University of Chinese Medicine, so as to further improve the quality of personnel training and provide a reference for excellent pharmaceutical personnel training.
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Objective To compare the epidemiological characteristics of COVID-19 in Guangzhou and Wenzhou, and evaluate the effectiveness of their prevention and control measures. Methods Data of COVID-19 cases reported in Guangzhou and Wenzhou as of 29 February, 2020 were collected. The incidence curves of COVID-19 in two cities were constructed. The real time reproduction number ( R t ) of COVID-19 in two cities was calculated respectively. Results A total of 346 and 465 confirmed COVID-19 cases were analysed in Guangzhou and Wenzhou, respectively. In two cities, most cases were aged 30-59 years (Guangzhou: 54.9%; Wenzhou: 70.3%). The incidence curve peaked on 27 January, 2020 in Guangzhou and on 26 January, 2020 in Wenzhou, then began to decline in both cities. The peaks of imported COVID-19 cases from Hubei occurred earlier than the peak of COVID-19 incidences in two cities, and the peak of imported cases from Hubei occurred earlier in Wenzhou than in Guangzhou. In early epidemic phase, imported cases were predominant in both cities, then the number of local cases increased and gradually took the dominance in Wenzhou. In Guangzhou, the imported cases was still predominant. Despite the different epidemic pattern, the R t and the number of COVID-19 cases declined after strict prevention and control measures were taken in Guangzhou and in Wenzhou. Conclusion The time and scale specific differences of imported COVID-19 resulted in different epidemic patterns in two cities, but the spread of the disease were effectively controlled after taking strict prevention and control measures.
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Objective To assess the imported risk of COVID-19 in Guangdong province and its cities, and conduct early warning. Methods Data of reported COVID-19 cases and Baidu Migration Index of 21 cities in Guangdong province and other provinces of China as of February 25, 2020 were collected. The imported risk index of each city in Guangdong province were calculated, and then correlation analysis was performed between reported cases and the imported risk index to identify lag time. Finally, we classified the early warming levels of epidemic by imported risk index. Results A total of 1 347 confirmed cases were reported in Guangdong province, and 90.0% of the cases were clustered in the Pearl River Delta region. The average daily imported risk index of Guangdong was 44.03. Among the imported risk sources of each city, the highest risk of almost all cities came from Hubei province, except for Zhanjiang from Hainan province. In addition, the neighboring provinces of Guangdong province also had a greater impact. The correlation between the imported risk index with a lag of 4 days and the daily reported cases was the strongest (correlation coefficient: 0.73). The early warning base on cumulative 4-day risk of each city showed that Dongguan, Shenzhen, Zhongshan, Guangzhou, Foshan and Huizhou have high imported risks in the next 4 days, with imported risk indexes of 38.85, 21.59, 11.67, 11.25, 6.19 and 5.92, and the highest risk still comes from Hubei province. Conclusions Cities with a large number of migrants in Guangdong province have a higher risk of import. Hubei province and neighboring provinces in Guangdong province are the main source of the imported risk. Each city must strengthen the health management of migrants in high-risk provinces and reduce the imported risk of Guangdong province.
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Objective To analyze the clinical courses and outcomes of COVID-19 cases and the influencing factors in Guangdong province and provide basis for the formulation or adjustment of medical care and epidemic control strategy for COVID-19. Methods We collected demographic data, medical histories, clinical courses and outcomes of 1 350 COVID-19 patients reported in Guangdong as of 4 March 2020 via epidemiological investigation and process tracking. Disease severity and clinical course characteristics of the patients and influencing factors of severe illness were analyzed in our study. Results Among 1 350 cases of COVID-19 cases in Guangdong, 72 (5.3%) and 1049 (77.7%) were mild and ordinary cases, 164 (12.1%) were severe cases, 58 (4.3%) were critical cases and 7 (0.5%) were fatal. The median duration of illness were 23 days ( P 25 - P 75 : 18-31 days) and the median length of hospitalization were 20 days ( P 25 - P 75 : 15-27 days). For severe cases, the median time of showing severe manifestations was on the 12th day after onset ( P 25 - P 75 : 9th to 15th days), and the median time of severe manifestation lasted for 8 days P 25 - P 75 : 4-14 days). Among 1 066 discharged/fetal cases, 36.4% (36/99) and 1.0% (1/99) of the mild cases developed to ordinary cases and severe cases respectively after admission; and 5.2% (50/968) and 0.6% (6/968) of the ordinary cases developed to severe cases, and critical cases respectively after admission. In severe cases, 11.4% developed to critical cases (10/88). The influencing factors for severe illness or worse included male (a HR =1.87, 95% CI : 1.43-2.46), older age (a HR =1.67, 95% CI : 1.51-1.85), seeking medical care on day 2-3 after onset (a HR =1.73, 95% CI : 1.20-2.50) pre-existing diabetes (a HR =1.75, 95% CI : 1.12-2.73) and hypertension (a HR =1.49, 95% CI : 1.06-2.09). Conclusions The course of illness and length of hospitalization of COVID-19 cases were generally long and associated with severity of disease clinical outcomes. The severe cases were mainly occurred in populations at high risk. In the epidemic period, classified management of COVID-19 cases should be promoted according to needs for control and prevention of isolation and treatment for the purpose of rational allocation of medical resources.
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Objective To analyze the epidemiological characteristics of hand foot and mouth disease (HFMD) cases caused by Coxsackie virus A16 (Cox A16) in Guangdong province from 2012 to 2016.Methods The data of mild HFMD cases caused by Cox A 16 were collected from 8 sentinel hospitals in 8 prefecture-level cities in Guangdong to estimate Cox A16 infection status and its population and time distribution characteristics.Results (1) The highest estimated incidence of Cox A16 infection was in 2014 (113.0/100 000),followed by 2016 (86.4/100 000) and 2012 (79.1/100 000),while the estimated incidence was lower in 2015 (29.0/100 000) and 2013 (28.8/100 000).(2) Cox A16 was confirmed to be the predominant pathogen causing HFMD outbreaks (54.6％,89/163).The number of outbreaks in the year with high incidence (28 outbreaks) was 11.2 times higher than that in the year with low incidence (2.5 outbreaks).(3) Across all age groups,the annual estimated incidence of Cox A16 infection decreased with age (trend x2=853 905.63,P＜0.01).The incidence was highest in age group 1 year (1 449.2/100 000),followed by that in age group 3 years (1 097.0/100 000),in age group 2 years (1 083.5/100 000),in age group 4 years (687.8/100 000) and in age group 0 year (604.9/100 000).Among the age groups ＜12 months,the estimated incidence increased with age (trend g2=5 541.77,P ＜ 0.01),which was highest in age group 11-months (2 105.1/100 000),followed by that in age groups 10-months (1 448.6/100 000),9-months (938.3/100 000),8-months (703.3/100 000) and 6-months (664.6/100 000).(4) The annual incidence peak was during May (143.9/100 000)-June (131.5/100 000).Conclusion The prevalence of Cox A16 infection differed with year in Guangdong during 2012-2016.When the incidence of Cox A16 infection was high,more outbreaks occurred.The prevalence occurred mainly in nurseries and kindergartens from May to June each year.Children aged 0-4 years were the high risk group for Cox A16 infection,children aged 6-11 months were at high risk for Cox A16 infection.
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Objective@#To analyze the hand-foot-mouth disease (HFMD) enterovirus 71 (EV-A71) infection epidemic characteristics of Guangdong Province from 2011 to 2015.@*Methods@#We colleted data on common cases of hand-foot-mouth disease infected with EV-A71 reported from eight sentinel hospitals in Guangdong Province from January 2011 to December 2015, through the "Guangdong Province Acute Infectious Disease Surveillance Information Platform System" , including the age and incidence of cases. Time and etiological data, etc.We also collected data on the number of reported cases of HFMD disease and the number of laboratory-confirmed cases, through the "China Disease Prevention and Control Information System" , including data on common cases of HFMD disease, data on epidemics of severe cases and deaths, and the age, onset time, and pathogens of cases. Learning data, etc.The data from two sources were used to estimate the incidence of HFMD in EV-A71 and describe its distribution characteristics.Chi-square test was used to compare the positive rate of HF-A71 infection in hand-foot-mouth disease and the difference in estimated incidence among different age groups and months.@*Results@#Eight sentinel hospitals from 2011 to 2015 reported a total of 1 855 common cases of EV-A71 infection, of which the highest was in 2014 (31.6%, 605/1 916) and the lowest was in 2015 (6.8%, 134/1 971) (χ2=521.85, P<0.001).According to the Disease Surveillance Reporting Information System, 1 772 516 cases of HFMD disease were reported from 2011 to 2015 in Guangdong Province, and 1 902 cases of severe and fatal cases of EV-A71 infection.The composition ratio of EV-A71 infected was 72.6% (1 775/2 444) and 97.0% (127/131) of severe HFMD disease in Guangdong province during 2011-2015.The average annual incidence of HF-A71 infection in all age groups showed a decreasing trend with age (χ2trend=990 273.20, P<0.001), and it was the highest in the 1-year-old group, which was 1 697.67/100 000, and the lowest in the 4-year-old group, which was 705.46/100 000. The difference of monthly average incidence of EV-A71 infection in HF-A71 in each month was statistically significant (χ2=401.23, P<0.001), the highest in May at 15.51 per 100 000, and the lowest in July at 9.42 per 100 000.@*Conclusion@#EV-A71 infection rate of ordinary HFMD varies in different years. The most severe and death cases of HFMD were EV-A71 infected. 1 year old children were the high-risk group of infected with EV-A71 HFMD. April was the epidemic months of EV-A71 HFMD infection.
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Objective@#To investigate the sensitivity and specificity of commercial nonstructural protein 1 (NS1) testing kits for Dengue fever diagnose, and provide the evidence for diagnostic criteria revision.@*Methods@#300 PCR or virus isolation positive blood samples for dengue virus were collected from sentinel hospitals for dengue surveillance in Guangzhou, Dongguang and Zhongshang from May 2015 to Nov. 2016. At the same time, 308 PCR negative samples for Dengue virus were collected as control group. The information of the sample was collected using questionnaires. These samples were tested using imported and domestic ELISA and the colloidal gold-labeled kits that were widely used for detecting dengue NS1. Sensitivity, specificity and coincidence were calculated and analyzed, and Z hongshan's result was regarded as the reslut of the third part.@*Results@#The positive group includes 133 males and 167 females, average ages are 47.2±13.3, 179, 110 and 11 of them is Dengue Ⅰ, Ⅱ and Ⅲ respectively. The negative group includes 154 males and 154 females, average ages are (40.1±11.6) years old. The sensitivity of domestic ELISA Kits (94.5%) is less than imported (99.5%), and the result has statistical significance (χ2=8.59, P=0.030), the specificity is 99.7% and 97.7% respectively; The sensitivity of imported and domestic the colloidal gold-labeled Kits is 97.5% and 96.5% respectively, both of specificities are 100%. The sensitivity and specificity of Dengue Ⅰ for NS1 test are more than 97.0%. The sensitivity of domestic ELISA and gold-labeled Kits is 90.0% and 95.0%, and the specificity is 96.8% and 100% respectively for Dengue Ⅱ test. The sensitivity of imported ELISA and gold-labeled Kits is 100% and 98.0%, and the specificity is 99.4% and 100% respectively for Dengue Ⅱ test. The result of the third party show the sensitivity and specificity of domestic ELISA and gold-labeled Kits are 90.0% and 98.0%, the differences has statistical significance (χ2=5.67, P=0.020).@*Conclusion@#NS1 testing can be used as early dengue fever diagnose for higher sensitivity and specificity.
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Objective To discuss the role of teachers in the integrated PBL teaching of pediatrics in the light of the investigation of students after PBL teaching.Method The multidisciplinary integrated PBL course established by the Department of Pediatrics of Chongqing Medical University has been implemented for more than two years in the teaching of the five year program in the Department of clinical medicine (pediatric direction).From September 28,2016 to October 25th,the researchers conducted a survey of 26 undergraduate students in the college who received PBL teaching at the professional probation stage.After the end of each PBL class,the teaching evaluation questionnaire recommended by Fudan University and Qian Ruizhe was distributed through the network teaching platform of Chongqing Medical University.The questionnaire was retrieved by students without a name,and the survey was carried out 3 times.The data of the questionnaire were summarized with Excel 2007.Result 77 questionnaires were issued and 77 were recovered,with a recovery rate of 100％.In the multidisciplinary integrated PBL class,94.8％-97.4％ students gave high score evaluation,and all the evaluation of teachers reached "excellent" level.In response to open-ended questions,students believed that teachers in teaching could inspire students to think positively,encourage students to express different views,create a mutually trusted environment for students,and cultivate students' interpersonal communication,communication and cooperation ability.Conclusion In pediatric multidisciplinary integrated PBL teaching,teachers should teach students correct learning methods,judge each student's knowledge and thinking level,and individualize teaching for each student's problems and characteristics.
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Objective To investigate the inhibiting effect of CGP77675 (CGP),a Src inhibitor,on epithelial-mesenchymal transition (EMT) of human retinal pigment epithelial (RPE) cells induced by transformation growth factor-β1 (TGF-β1).Methods Human RPE cell line (ARPE19 cells) was cultured in vitro and divided into control group,TGF-β1 group and TGF-β1 +CGP group.Corresponding agent was added into culture medium based on grouping.The morphology of the cells were examined under the optical microscope 3 days after culture.The expressions of EMT-related genes and proteins in the cells were detected by real-time quantitative PCR and Western blot,respectively,including fibronectin 1 (FN 1),and plasminogen activation inhibitor 1 (PAI1),and the expressions of zonula occludens protein 1 (ZO1) and cytoskeleton protein filamentous actin (F-actin) were detected by immunofluorescence staining.MTT assay was employed to evaluate the cell proliferation rate.The migration distance of the cells was measured by scratch test.Results The ARPE19 cells in the control group showed an epithelial-like morphology and F-actin and ZO-1 were expressed along cell membrane.In the TGF-β1 group,the cells appeared to be fibrous-like,and the fluorescence staining of F-actin was disordered and ZO-1 was discontinuous on the cell membrane.The cells in the TGF-β1 +CGP group remained to be an epithelial-like in shape with clear and complete expressions of F-actin and ZO-1.The relative expressions of FN1 mRNA and PAI1 mRNA in the cells were 0.211 ± 0.080 and 0.116±0.073,1.000±0.001 and 1.000±0.001,0.368±0.097 and 0.362±0.048 in the control group,TGF-β1 group and TGF-β1 +CGP groups,showing significant differences among the groups (F=33.14,82.92;both at P＜0.01),with the highest expressions ofFN1 mRNA and PAI1 mRNA in the TGF-β1 group (all at P＜0.05).The relative expressions of FN1 and PAI1 proteins were 0.166±0.055 and 0.327±0.066,1.000±0.001 and 1.000± 0.001,0.143 ± 0.030 and 0.260 ± 0.077 in the control group,TGF-β1 group and TGF-β1 + CGP group,with significant differences among three groups (F=181.90,48.85;both at P＜0.01),and the expressions FN1 and PAI1 proteins were significantly higher in the TGF-β1 than those in the control group and TGF-β1 +CGP group (all at P＜0.05).The cell proliferative rate in the TGF-β1+CGP group was (79.30±3.44) ％ and (54.80±7.39) ％ at the third day and seventh day after culture,which were significantly reduced in comparison with (99.50 ± 1.00)％ and (99.10±0.50)％ in the control group as well as (95.10±4.20)％ and (92.10±4.50)％ in the TGF-β1 group (all at P＜0.05).The migration distance was disappeared in the TGF-β1 group,and the scratch width was not obviously changed in the TGF-β1 +CGP group.Conclusions Src inhibitor can inhibit EMT process of ARPE19 cells induced by TGF-β1,indicating that Src signaling pathway may play a critical role in EMT of RPE cells.
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Dengue is the most prevalent and rapidly spreading mosquito-borne viral disease.As a dengue non-endemic country,China has experienced several dengue outbreaks in recent years.However,dengue patients in China displayed distinct clinical characteristics compared to patients in endemic countries.To standardize the diagnosis and treatment of dengue fever,the experts of the Society of Infectious Diseases,Society of Tropical Medicine and Parasitology of Chinese Medical Association,and the Society of Emergency Medicine,China Association of Chinese Medicine have reached this guideline based on guidelines for diagnosis,treatment,prevention and control of dengue (World Health Organization,2009);guidelines for diagnosis and treatment of dengue (National Health and Family Planning Commission of the People's Republic of China,2014,Edition 2),health industry standard of the People's Republic of China "diagnosis for dengue fever (WS216-2018)" and systemic reports on dengue.The guideline includes 8 aspects:introduction,terminology,epidemiology and prevention,etiology and pathogenesis,clinical features,diagnosis,treatment and problems to be solved.
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Objective To analyze the epidemiological characteristics of hand foot and mouth disease (HFMD) cases caused by Coxsackie virus A16 (Cox A16) in Guangdong province from 2012 to 2016.Methods The data of mild HFMD cases caused by Cox A 16 were collected from 8 sentinel hospitals in 8 prefecture-level cities in Guangdong to estimate Cox A16 infection status and its population and time distribution characteristics.Results (1) The highest estimated incidence of Cox A16 infection was in 2014 (113.0/100 000),followed by 2016 (86.4/100 000) and 2012 (79.1/100 000),while the estimated incidence was lower in 2015 (29.0/100 000) and 2013 (28.8/100 000).(2) Cox A16 was confirmed to be the predominant pathogen causing HFMD outbreaks (54.6％,89/163).The number of outbreaks in the year with high incidence (28 outbreaks) was 11.2 times higher than that in the year with low incidence (2.5 outbreaks).(3) Across all age groups,the annual estimated incidence of Cox A16 infection decreased with age (trend x2=853 905.63,P＜0.01).The incidence was highest in age group 1 year (1 449.2/100 000),followed by that in age group 3 years (1 097.0/100 000),in age group 2 years (1 083.5/100 000),in age group 4 years (687.8/100 000) and in age group 0 year (604.9/100 000).Among the age groups ＜12 months,the estimated incidence increased with age (trend g2=5 541.77,P ＜ 0.01),which was highest in age group 11-months (2 105.1/100 000),followed by that in age groups 10-months (1 448.6/100 000),9-months (938.3/100 000),8-months (703.3/100 000) and 6-months (664.6/100 000).(4) The annual incidence peak was during May (143.9/100 000)-June (131.5/100 000).Conclusion The prevalence of Cox A16 infection differed with year in Guangdong during 2012-2016.When the incidence of Cox A16 infection was high,more outbreaks occurred.The prevalence occurred mainly in nurseries and kindergartens from May to June each year.Children aged 0-4 years were the high risk group for Cox A16 infection,children aged 6-11 months were at high risk for Cox A16 infection.
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Objective To analyze transmission factors of norovirus outbreaks in Guangdong province during 2008-2015 and provide evidence for the prevention and control of norovirus infection.Methods Epidemiological analysis was performed on the data of norovirus outbreaks reported in Guangdong from January 1,2008 to December 31,2015,which were obtained from the Public Health Emergency Management Information System of Guangdong province.The samples collected from the norovirus outbreaks were detected for norovirus by RT-PCR and the gene sequencing of the positive PCR products were performed.Results A total of 96 norovirus outbreaks were reported in Guangdong during 2008-2015.Sixteen outbreaks were reported during 2008-2012and 80 outbreaks were reported during 2013-2015 (83.3％).Eighty-two outbreaks (85.4％) occurred in schools.The infection routes included foodborne transmission in 39 outbreaks (40.6％),person to person transmission in 23 outbreaks (24.0％) and waterborne transmission in 8 outbreaks (7.3％).The gene sequencing results showed that variant G Ⅱ.4/Sydney2012 was the predominant pathogen for 6 of the 20 outbreaks (30.0％) during 2012-2013.Variant G lⅡ.17 was the predominant pathogens for 33 of the 53 outbreaks (62.3％) during 2014-2015.Conclusion The norovirus outbreaks in Guangdong during 2008-2015 were caused by foodborne and person to person transmissions of two emerging variant:G Ⅱ.4/Sydney2012 and G Ⅱ.17.
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Leber's hereditary optic neuropathy (LHON) is an inherited mitochondrial disorder characterized by bilateral progressive vision loss.Current management includes therapies directed at enhancing mitochondrial function and preventing oxidative damage.This article reviews the progress of treatments from mitochondria cocktail,idebenone,gene therapy,EPI-743,brimonidine,traditional Chinese medicine and physical therapy,providing a new insight in the treatments of LHON.
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Objective T o explore the value of M odified O vert A ggression Scale (M O A S ) on predicting serious aggressive behavior in the inpatients w ith m ental disorders and to provide theoretical basis for violence risk assessm ents in the inpatients w ith m ental disorders. Methods T otal 918 inpatients in a psy-chiatric hospital w ere evaluated by trained m edical w orkers using M O A S in Septem ber 2009, and their serious violent behavior w ere follow ed up for 2 years. T he value of M O A S on predicting violence in the inpatients w ith m ental disorders w as analyzed by SPSS 21.0. Results (1) C om pared to the patients w ithout serious aggressive behaviors, the patients w ith serious aggressive behavior w ithin 2 years show ed significantly higher scores (P<0.05) on verbal aggression, aggression against property, physical aggres-sion and total w eighted score of M O A S; (2) Significant correlation w as found betw een the score of ver-bal aggression and the serious acts of violence w ithin 2 years (P<0.05); (3) Scores of verbal aggres-sion, physical aggression and total w eighted score of M O A S had predictive value on serious aggressive behaviors w ithin 2 years. Conclusion M O A S has certain value on predicting the serious aggressive be-haviors of patients w ith m ental disorders w ithin 2 years.
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Objective To analyze transmission factors of norovirus outbreaks in Guangdong province during 2008-2015 and provide evidence for the prevention and control of norovirus infection.Methods Epidemiological analysis was performed on the data of norovirus outbreaks reported in Guangdong from January 1,2008 to December 31,2015,which were obtained from the Public Health Emergency Management Information System of Guangdong province.The samples collected from the norovirus outbreaks were detected for norovirus by RT-PCR and the gene sequencing of the positive PCR products were performed.Results A total of 96 norovirus outbreaks were reported in Guangdong during 2008-2015.Sixteen outbreaks were reported during 2008-2012and 80 outbreaks were reported during 2013-2015 (83.3％).Eighty-two outbreaks (85.4％) occurred in schools.The infection routes included foodborne transmission in 39 outbreaks (40.6％),person to person transmission in 23 outbreaks (24.0％) and waterborne transmission in 8 outbreaks (7.3％).The gene sequencing results showed that variant G Ⅱ.4/Sydney2012 was the predominant pathogen for 6 of the 20 outbreaks (30.0％) during 2012-2013.Variant G lⅡ.17 was the predominant pathogens for 33 of the 53 outbreaks (62.3％) during 2014-2015.Conclusion The norovirus outbreaks in Guangdong during 2008-2015 were caused by foodborne and person to person transmissions of two emerging variant:G Ⅱ.4/Sydney2012 and G Ⅱ.17.
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Objective To explore the value of maternal serum triple markers screening,consisted of AFP (α-fetal protein),β-human chorionic gonadotropin (β-hCG) and free estriol (uE3),for Down's syndrome,in second trimester.Methods We searched published literatures from PubMed,MEDLINE,China National Knowledge Internet (CNKI) and Wanfang Database from January 1990 to August 2014 and articles met the following criteria were collected:(1) The report was of a screening test;(2) The research purpose was to study the efficiency ofAFP,hCG and uE3 (triple markers) screening for Down's syndrome;(3) The research subjects were pregnant women in second trimester;(4) All of the studied cases were confirmed by amniocentesis and chromosome karyotyping;(5) The pregnant outcomes must be available;(6) Each report should have at least one case of Down's syndrome identified;(7) The literature could be retrieved by Science Citation Index or Chinese core periodicals;(8) When assessed by QUADAS (quality assessment of studies of diagnostic accuracy included in systematic reviews) Quality Assessment Scale,the score should be ≥ 8.Information were extracted,including name of the first author,publication time,sample size,sensitivity,specificity,maternal age,gestational age,cutoff value,β-hCG type and others.MetaDiSc 1.4 software was applied for meta-analysis.I2 was used for heterogeneity,and the fixed or random effects model for calculation of the combined sensitivity,specificity,diagnostic odds ratio (DOR) and the 95％CI.The summary receiver operating characteristic (SROC) curve was drawn.Deek's test in Stata Software was used to validate publication bias.Results A total of 49 literatures were recruited in this study with a total sample size of 960 245.Deck's funnel plot analysis showed that the correlation coefficient and the standard error of bias were-1.067 and 3.64 (t=-0.290,P=0.771).The correlation coefficient and the standard error of the slope were 3.578 and 0.26 (t=13.740,P=0.000).The random effects model showed the pooled sensitivity of the 49 literatures was 0.72 (95％CI:0.70 0.74),the pooled specificity was 0.92 (95％CI:0.92-0.93),and DOR was 33.80 (95％CI:25.03-45.65).The area under the SROC was 0.900 7.DOR of younger age group (including three literatures) was 14.38 (95％CI:3.67-56.42) and 26.64 (95％CI:19.49-36.41) for the older age group (two literatures).For two literatures determining the gestational age based on ultrasonography,the DOR was 50.22 (95％CI:26.91-93.71),and DOR was 33.09 (95％CI:17.33-63.19) for those based on last menstrual period in these two literatures.For eight literatures applied the cutoff value of 1:270,12 applied 1:250 and four applied mixed cutoff value,the DOR was 10.94 (95％CI:3.04-39.38),54.34 (95％CI:42.19-70.01) and 36.37 (95％CI:31.19-42.40),respectively.DOR of total β-hCG group (12 literatures) was 22.06 (95％CI:16.46-29.58) and that of free β-hCG group (ten literatures) was 37.15 (95％CI:30.00-46.02).Conclusions Triple regimen of second trimester maternal serum screening for Down's syndrome is much more efficient.The detection rate could be further improved by determination of the gestational age with ultrasound,and application of 1:250 as the risk cutoff value and free β hCG as a screening marker.
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<p><b>OBJECTIVE</b>To analyze epidemiological characteristics of norovirus variant of GII.4 Sydney from January 2012 to June 2014 in sentinel hospitals of Guangdong province, as well as the outbreaks caused by norovirus variant of GII.4 Sydney.</p><p><b>METHODS</b>During January 2012 to June 2014, a total of 10 750 fecal samples were obtained from 22 hospitals of surveillance sites in Guangdong province. Those samples were sent to the local municipal CDCs for extracting and detecting norovirus nucleic acid. Then, all the positive samples were delivered to Guangdong provincial CDC that used Random Number Method to draw 855 positive samples for norovirus genotyping, and 690 samples were successfully sequenced. Chi-square tests were used to compare norovirus infection status of diarrhea cases in different age groups as well as during different periods. Epidemiological data of 13 outbreaks which were caused by norovirus variant of GII.4 Sydney from January 2012 to June 2014 were collected from the Public Health Emergency Management Information System of Guangdong Province, and the epidemiological characteristics were analyzed.</p><p><b>RESULTS</b>The norovirus variant of GII.4 Sydney was first detected in August 2012 and the detection rate was 13/15 in November 2012. During November 2012 to January 2013 (period T1), the norovirus positive rate of each month was 23.8% (100/421), 15.9% (61/383) and 19.2% (95/495), respectively. During November 2013 to January 2014 (period T2), the norovirus positive rate of each month was 17.0% (90/529), 8.7% (37/426) and 11.2% (46/409), respectively which were significantly lower than that of period T1 (χ² alue was 6.65, 9.93 and 10.74. P value was 0.010, 0.002, and 0.001, respectively). In period T1, the norovirus positive rate of people ages 15 and older was 26.3% (143/543) and the rate of people under 15 was 14.9% (113/756) (χ² = 2.90, P < 0.001). In period T2, the norovirus positive rate of people ages 15 and older was 10.1% (52/516) and the rate of people under 15 (14.3% (121/848)) (χ²= 5.09, P = 0.024). The foodborne transmission was the infection source for ten of thirteen outbreaks.</p><p><b>CONCLUSION</b>The norovirus variant of GII.4 Sydney was first detected in August 2012. The epidemic began to occur in the community since November 2012, and the strength of the epidemic declined 1 year later. The foodborne transmission was the main infection sources for the outbreaks caused by norovirus variant of GII.4 Sydney.</p>
Subject(s)
Adolescent , Adult , Child , Humans , Chenodeoxycholic Acid , China , Diarrhea , Disease Outbreaks , Epidemics , Foodborne Diseases , Genotype , Norovirus , Sentinel SurveillanceABSTRACT
Magnetic resonance (MR) images can be used to detect lesions in the brains of patients with multiple sclerosis (MS). An automatic method is presented for segmentation of MS lesions using multispectral MR images in this paper. Firstly, a Pd-w image is subtracted from its corresponding T1-w images to get an image in which the cerebral spinal fluid (CSF) is enhanced. Secondly, based on kernel fuzzy c-means clustering (KFCM) algorithm, the enhanced image and the corresponding T2-w image are segmented respectively to extract the CSF region and the CSF-MS lesions combinatoin region. A raw MS lesions image is obtained by subtracting the CSF region from CSF-MS region. Thirdly, based on applying median filter and thresholding to the raw image, the MS lesions were detected finally. Results were tested on BrainWeb images and evaluated with Dice similarity coefficient (DSC), sensitivity (Sens), specificity (Spec) and accuracy (Acc). The testing results were satisfactory.
Subject(s)
Humans , Algorithms , Brain , Pathology , Image Enhancement , Magnetic Resonance Imaging , Multiple Sclerosis , Diagnosis , Sensitivity and SpecificityABSTRACT
Objective To understand the status of infection and epidemic trend of Dengue fever and Chikungunya in Guangdong.Methods Retrospective survey and literature review were used to obtain data on the incidence,etiology of Dengue and Chikungunya.Serological survey was conducted to detect the specific-antibodies in healthy individuals for both Dengue virus (DENV) and Chikungunya virus (CHIKV).Results Three epidemics of Dengue fever were observed during 1990-2012,with the annual incidence rates as 9.75/100 000 in 1995,1.76/100 000 in 2002 and 1.25/100 000 in 2006,respectively.The predominant epidemic strains appeared to be DENV-2 and DENV-4 during 1990-1994.Since 1995,DENV-1 had become the predominant transmission strain which lasted for almost 13 years.Co-existence of multiple serotypes of DENV started in 2009.Of the 7 718 sera from healthy population during 2003-2012,180 specimens were detected positive for specific DENV-IgG antibody,ended with a sero-prevalence rate of 2.33％.All 2 132 sera in 2012 were detected negative for CHIKV-IgG antibody.Conclusion The overall exposure level to Dengue was considered to be low in Guangdong province.However,the predominant transmission mode caused by DENV-1 had been gradually changed into the co-existence of multiple serotypes with the endemic signs appeared in some part of the areas.Chikungunya was a newly emerging disease in Guangdong since local people were lack of basic immunity barrier.Surveillance and control programs thus seemed important.
ABSTRACT
In the process of positron emission tomography (PET) data acquiring, respiratory motion reduces the quality of PET imaging. In this paper, we present a correction method using three level grids B-spline elastic method to correct denoised and reorganized sinograms for respiratory motion correction. Using GATE simulates NCAT respiratory motion model to generate raw data which are used in experiment, the experiment results showed a significantly improved respiratory image with higher quality of PET, and the motion blur and structural information were fixed. The results proved the method of this paper would be effective for the elastic registration.