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Objective:To analyze a family clustering of coronavirus disease 2019 （COVID-19） associated with the exposure to an asymptomatic case， and to provide evidences of developing strategies for COVID-19 prevention. Methods:Epidemiological investigation was conducted on a COVID-19 family cluster （1 confirmed case and 2 asymptomatic cases）. The specimens of the cases were tested for 2019 novel coronavirus nucleic acid with real-time fluorescence quantitative polymerase chain reaction. Results:The clustering epidemic occurred in a family. Two asymptomatic cases B and C （B’s son） had Wuhan residential history. After arrival in Beijing on January 24， 2020， B stayed in his mother's house. One family member A （B’s mother） developed the disease on February 7， 2020， while the other two family members D and E （B’s wife and brother） did not develop the disease， and they were managed as close contacts. Conclusion:Thisfamily COVID-19 clustering is induced by the exposure to an asymptomatic case. Identification of asymptomatic cases is very important for the control of COVID-19 epidemic.
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Objective:To conduct epidemiological investigation of a family cluster of coronavirus disease 2019 （COVID-19） in Fangshan District， Beijing， so as to provide reference and scientific basis for the strategy of prevention and control. Methods:Based on the "Prevention and Control Plan for COVID-19 （Third Edition）"issued by the National Health Commission of China， two cases from the same family were studied by field epidemiological investigation method. Sputum and/or throat swab specimens were collected and sent to the laboratory of Fangshan District Center for Disease Control and Prevention （CDC） for nucleic acid detection of 2019 novel coronavirus （2019-nCoV）. Tracking close contacts and isolation observation were conducted. Results:Both sputum and throat swab specimens of case 1 were positive for 2019-nCoV nucleic acid on February 3rd， 2020. Case 2 （wife of case 1） received screening as a close contact， and throat swab specimen was positive on February 4th， 2020. Therefore， it was determined to be a family cluster. The epidemic was effectively controlled after a series of measures， including isolation treatment， medical observation according to management of close contact and terminal disinfection of residence. Conclusion:The CDC professionals should strengthen monitoring of new findings， comprehensively analyze case data based on the latest research trends， improve professional sensitivity， and conduct timely screening to detect cases as soon as possible for the prevention of further epidemic spreading.
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BACKGROUND@#The efficacy of entecavir (ETV) add-on peg-interferon therapy compared with ETV monotherapy in treatment-naïve hepatitis B virus (HBV) patients remains controversial. We investigated whether adding peg-interferon to ongoing ETV treatment leads to a better curative effect or not.@*METHODS@#All patients have been recruited between August 2013 and January 2015 from the Shanghai Public Health Clinical Center and Zhongshan Hospital (China). Eligible HBV patients (n = 144) were randomly divided (1:1) to receive either ETV monotherapy (n = 70) or peg-interferon add-on therapy from week 26 to 52 (n = 74). Patients were followed-up for at least 2 years. Indexes including hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) seroconversion rate, sustained virologic response, transient elastography value, and histological scores were evaluated every 3 months until the end of the study. The rate of patients with HBsAg loss was defined as the primary endpoint criteria.@*RESULTS@#At week 26, no patient achieved HBsAg seroconversion in either group. At week 52, one patient in the monotherapy group was HBsAg-negative but there was none in the combination therapy group. The monotherapy group showed significantly better liver function recovery results than the combination therapy group. At week 78, one patient in the combination group had HBsAg seroconverted. At week 104, only three patients in the combination therapy group were HBsAg-negative compared with one patient in monotherapy. The mean alanine aminotransferase and aspartate aminotransferase levels and transient elastography values decreased significantly compared with baseline. Both groups showed a favorable decrease in alpha-fetoprotein (monotherapy: 4.5 [2.8, 7.1] vs. 2.2 [1.8, 3.1] ng/mL, P < 0.001; combination therapy: 5.7 [3.0, 18.8] vs. 3.2 [2.0, 4.3] ng/mL, P < 0.001) and an improved result of liver biopsy examination scores. The combination group showed a better improvement in histology compared with the monotherapy group (mean transient elastography value 6.6 [4.9, 9.8] vs. 7.8 [5.4, 11.1] kPa, P = 0.028). But there was no significant difference in HBsAg conversion rate (1.8% [1/56] vs. 4.1% [3/73], P = 0.809) and HBeAg conversion rate (12.5% [7/56] vs. 11.0% [8/73], P = 0.787), as well as HBV-DNA, sustained virologic response (93.2% vs. 98.5%, P = 0.150) between the two groups.@*CONCLUSIONS@#Both therapies supported liver function recovery and histology improvement. Combination therapy did not show better anti-viral efficacy in HBsAg or HBeAg seroconversion compared with monotherapy. However, combination therapy played a more positive role in reversing hepatic fibrosis compared with monotherapy.@*TRIAL REGISTRATION@#ClinicalTrials.gov: NCT02849132; https://clinicaltrials.gov/ct2/show/NCT02849132.
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OBJECTIVE@#To validate five-year risk prediction models for stroke in a contemporary rural Northern Chinese population.@*METHODS@#Totally 6 483 rural adults aged 40 to 79 years without cardiovascular diseases were enrolled at baseline between June and August 2010, and followed up through January 2017. Expected prediction risk using the China-PAR (prediction for atherosclerotic cardiovascular disease risk in China) stroke risk equations were compared with the new Framingham stroke risk profile (FSRP). The recalibrated models were applied by adjusting the five-year baseline survival rate and the mean score to our rural northern Chinese population, while keeping other coefficient parameters the same as the original models. Kaplan-Meier analysis was used to obtain the observed event (nonfatal or fatal stroke) rate for the five years, and the expected-observed ratios were calculated to evaluate overestimation or underestimation in the cohort. The models were assessed by discrimination C statistic, calibration χ2, and calibration charts and plots for illustration as well.@*RESULTS@#Over an average of (5.83 ± 1.14) years of the follow-up in this validation cohort with 6 483 rural Chinese participants, 438 subjects deve-loped a first stroke event. Recalibrated China-PAR stroke risk equations and FSRP well-performed for predicting five-year stroke risk in men, and had C statistics of 0.709 (95%CI, 0.675 - 0.743) and 0.721 (95%CI, 0.688 - 0.754), with calibration χ2 values being 5.7 (P = 0.770) and 13.6 (P = 0.137), respectively. However, both China-PAR and FSRP overestimated stroke events by 11.6% and 30.0% in women, and had C statistics of 0.713 (95%CI, 0.684-0.743) and 0.710 (95%CI, 0.679-0.740), respectively. Calibration χ2 values in women were 12.5 (P = 0.188) for China-PAR and 24.0 (P = 0.004) for FSRP. In addition, the calibration charts and plots illustrated good agreement between the observations and the predictions only in the China-PAR stroke risk equations, especially for men.@*CONCLUSION@#In this validation cohort of rural northern Chinese adults, the China-PAR models had better performance of five-year stroke risk prediction than the FSRP, indicating that recalibrated China-PAR stroke risk equations might be appropriate tools for risk assessment and primary prevention of stroke in China.
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Adult , Aged , Female , Humans , Male , Middle Aged , Cardiovascular Diseases , China , Cohort Studies , Risk Assessment , Risk Factors , StrokeABSTRACT
Objective The aim of this study was to investigate associations of overall obesity (OO) and abdominal obesity (AO) with brachial-ankle pulse wave velocity (baPWV) among type 2 diabetes(T2DM) patients. Methods A community-based study for T2DM patients was conducted in rural communities in Beijing．Every patient completed a questionnaire to collect demography, lifestyle and diseases history, and underwent physical examinations, baPWV assessments and blood biochemical tests. Multivariate linear regression was used to assess the relationship between obesity index and baPWV. Abnormal baPWV was defined as patients with baPWV≥1,700 cm/s. Logistic regression model was performed to explore the risk of abnormal baPWV after adjusting for poetential confounders step by step. Results A total of 2 048 T2DM patients were recruited. The average age was (59.2±8.3) years and total prevalence of abnormal baPWV was 49.7%. After multivariable adjustment, linear regression showed that there was a negative correlation between body mass index(BMI) and baPWV and a positive correlation between waist-to-hip ratio (WHR) and baPWV. Compared to normal weight group, those with BMI≥28 kg/m2 had lower risk of abnormal baPWV (OR=0.59, 95% CI: 0.44-0.78，P<0.001), but there was an increased risk of 46% among patients with obesity in WHR (OR=1.46, 95% CI:1.07-2.00，P=0.018). Compared to those without OO and AO, patients without OO but with AO had a 1.67-fold increasesd risk of abnormal baPWV (OR=1.67, 95% CI: 1.19-2.35，P=0.003). Conclusions Abdominal obesity is related with arterial stiffnening among T2DM patients, and it is critical to evaluate arterial stiffness of T2DM patients with abdmonal obesity and normal BMI in order to reduce future risk of cardiovascular diseases.
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Objective To explore the relationship between sleep duration and different ischemic stroke (IS) subtypes. Methods Participants in the study were recruited from rural communities in Beijing. The survey questionnaires, physical examination and biochemical tests were performed. Sleep duration was categorized into 5 groups, namely ≤5 hours/day, 6 hours/day (5.5-6.5 h/d), 7 hours/day (6.5-7.5 h/d), 8 hours/day (7.5-8.5 h/d) and ≥9 hours/day(≥8.5 h/d). Classification of ischemic stroke was based on Trial of org 10172 in acute stroke treatment(TOAST)classification. Logistic models were used to evaluate the associations between sleep duration and different IS subtypes. Results A total of 6 370 participants were recruited. The average age was (58.34±9.37) years old. Logistic regression analysis showed that after adjusting for age, sex, behavioral lifestyle, socioeconomic status and health status, compared to subjects with 7 hours/day, subjects with sleep duration ≤5 hours/day was significantly associated with increased risk of IS (OR=1.75, 95% CI: 1.42-2.15, P<0.001), large-artery atherosclerosis (OR=1.98, 95% CI:1.46-2.70, P<0.001), small-artery occlusion lacunar (OR=5.73, 95% CI:3.34-9.83, P<0.001) and stroke of undetermined etiology (OR=4.43, 95% CI:1.86-10.53, P=0.001). Subjects with sleep duration 8 hours/day and ≥9 hours/day was only found to be significantly associated with IS and large-artery atherosclerosis (P<0.05). Conclusions Short sleep duration is associated with increased risk of IS, large-artery atherosclerosis, small-artery occlusion lacunar and stroke of undetermined etiology. But long sleep duration is only associated with increased risk of IS and large-artery atherosclerosis.
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<p><b>OBJECTIVE</b>To study the effect of cyclooxygenase -2 selective inhibitor celecoxib on the expression of major vault protein ( MVP) in the brain of rats with status epilepticus and its possible roles in the treatment of refractory epilepsy.</p><p><b>METHODS</b>Sixty adult male Sprague-Dawley rats were randomly assigned to blank control (n=16), epilepsy model (n=22) and celecoxib treatment groups (n=22). After the status epilepticus was induced in rats by injecting lithium and pilocarpine, each group had 16 rats enrolled as subjects. Immunohistochemical method and Western blot method were used to detect the expression of MVP in the frontal cortex and hippocampus.</p><p><b>RESULTS</b>The expression of MVP was significantly higher in the epilepsy model group than in the control group (P<0.01). The expression of MVP in the celecoxib treatment group was significantly decreased compared with the epilepsy model group, but it was still higher than in the control group (P<0.01).</p><p><b>CONCLUSIONS</b>Celecoxib could decrease the expression of MVP in brain tissue of rats with status epilepticus, suggesting that it is promising for the treatment of intractable epilepsy.</p>
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Animals , Male , Rats , Blotting, Western , Brain , Metabolism , Celecoxib , Pharmacology , Therapeutic Uses , Cyclooxygenase 2 Inhibitors , Pharmacology , Immunohistochemistry , Rats, Sprague-Dawley , Status Epilepticus , Drug Therapy , Metabolism , Vault Ribonucleoprotein ParticlesABSTRACT
<p><b>OBJECTIVE</b>To study the relationship of activated astrocytes and multidrug resistance gene (MDR) expression in rats with epilepsy.</p><p><b>METHODS</b>Astrocytes of neonatal Sprague-Dawley rats were separated and cultured. The cultured cells of passage 3 were activated by TNF-α for 2, 24 or 48 hrs. The culture media of cells with different degrees of proliferation were infused to the lateral cerebral ventricle of rats with epilepsy. The expression of MDR in the brain tissue was ascertained by PCR, immunocytochemistry and Western blot.</p><p><b>RESULTS</b>After 2 hrs of TNF-α stimulation, astrocytes began to proliferate, and reached a peak at 24 hrs. The expression of MDR in the brain tissue increased after infusion of culture medium of proliferated astrocytes in the TNF stimulation group compared with that in the control group without TNF stimulation. The level of MDR expression in the TNF stimulation group was positively correlated with the degrees of cell proliferation.</p><p><b>CONCLUSIONS</b>Proliferation of astrocytes can increase the expression of MDR in rats with epilepsy and is probably involved in the development of refractory epilepsy.</p>
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Animals , Female , Male , Rats , ATP Binding Cassette Transporter, Subfamily B, Member 1 , Genetics , Astrocytes , Physiology , Cell Proliferation , Drug Resistance, Multiple , Genetics , Epilepsy , Metabolism , Rats, Sprague-Dawley , Tumor Necrosis Factor-alpha , PharmacologyABSTRACT
<p><b>BACKGROUND</b>From late May 2009, sporadic imported cases of novel influenza A (H1N1) were continuously confirmed in Shanghai, but there were few reports on its clinical presentation in China. The aim of the study was to investigate the demographic and clinical features of the laboratory-confirmed cases and the treatment with oseltamivir.</p><p><b>METHOD</b>We performed a retrospective study in the Shanghai Public Health Clinical Center (SHAPHC), reviewing the medical records of the laboratory-confirmed patients derived from June 10 to July 20, 2009.</p><p><b>RESULTS</b>A total of 156 cases were enrolled, of whom 152 had a history of recent travel. The mean age was 22.6 years and 89 cases (57.1%) were males. The most common symptoms were fever, cough, and sore throat, with children more likely to run a temperature above 38.5 degrees C than adults. The mean leucocyte count was 5.4 x 10(9)/L, the mean neutrophil count 3.2 x 10(9)/L and the mean lymphocyte count 1.4 x 10(9)/L. Other findings included a normal range or elevated level of C-reactive protein (CRP) and glutamic-pyruvic transaminase and a normal or decreased level of prealbumin; the levels of prealbumin and CRP were significantly lower in the children than in the adults. Fifty-two patients had abnormal chest CT results, with small unilateral or bilateral pulmonary infiltrates, axillary and mediastinal lymphadenopathy and local pleural thickening, while no cases showed symptoms of hypoxia. All the patients received oseltamivir and recovered without complications, but the duration of fever and virus shedding were significantly longer in the children than in the adults.</p><p><b>CONCLUSIONS</b>Travel-related circulation may be an important reason for the H1N1 epidemic in the non-epidemic areas, and the virus caused mild respiratory symptoms. The infection in children was more severe in terms of prealbumin levels, temperature, the duration of fever and virus shedding. Oseltamivir was effective for H1N1, but more effective in the adults than in the children.</p>
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Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Antiviral Agents , Therapeutic Uses , China , Influenza A Virus, H1N1 Subtype , Virulence , Influenza, Human , Blood , Diagnosis , Drug Therapy , Virology , Oseltamivir , Therapeutic Uses , Retrospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To study the effects of valproate acid (VPA) on serum lipid and leptin levels and cerebral cortex in juvenile and adult rats.</p><p><b>METHODS</b>Twenty healthy juvenile female Sprague-Dawley (SD) rats (21-day-old) and twenty healthy adult female SD rats (2-month-old) were randomly divided into four groups (n=10 each): juvenile control, juvenile VPA, adult control and adult VPA. Juvenile and adult VPA groups were fed with VPA 200 mg/kg daily, while the two control groups were fed with normal saline. The body weights were recorded weekly. Six weeks after feeding, serum and brain samples were obtained. Serum lipid levels including total cholesterol (TC), triglycerides (TG) and lower density lipoprotein cholesterol (LDL-C) were determined. Serum leptin (LEP) levels were measured by radioimmunoassay (RIA). Myelin staining and Nissl staining were used to evaluate the changes of brain tissues.</p><p><b>RESULTS</b>The weight and serum LEP and lipid levels in both juvenile and adult VPA groups increased significantly compared with those in the control groups (P<0.05). The juvenile VPA group had more increased serum LEP and lipid levels than the adult VPA group (P<0.05). The Myelin staining showed that the average fiber density in the VPA groups was significantly lower than that in the control groups (P<0.05). The Nissl staining showed that the number of toluidine blue staining neurons in the VPA groups was not statistically different from the control groups.</p><p><b>CONCLUSIONS</b>VPA may increase serum LEP and lipid levels in both juvenile and adult rats, and more increased levels may be found in juvenile rats. Long-term VPA treatment may have an adverse effect on brain myelination, but no effect on neurons.</p>
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Animals , Female , Rats , Anticonvulsants , Toxicity , Body Weight , Cerebral Cortex , Pathology , Leptin , Blood , Lipids , Blood , Myelin Sheath , Pathology , Rats, Sprague-Dawley , Valproic Acid , ToxicityABSTRACT
<p><b>OBJECTIVE</b>Fructose-1, 6-diphosphate (FDP), serving as a cellular energy substance, has shown its roles in the treatment of hypoxic-ischemic encephalopathy and myocardial damage. The present study aimed at exploring the potentiality of the protective effect of FDP against ultrastructural damage of the hippocampus caused by febrile seizures (FS) in rats.</p><p><b>METHODS</b>Thirty-six 21-day-old male Sprague-Dawley rats were randomly divided into three groups: untreated FS (control), high-dose FDP-treated FS and low-dose FDP-treated FS. FS were induced by hyperthermal bath. Thirty minutes before FS induction, rats in the high-dose and low-dose FDP-treated groups received a peritoneal injection of FDP at a dosage of 50 and 25 mg per 100 g of body weight respectively, whereas the same volume of 0.9% sodium chloride solution were injected to the rats in the control group. Transmission electron microscopy was used to examine the ultrastructural pathologic changes of neurons and organelles as well as the features of synaptic morphological parameters in the hippocampal CA1 area.</p><p><b>RESULTS</b>Neuronal degeneration and necrosis, mitochondria swelling, polyribosomes disaggregation from endoplasmic reticula, and golgiosomes dilation in the hippocampal CA1 area in the two FDP intervention groups were less severe compared with the control group. FDP treatment resulted in significant increases in postsynaptic density thickness (F=12.47, P<0.01), synaptic active zone length (F=14.75, P<0.01) and synaptic interface curvature (F=3.77, P<0.05), as well as a shorter interspace of neural synapses (F=7.29, P<0.01) when compared with the control group. There were no significant differences in the ultrastructural changes between the two FDP treatment groups.</p><p><b>CONCLUSIONS</b>FDP can ameliorate ultrastructural damage in the hippocampus caused by FS in rats. However, further research is warranted for a reasonable and effective dosage of FDP.</p>
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Animals , Male , Rats , Fructosediphosphates , Therapeutic Uses , Hippocampus , Neuroprotective Agents , Therapeutic Uses , Rats, Sprague-Dawley , Seizures, Febrile , Drug Therapy , PathologyABSTRACT
<p><b>OBJECTIVE</b>To study the effects of topiramate (TPM) and valproate acid (VPA) on serum insulin and leptin levels in young and adult rats.</p><p><b>METHODS</b>Thirty healthy female young rats (21 days old) and thirty healthy female adult rats (2 months old) were randomly administered with TPM (50 mg/kg daily), VPA (200 mg/kg daily) or normal saline (control group) by intragastric administration for 5 weeks. After 5 weeks, serum leptin and insulin levels were detected by radioimmunoassay (RIA).</p><p><b>RESULTS</b>Serum leptin and insulin levels in both the young and adult TPM groups were remarkably lower than those of the corresponding control group (P < 0.05). The adult TPM group had significantly lower serum leptin and insulin levels than the young TPM group (P < 0.05). In contrast, serum leptin and insulin levels in both the young and adult VPA groups were remarkably higher than those of the corresponding control group (P < 0.05). The young TPM group had significantly higher serum leptin and insulin levels than the adult TPM group (P < 0.05).</p><p><b>CONCLUSIONS</b>TPM decreases serum leptin and insulin levels in young and adult rats, especially in adult rats. VPA increases serum levels of both in young and adult rats, especially in young rats.</p>
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Animals , Female , Rats , Age Factors , Anticonvulsants , Pharmacology , Body Weight , Fructose , Pharmacology , Insulin , Blood , Leptin , Blood , Rats, Sprague-Dawley , Valproic Acid , PharmacologyABSTRACT
Interaction teaching model of teaching and studying exchanging,simulation scenes,and clinical scientific research training were developed in medical interns.With the helps of such teaching model,rapid progresses of studying interests,activi- ties,and abilities were found in such pediatric interns.Under grasping basic pediatrics knowledge according to teaching program, they all have multiple abilities of clinical practices,medical teaching,and scientific research to a degree.The interaction teaching model which regards student as principal part plays a very important role in the development of pediatric probation quality.
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0.05).The third day after SE,the expressions of MVP in CA1 and CA3 in adult rats experiment group increased,and in CA3,the value reached up to(4.0?1.41)in adult experiment group,which had significant differences compared with control groups(P
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Objective To explore the change of degrade of clonazepam in serum with single and repeated - dose administration in children with seizure, and find a reasonable method for using the clonazepam. Methods Children with seizures were divided into single - dose paradigam, repeated - dose paradigam, and decreased - dose paradigam. The concentration of CZP in serum was determined by high performance liquid chromatography( HPLC). Results The serum concentrations of clanazepain in single - dose paradigam were (101.9?12.1),(76.9 ? 5.8),(50.7?2.9),(30.9?5.4),(21.5?6.8)?g/L,the time point that the blood samples collected were 15,30,60,120 and 480 min. The serum concentrations in repeated - dose paradigam were (97. 2 ? 6. 1),(130.4? 13. 4), (99. 4 ? 9.8),(79.6?2.4)?g/L,in decreased-dose paradigam were( 101.1 ?13.1),(123.1 ?6. 6), (99.4 ?9. 8), (79. 3 ? 2. 2)?g/L,in these two groups,the time point were 15,45,60 and 120 min. Conclusion Repeated administration of CZP with decreased dose may increase its effectiveness in treatment without substantially increasing toxicity.
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Objective To explore the expression of c-Fos protein and character of mossy fiber sprouting(MFS) in hippocampus of rat with febrile seizures(FS).Methods Thirty-six 21-day-old male Sprague-Dawley rats were randomly divided into FS group,febrile control(FG) group and normal control(NG) group.FS was established by hyperthermal bath.Immune histochemistry and(Timm′s) staining were used to examine the expression of c-Fos protein in CA1 region and MFS in CA3 region of hippocampus.Results Excessive expression of c-Fos protein presented in the hippocampal CA1 region of FS group.The surface area percentage of c-Fos protein of FS group[(2.26?0.23)%] was higher than that of FG group[(1.08?0.19)%] and NG group[(0.71?0.14)%],there were significant difference between FS group and the other two groups(?~2=10.48 P