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Objective:To investigate the clinical effects of robot-assisted minimally invasive percutaneous pedicle screwing in the treatment of multi-segmental thoracolumbar burst fractures without neurological dysfunction.Methods:A retrospective analysis was conducted of the 24 patients who had been treated at Department of Orthopaedics, Hospital Affiliated to Inner Mongolia Medical University for multi-segmental thoracolumbar fractures from January 2019 to December 2020. They were randomly divided into a robot group ( n=12) in which the minimally invasive percutaneous pedicle screwing was assisted by a surgical robot and a manual group ( n=12) in which the minimally invasive percutaneous pedicle screwing was performed manually. There were 8 males and 4 females in the robot group, aged from 35 to 74 years; there were 7 males and 5 females in the manual group, aged from 36 to 69 years. The clinical effects were evaluated by comparing the 2 groups in terms of operation time, fluoroscopy frequency, fluoroscopy time, intra-operative needle adjustments, intra-operative blood loss, screwing accuracy, and visual analogue scale (VAS) scores, anterior vertebral height ratios and sagittal cobb angles at preoperation, postoperative 3 days and the last follow-up. Results:There was no statistically significant difference in the preoperative general data between the 2 groups, showing comparability ( P>0.05). A total of 128 screws were implanted in the robot group and 126 ones in the manual group. In the robotic group, operation time [(129.2±10.5) min], fluoroscopy frequency [(8.5±2.1) times], fluoroscopy time [(9.8±1.9) s], guide needle adjustments [(2.3±1.4) times], and intraoperative blood loss [(65.3±9.8) mL] were significantly less than those in the manual group [(153.8±18.1) min, (39.8±5.1) times, (43.9±4.8) s, (18.6±2.6) times and (96.8±10.9) mL] (all P<0.05). Regarding the screwing accuracy evaluated using CT scanning, the robot group was significantly higher (93.75%, 120/128) than the manual group (84.92%, 107/126) ( P<0.05). There was no significant difference between the 2 groups in VAS score, anterior vertebral height ratio or sagittal cobb angle at postoperative 3 days or the last follow-up ( P>0.05). The VAS scores, anterior vertebral height ratios and sagittal cobb angles at postoperative 3 days and the last follow-up were significantly improved than the preoperative values in all patients ( P<0.05). There was no supplementary surgery or screw loosening in either of the 2 groups. Conclusion:In the treatment of multi-segmental thoracolumbar fractures, robot-assisted percutaneous pedicle screwing can achieve satisfactory clinical effects, because, compared with traditional open surgery, it has exhibited advantages of less operation time, lower radiation exposure, less intraoperative blood loss, and higher screwing accuracy.
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Objective:To understand the epidemiological characteristics of brucellosis in non-occupational population reported in Hangzhou, and provide basis for diagnosis and further prevention and control of brucellosis in non-occupational population.Methods:The basic information, epidemiological characteristics, clinical characteristics and laboratory test data of brucellosis patients reported in Hangzhou from 2008 to 2019 were collected retrospectively. The data were obtained from the case questionnaire of confirmed brucellosis and annual report of brucellosis prevention and control work of Hangzhou Center for Disease Control and Prevention over the years. The epidemiological characteristics, clinical characteristics and diagnosis of brucellosis in non-occupational population were analyzed.Results:From 2008 to 2019, 76 cases of brucellosis in non-occupational population were reported in Hangzhou, accounting for 34.23% (76/222) of the total reported brucellosis cases. In the 76 cases of brucellosis in non-occupational population, there were 47 males and 29 females, the ratio of male to female was 1.62∶1.00; the age was (47.37 ± 16.04) years old, ranging from 6 to 84 years old. The peak incidence of brucellosis in non-occupational population was from March to May, accounting for 59.21% (45/76); the main routes of infection were direct contact and digestive tract, accounting for 80.26% (61/76). The main clinical symptoms were fever (100.00%, 76/76), hyperhidrosis (73.68%, 56/76) and muscle and joint pain (69.74%, 53/76); the diagnosis time was 27 (14, 49) d, and the longest diagnosis time was 190 d. Among them, 39 cases were misdiagnosed, accounting for 51.32% (39/76). Sixty suspected Brucella strains were identified by routine culture of automatic blood culture apparatus in hospital laboratory, and 54 strains of Brucella melitensis were identified by typing, with a coincidence rate of 90.00%. The blood culture rate of patients from 2015 to 2019 (88.46%, 46/52) was significantly higher than that from 2008 to 2014 (58.33%, 14/24), the difference was statistically significant (χ 2=8.968, P < 0.05). Conclusions:From 2008 to 2019, the onset of brucellosis in non-occupational population is seasonal in Hangzhou, the infection mode is diverse, the clinical symptoms are not typical, and it is easy to be misdiagnosed. Blood culture for suspected brucellosis patients in high incidence season is conducive to the early diagnosis of brucellosis.
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Objective:To understand the iodine deficiency disorders (IDD) knowledge, attitude and practice (KAP) among population in and near salts marketing areas of Hangzhou urban areas, so as to provide the evidence for making effective health education and health promotion models.Methods:A face to face KAP questionnaire investigation was conducted in 5 salts marketing survey points of 5 urban areas according to the north, south, east, west and center locations in 2018. The survey included basic information, awareness of the harm of iodine deficiency disorders (IDD), ways to acquire knowledge of IDD prevention and control, knowledge of IDD prevention, and attitudes towards iodized salt and iodine-free salt. The survey results were analyzed.Results:Totally 991 people completed the investigation; and 80.8% (801/991) of the population surveyed knew that iodine deficiency will cause endemic goiter, and 41.7% (413/991) of them knew that IDD could lead to varying degrees of mental impairment; 62.1% (615/991) obtained IDD prevention knowledge from TV, radio, Internet and newspaper; 76.8% (761/991) knew that IDD can be prevented by taking iodized salt. However, 8.9% (88/991) thought eating seafood was the best way to prevent IDD; 50.9% (504/991) thought iodized salt may not cause excessive iodine intake, but 56.5% (560/991) considered that there was a correlation between iodized salt and thyroid nodules. 56.2% (557/991) believed that the supply of iodized salt should be opened.Conclusions:The population in and near salts marketing areas of Hangzhou urban areas remains relatively lack of knowledge on IDD and salt iodization. The routes people obtaining IDD knowledge are very limited and the health education should be highlighted.
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Background/Aims@#The risk factors of colorectal stricture associated with ulcerative colitis (UC) carcinogenesis in the long-term disease duration remain unclear. @*Methods@#This study included all UC patients registered from a prospectively maintained database between June 1986 to July 2018. The demographic data, clinical features, and outcomes in patients with dysplasia and stricture were assessed using univariable analysis and multivariate logistic regression models. @*Results@#A total of 246 eligible patients were in-cluded in the analysis. The median follow-up time was 13.0 years (interquartile range [IQR], 9.0 to 16.0). There were 35 cases (14.2%) of colorectal stricture. Patients with stricture had worse clinical outcomes. Stricture formation (odds ratio [OR], 9.350; 95% confidence interval [CI], 2.842 to 30.762), inflammatory polyps (OR, 5.464; 95% CI, 1.692 to 17.638), disease duration of more than 10 years (OR, 3.223; 95% CI, 1.040 to 9.985), and age >40 years at diagnosis (OR, 8.499; 95% CI, 1.903 to 37.956) were significantly associated with high-grade dysplasia or colorectal cancer. In addition, disease duration of more than 5 years (OR, 3.211; 95% CI, 1.168 to 8.881), moderated anemia (OR, 3.373; 95% CI, 1.472 to 7.731), and primary sclerosing cholangitis (OR, 5,842; 95% CI, 1.395 to 24.468) were contributing factors for the development of colorectal stricture. @*Conclusions@#Colorectal stricture had the highest risk for malignant transformation.Earlier initiation of colonoscopic surveillance in UC patients with risk factors for stricture should be considered to prevent stricture formation and further malignant transformation.
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Objective@#To assess the diagnostic performance of contrast-enhanced spectral mammography (CESM) in suspected breast lesions.@*Methods@#A total of 97 patients with suspected breast cancer identified by clinical examination or screening underwent two-views CESM examination on the basis of digital breast tomosynthesis (DBT) combined with full-field digital mammography (FFDM), and they were finally confirmed by biopsy or pathology. Three senior radiologists analyzed images, including lesion visibility, lesion characteristics, enhancement type, degree of enhancement, BIRDS classification, etc. Finally, based on the pathology, we compared the CESM+DBT+FFDM and DBT+FFDM two models according to sensitivity, specificity and ROC for diagnostic performance.@*Results@#There were a total of 120 lesions. Eighty-nine lesions were malignant, 31 benign; CESM was not enhanced in 2 cases, mild enhancement was performed in 22 cases, moderately intensive in 15 cases, highly intensive in 81 cases, and 2 cases were not enhanced; mass-enhanced in 96 cases, including ring-enhanced in 12 cases, 22 cases of non-mass type. The sensitivities of the combination of CESM and not combination of CESM were 91.0% and 80.9%, respectively, and the specificities were 93.5% and 87.1%, respectively. The area under the ROC curve of combination of CESM was higher than the without combination of CESM (0.923 and 0.900, P<0.05), The difference was statistically significant.@*Conclusion@#For suspicious lesions, CESM examination can improve the diagnosis accuracy of breast cancer.
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Objective To investigate the effects of administrative region changes on prevention and control of fluorosis,in order to provide a scientific basis for evaluation and improvement of prevention and control measures.Methods An investigation was conducted in all drinking water-born endemic fluorosis areas in Hangzhou in 2017,to evaluate the status quo of water-improving defluoridation projects,measure the water fluoride content with "the Standard Detection Methods for Domestic Drinking Water" (GB/T 5750.7-2006),detect the dental fluorosis with Dean method and the urinary fluoride content by fluoride selective electrode method in children aged 8 to 12 years old.Results The historical endemic fluorosis areas in Hangzhou now involved 38 natural villages of 22 administrativevillages in 8 townships of 5 counties (cities and districts).All villages had completed water-improving projects which were running well as the fluoride contents of drinking water were less than 1.00 mg/L.The detection rate of dental fluorosis was 1.13％ (9/795) among children aged 8-12 years.A total of 198 urine samples were tested,the urinary fluoride content varied from 0.12 to 2.90 mg/L,and the geometric mean was 0.77 mg/L.Conclusion Administrative region changes do not influence the effect of water-improving defluoridation projects,but management and monitoring of the water-improving projects still should be strengthened.
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Objective To assess the diagnostic performance of contrast-enhanced spectral mammography (CESM) in suspected breast lesions. Methods A total of 97 patients with suspected breast cancer identified by clinical examination or screening underwent two-views CESM examination on the basis of digital breast tomosynthesis (DBT) combined with full-field digital mammography (FFDM), and they were finally confirmed by biopsy or pathology. Three senior radiologists analyzed images, including lesion visibility, lesion characteristics, enhancement type, degree of enhancement, BIRDS classification, etc. Finally, based on the pathology, we compared the CESM+DBT+FFDM and DBT+FFDM two models according to sensitivity, specificity and ROC for diagnostic performance. Results There were a total of 120 lesions. Eighty-nine lesions were malignant, 31 benign; CESM was not enhanced in 2 cases, mild enhancement was performed in 22 cases, moderately intensive in 15 cases, highly intensive in 81 cases, and 2 cases were not enhanced; mass-enhanced in 96 cases, including ring-enhanced in 12 cases, 22 cases of non-mass type. The sensitivities of the combination of CESM and not combination of CESM were 91.0% and 80.9%, respectively, and the specificities were 93.5% and 87.1%, respectively. The area under the ROC curve of combination of CESM was higher than the without combination of CESM (0.923 and 0.900, P<0.05), The difference was statistically significant. Conclusion For suspicious lesions, CESM examination can improve the diagnosis accuracy of breast cancer.
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Objective To evaluate the diagnostic performance of digital breast tomosynthesis (DBT) breast X-ray photography image texture characteristics based deep learning classification model on differentiating malignant masses. Methods Retrospectively collected 132 cases with simplex breast lesions (89 benign lesions and 43 malignant lesions) which were confirmed by pathology and DBT during January 2016 to December 2016 in Nanfang Hospital. DBT was performed before biopsy and surgery. Image of cranio-caudal view (CC) and medio-lateral oblique (MLO) were captured. The lesion area was segmented to acquire ROI by ITK-SNAP software. Then the processed images were input into MATLAB R2015b to establish a feature model for extracting texture features. The characteristics with high correlation was analyzed from Fisher score and one sample t test. We built up support vector machine (SVM) classification model based on extracted texture and added neural network model (CNN) for deep learning classification model. We randomly assigned collected cases into training group and validation group. The diagnosis of benign and malignant lesions were served as the reference. The efficiency was evaluated by ROC classification model. Result We extracted 82 texture characteristics from 132 images of leisure (132 images of CC and 132 images of MLO) by establishing deep learning classification model of breast lesions. We randomly chose and combined characteristics from 15 texture characteristics with statistical significance, then differentiated benign and malignant by SVM classification model. After 50 iterations on each combination of characteristics, the average diagnostic efficacy was compared to obtained the one with higher efficacy. Nine of CC and 8 of MLO was selected. The result showed that the sensitivity, specificity, accuracy and area under curve (AUC) of the model to differentiate simplex breast lesions for CC were 0.68, 0.77, 0.74 and 0.74, for MLO were 0.71, 0.71, 0.71 and 0.76. Conclusions MLO has better diagnostic performance for the diagnosis than CC. The deep learning classification model on breast lesions which was built upon DBT image texture characteristics on MLO could differentiate malignant masses effectively.
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Objective To study epidemic of schistosomiasis in the Qiandao Lake reservoir area,and to provide a reference for prevention and control of schistosomiasis in the construction of large water conservancy projects in the epidemic area of schistosomiasis.Methods The data over the years of snail condition and monitoring of schistosomiasis before and after building the dam,and water conservancy project reconstruction related information were collected.Based on the survey results of the river channel,the lake beach and the dissipation zone in the reservoir area,the influence of Xin'an River water conservancy project on epidemic of schistosomiasis in the Qiandao Lake reservoir area was analyzed,and the epidemic factors of the schistosomiasis in the Three Gorges reservoir were compared and analyzed.Results Before the dam was built,an area of 38 144 000 m2 was examined but Oncomelania was undetected.The Qiandao Lake reservoir area belonged to a non epidemic area of schistosomiasis.After the dam was built,557 cases of schistosomiasis were found in 6 232 immigrants during 1962-1965,resulting in an imported epidemic.In 1970-1980,an area of 379 654 m2 in which Oncomelania was found was examined and snails were mainly distributed in some rice fields and ditches in the end of the reservoir.949 cases of local schistosomiasis were found in the snails.The condition and condition of the snail are gradually controlled through several decades of comprehensive prevention and control.Compared with the epidemic factors of schistosomiasis in Qiandao Lake and the Three Gorges reservoir,the environment of elevation beach and ecologically fragile fluctuation zone coexist in the two reservoir areas.Conclusion From the long-term longitudinal monitoring data of the Qiandao Lake reservoir area and the epidemic regularity of schistosomiasis and the comparison with the ecology of the Three Gorges reservoir,it is concluded that the two reservoir areas will not cause a large range of schistosomiasis epidemic in general,but it does not exclude the possibility of the breeding of the inputting Oncomelania.
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Objective To establish a normal reference range of thyroid-related indicators of early pregnant women in Hangzhou,and investigate the prevalence of thyroid disease among them after the implementation of a new standard of salt iodine content, in order to provide reference for monitoring of thyroid disease in pregnant women.Methods A total of 582 women in early pregnancy(0 - 13 weeks of gestation) in Hangzhou were selected via the stratified random sampling method as the subjects of the study and for detection of serology thyroid function. The levels of serum thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroid peroxidase antibody(TPOAb) and thyroglobulin antibody (TgAb) were measured by chemiluminescence method. According to the standard American Academy of Clinical Biochemistry (NACB), 359 women in early pregnancy were strictly screened to establish the normal reference value of TSH, FT4, and the reference range using the 95% confidence interval (95%CI). At the same time, the newly establish reference interval was used to evaluate the thyroid function of 582 early pregnant women. Results The reference interval of TSH in early pregnant women of Hangzhou was 0.048 -3.354 mU/L.The reference interval of FT4was(13.023 ± 3.316) pmol/L, and the tenth percentile of FT4was 11.030 pmol/L. Eighty-four persons' thyroid function was abnormal in 582 and the rate of abnormal was 14.4% (84/582), in which the rates of abnormal in clinical hypothyroidism, subclinical hypothyroidism, subclinical hyperthyroidism and hypothyroxinemia were 0.2% (1/582), 3.4% (20/582), 1.9% (11/582) and 8.9% (52/582), respectively. The case with clinical hyperthyroidism was not detected. The positive rate of TPOAb and TgAb were 10.8% (63/582) and 11.7%(68/582). The abnormal rate of hypothyroxinemia and the positive rate of TPOAb in early pregnant women in the city(11.4%,13.5%)were significantly higher than that in the rural areas(6.3%,8.1%,χ2=4.708,4.309, P < 0.05). Conclusions The normal reference value of thyroid hormones in early pregnant women in Hangzhou is established, and it is found that the incidence of thyroid disease is higher in pregnant women in Hangzhou after the implementation of the new standard of salt iodine content, therefore, it is imperative to carry out monitoring (or screening)of thyroid function in early pregnant women.
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Objective To explore the diagnostic value of full-field digital mammography (FFDM) combined with digital breast tomosynthesis (DBT) in breast diseases.Methods 506 patients receiving mammary gland molybdenum target inspection from January 1, 2014 to December 31, 2014 were selected.The images from FFDM and DBT were analyzed, respectively.The breast imaging reports and pathological results were compared to investigate the sensitivity, specificity and accuracy of FFDM, DBT alone and combined use of DBT and FFDM.Results The results of preoperative mammography in the 506 women (bilateral breast) were as follows: FFDM combined with DBT detected 202 benign cases (39.9%) and 304 malignant cases (60.1%);FFDM alone detected 194 benign cases (38.3%) and 312 malignant cases (61.7%);DBT alone detected 187 benign cases (37.0%) and 319 malignant cases (63.0%).Pathologically, 214 benign cases (42.3%) were detected and 292 malignant cases (57.7%).In terms of the sensitivity, specificity and accuracy, The combined use of DBT combined with FFDM was the best, followed by FFDM alone and DBT alone.Conclusion The sensitivity, specificity and accuracy of FFDM combined with DBT for diagnosis are better than those of FFDM alone or DBT alone.
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Objective To explore the impact of iodine nutrition on pregnant women before and after adjusting the iodine content in iodine salt.Methods Twelve counties (areas,cities) in Hangzhou were divided into urban,suburban and rural areas before and after adjusting the iodine content of salt.One survey spot was selected in each district and one hundred pregnant women were selected;family salt and urinary samples of each pregnant woman were collected.The levels of salt and urinary iodine were measured by the methods of picric sodium thiosulfate titrimetric (GB 13025.7-2012) and spectrophotometer (WS/T 107-2006),respectively.Results One thousand two hundred and thirty-nine and one thousand two hundred and thirty-three household salt samples were collected before and after adjusting the iodine content in iodine salt.The median of salt iodine of pregnant women (23.30 mg/kg) before adjusting the iodine content in iodine salt was lower than that after adjusting the iodine content in iodine salt (30.09 mg/kg,x2 =-4.71,P ＜ 0.01).The iodine salt coverage rate and the consumption rate of qualified iodized salt after adjusting the iodine content in iodine salt [93.92％ (1 158/1 233),93.84％ (1 157/1 233)] were higher than those before adjusting the iodine content in iodine salt [91.85％ (1 138/1 239),91.37％ (1 132/1 239),x2 =4.01,5.51,all P ＜ 0.05].The iodine salt coverage rate and the consumption rate of qualified iodized salt in urban and suburb areas after adjusting the iodine content in iodine salt [99.42％ (510/513),100.00％ (203/203),97.86％ (5021513),100.00％ (203/203)] were higher than those before adjusting the iodine content in iodine salt [86.71％ (450/519),98.00％ (196/200),77.26％ (401/519),85.00％ (170/200)],but the iodine salt coverage rate and the consumption rate of qualified iodized salt in rural area before adjusting the iodine content in iodine salt [94.62％ (492/520),86.92％ (452/520)] were higher than those after adjusting the iodine content in iodine salt [85.69％(443/517),76.98％ (398/517),x2=64.22,2.32,100.02,32.90,23.31,17.33,all P ＜ 0.05].One thousand two hundred and thirty-four and one thousand two hundred and thirty-one household urine samples were collected before and after adjusting the iodine content in iodine salt.The median of urinary iodine (MUI,114.80 μg/L) of pregnant women after adjusting the iodine content in iodine salt was lower than that before adjusting the iodine content in iodine salt (168.60 μg/L,x2 =36.92,P ＜ 0.01).The MUIs of pregnant women in urban,suburban,and rural areas (171.30,170.20 and 162.40 μg/L) before adjusting the iodine content in iodine salt were higher than those after adjusting the iodine content in iodine salt (101.00,149.48 and 119.90 μg/L,x2 =-7.78,-2.63,-6.28,all P ＜ 0.01).The differences of urinary iodine between groups were statistically significant in urban,suburban and rural areas after adjusting the iodine content in iodine salt (x2 =32.86,P ＜ 0.01),the MUI of pregnant women in urban areas was lower than those in the suburban and rural areas (x2 =6.70,8.13,all P ＜ 0.05).Conclusions After adjusting the iodine content of salt in Hangzhou,the iodine-nutrition level of pregnant women is decreased.But the consumption rates of qualified iodized salt and the MUIs in urban,suburb,rural areas are different,so the coverage of iodized salt at household level needs to be enhanced and the health education should be highlighted.
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Objective To explore the impact of iodine nutrition on pregnant women after adjusting the iodine content in iodized salt in Hangzhou and provide a scientific basis for supplementation of iodine to pregnant women.Methods After adjusting the iodine content of salt from 2012 to 2014,proportional probability sampling method was used to select 300 families and 100 pregnant women from every county (area,city) of Hangzhou City,and the household salt and urine samples were collected to detect iodine.Results Totally 3 904,3 900 and 3 900 samples of household salts were collected with the medians of salt iodine concentration of 23.77,22.75 and 23.30 mg/kg of each year from 2012 to 2014,respectively.The qualified rate of iodized-salt was 95.87％ (3 550/3 703),97.04％ (3 510/3 617) and 96.53％ (3 564/3 692) and the consuming rate of qualified iodized salt was 90.92％ (3 550/3 904),90.01％ (3 510/3 900) and 91.38％ (3 564/3 900),respectively,from the year 2012 to 2014.Totally 1 300,1 217 and 1 315 urine samples of pregnant women were collected and the median of urinary iodine (MUI) of each year from 2012 to 2014 was 119.90,136.40 and 124.00 μg/L,respectively.Conclusion After adjusting the iodine content of salt in Hangzhou,the salt iodine consumption levels of pregnant women's family are stable,but the level of urinary iodine is low,which should be pay attention to.
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Objective To explore the impact of iodine nutrition on children in areas with different iodized-salt covering rate after adjusting the iodine content in iodized salt in Hangzhou.Methods After adjusting the iodine content of salt,every county (area,city) of Hangzhou was divided into east,west,south,north and middle districts;one school was selected in each district,40 children aged 8-10 years old in each school were selected.The goiter rates of 8-10 years old students were examined (WS 276-2007).The family salt and urine samples of each student were collected.The levels of salt and urinary iodine were measured by picric sodium thiosulfate titrimetric (GB 13025.7-2012) and spectrophotometer method (WS/T 107-2006),respectively.Areas were classified according to the coverage rate of iodized salt ＜95％ and ≥95％,and their urinary iodine levels were compared.Results A total of 2 395 samples were collected with a median salt iodine concentration of 23.50 mg/kg and a urinary iodine level of 167.45 μg/L.The goiter rate of children 8-10 years old was 1.75％ (42/2 395).The total iodized-salt covering rate was 93.15％ (2 231/2 395) and the difference was statistically significant between different districts and towns (x2 =153.13,P ＜0.01),but the level was less than 95％ in 6 areas.The urinary median iodine was 151.00 μg/L in the areas where the iodized-salt covering rate was less than 95％,lower than 173.50 μg/L in the areas where the iodized-salt covering rate was more than or equal to 95％ (x2 =-5.28,P ＜0.01).Conclusions After adjusting the iodine content of salt in Hangzhou,the iodine-nutrition status of 8 to 10 years old students is optimal.But the urinary iodine levels are different in areas with different iodized-salt covering rates,so the coverage of iodized salt at household level need to be enhanced and the health education should be strengthen.
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Objective To investigate the epidemiological characteristics of Brucella aggregation of disease outbreaks, and explore the causes and possible routes of transmission in Tongxiang City for proposing prevention and control measures.Methods A case investigation was done to the first case of bovine brucellosis, while search of new case was carried out in the population.Epidemiological survey was carried out in accordance with the case study form from Chinese Center for Disease Control and Prevention that developed the unified form, at the same time, survey of risk factors were carried out.According to the principle of informed consent, blood samples were collected, brucellosis rose bengal plate agglutination test (RBPT) and tube agglutination test (SAT) were used, and positive specimens were identified by Brucella culture.Brucellosis diagnosis was based on Brucellosis Diagnostic Criteria (WS 269-2007).Results The first case was a male Fifty-six years old wine salesman from the farmers market.Serum of the patient was (+) in RBPT test, and 1 : 400 (++) in SAT test.Cattle Brucella was check out by blood culture.Totally 66 human serum samples from the case search in key groups were tested, three people were detected seropositive but Brucella culture result was negative.Three cases were determined latent infection who had contacted beef sales staff.Conclusions The survey has shown that it is possible to get infected through contact with respiratory, skin, mucous membranes of Brucella infected beef or contaminated environment.Epidemic form should be concerned of non-professional personnel who are infected with different isoforms of brucellosis.The training of clinicians should be strengthened to improve their diagnosis and treatment technology.Health education should also be carried out to raise awareness of key population of disease prevention.
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<p><b>OBJECTIVE</b>To explore the correlation between pathological findings and mammographic features of microcalcification in calcified breast carcinoma without a mass.</p><p><b>METHODS</b>The morphology and distribution of the microcalcification lesions displayed by mammography were retrospectively analyzed in 108 cases of the calcified breast carcinoma without a mass in comparison with the pathological findings of the lesions.</p><p><b>RESULTS</b>The mammographic morphology or distribution of the microcalcification lesions did not differ significantly across different pathological types of calcified breast carcinoma without a mass (P>0.05). The microcalcification lesions showed no significant morphological difference between invasive and noninvasive breast carcinomas (P>0.05). Fine pleomorphic calcifications were frequently found in both invasive and noninvasive breast carcinomas, but fine linear and fine linear branching calcifications and mixed malignant calcifications were more common in invasive breast carcinoma. The distribution of the microcalcifications showed significantly different patterns between invasive and noninvasive breast carcinoma (P=0.006), characterized by segmental and cluttered distributions of the lesions, respectively.</p><p><b>CONCLUSION</b>There is no specific mammographic features in correlation with the pathological types of microcalcification lesions in calcified breast carcinoma without a mass, but invasive and noninvasive calcified breast carcinomas have different mammographic features in the morphology and distribution of the microcalcifications to allow their preoperative differentiation.</p>
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Female , Humans , Breast Neoplasms , Diagnostic Imaging , Pathology , Calcinosis , Diagnostic Imaging , Pathology , Carcinoma, Ductal, Breast , Diagnostic Imaging , Pathology , Mammography , Methods , Retrospective StudiesABSTRACT
Objective To investigate the prevalence of thyroid disease in early pregnancy women of Hangzhou,and further to discuss the necessity of screening thyroid function in early pregnant women.Methods From March to October 2013,1 165 cases of women in the center of community health service (or health) for routine prenatal care during early pregnancy were used as research subjects.Household salt,fasting morning urine and serum samples were collected.The salt iodine level was measured by direct titration of sodium thiosulfate.The urinary iodine level was measured by arsenic-cerium contact process method.The levels of serum TSH,FT4,and thyroid peroxidase antibody (TPOAb) were measured by chemiluminescence method.Results The median of urinary iodine of the early pregnancy women was 135.2 μg/L,and only 26.7％ of early pregnancy women' s iodine-nutrition status were optimal.These were no significant difference in median urinary iodine as well as the frequency distribution between urban and suburban(P＞0.05).The abnormal rates of TSH and FT4 in early pregnancy women with negative TPOAb were 6.8％ (71/1 039) and 8.9％ (92/1 039),and the abnormal rates of TSH and FT4 in suburban areas were higher than those in urban areas(P=0.035,P =0.001).The prevalences of hypothyroidism,subclinical hypothyroidism,and hypothyroxinemia in early pregnant women of Hangzhou were 0.3％ (3/1 165),2.0％ (23/1 165),and 4.8％ (56/1 165) respectively,and the prevalence of hypothyroxinemia in suburban areas was significantly higher than that in urban areas (6.1％ vs 3.5％,P =0.040).The positive rate of TPOAb was 9.9％ (114/1 153).The early pregnant women with positive TPOAb have an increased risk of thyroid dysfunction,the ratio of TSH over the reference values was significantly higher than that in the negative group and more prone to subclinical hypothyroidism (OR =3.34,95％ CI 1.29-8.65).Conclusion The early pregnant women in rural areas or with positive TPOAb have an increased risk of abnormal thyroid function,thyroid function and iodine nutrition screening or monitoring should be highlighted.
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Objective To understand the epidemiological distribution and epidemic situation of brucellosis cases in Zhejiang Province in 2003 - 2012. Methods Questionnaires of confirmed brucellosis cases, annual reports of prevention and control work of brucellosis in the cities and monitoring points were collected and analyzed in 2003 - 2012. Population distribution, regional distribution, infection sources and routes of infection, aetiology and clinical symptoms and signs of the brucellosis cases were analyzed descriptively. Results A total of 323 brucellosis cases were reported in 2003 - 2012, the average annual incidence rate was 0.070/one hundred thousand, the incidence rate in 2012(0.190/one hundred thousand) was high. There were 272 people of the 323 brucellosis cases were from occupational populations, accounting for 84.21%(272/323); people worked in buying, slaughtering and trafficking of livestock products were majority of the cases, accounting for 65.02%(210/323); and unoccupational population was accounting for 15.79%(51/323). Regional distribution of brucellosis was gradually spreading; the average incidence rate of Shaoxing City was the highest ( 0 . 226/one hundred thousand ) . Three hundred patients were infected by sheep, accounting for 92.88%(300/323), and only 7.12%(23/323) of the patients were infected by cattle. Two hundred and eighty-seven acute phase patients of brucellosis were checked by blood culture, and thirty-nine Brucella melitensis strains and two Brucella abortus strains were detected. The chronicity survey of 120 confirmed cases of brucellosis were conducted, chronicity rate was 3.33%(4/120). Conclusions Trends in the epidemic situation of brucellosis in Zhejiang Province has continued to spread. The main source of infection is sheep from the North. Occupational populations are major populations at risk. The key of prevention and control is to strengthen the active monitoring of occupation personnel , health education and behavior intervention.
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Objective To explore the impact of iodine nutrition on 8-10 years old children after adjusting the iodine content in iodized salt in Hangzhou.Methods Twelve counties (areas,cities) were divided into urban,suburban and rural areas in Hangzhou.By population proportion survey (PPS),every county(area,city) was divided into east,west,south,north and middle districts; one school was selected in each district; forty children (half male and half female) aged 8-10 years old in each school were selected; family salt and urine samples of each student were collected.The levels of salt and urinary iodine were measured by picric sodium thiosulfate titrimetric (GB 13025.7-2012) and spectrophotometer method (WS/T 107-2006),respectively.Results Two thousand seven hundred and twenty-five household salt samples were collected.The median of salt iodine,the iodized salt coverage rate,the qualification rate of iodized salt and the consumption rate of qualified iodized salt were 24.00 mg/kg,4.35％(2 571/2 725),91.02％(2 340/2 571) and 85.87％(2 340/2 725),respectively.The medians of salt iodine in urban,suburb and rural areas were 24.10,22.12,24.30 mg/kg,respectively.A total of 2 664 children urine samples were collected.The median of urinary iodine (MUI) of the children was 177.24 μg/L.The MUIs in urban,suburb and rural areas were 175.00,178.55,178.00 μg/L,respectively; in male was 183.00 μg/L and female was 170.50 μg/L.When non-iodized and unqualified iodized salt were taken,the differences of urinary iodine within groups were statistically significant in urban,suburb and rural areas(x2 =18.652,14.686,all P ＜ 0.05).In rural area,the difference of urinary iodine of 8-10 years old children who ingested different types of iodized salt was statistically significant(x2 =39.07,P ＜ 0.05).Conclusion After adjusting the iodine content of salt in Hangzhou,the iodine-nutritional status of 8-10 years old students is at a appropriatelevel.
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OBJECTIVE@#The subjective sensation of the patients and the treatment effect were compared prospectively between the no nasal packing group and the common nasal packing group.@*METHOD@#The patients were divided into no nasal packing group and nasal packing group matched for the type of chronic sinusitis. All patients received operation of functional endoscopic sinus surgery. The patients of no nasal packing group were given thoroughly bleeding control without nasal packing, while the patients of nasal packing group received nasal packing with sponge after hemostatic seaweed covering of wound. The nasal stents in nasal packing group were removed two days after operation, and the other treatments were all identical in the two groups. The clinical symptoms and treatment effect were compared between the two groups using visual analog scale. The levels of headache, rhinalgia, nasal obstruction, bleeding and nasal secretions volume at different time points, such as 1 day, 2 days and 3 days after operation, were evaluated and compared, as well as the recovering of operative region, such as crustal, secretion, reaction film, mucosal edema, vesicle and blockage of the sinus ostium.@*RESULT@#At the 1st day after operation, the degrees of headache, rhinalgia and nasal obstruction in the no nasal packing group were milder than the nasal packing group, and the differences have statistical significance. Two days after operation, the degrees of headache, rhinalgia and nasal obstruction, as well as the volume of bleeding and nasal secretions in the no nasal packing group were milder and lower than the nasal packing group, and the differences have statistical significance. Three days after operation, the differences of the indexes above were not statistically significant. The scores of total bleeding volume during the 3 days after operation showed no statistically significant difference between the two groups. Thirty-four patients were cured in no nasal packing group with the average epithelialization time of (10.7 +/- 2.6) weeks. Thirty-two patients were cured in nasal packing group with the average epithelialization time of (10.6 +/- 2.9) weeks. The difference of average epithelialization time between the two groups was not statistically significant.@*CONCLUSION@#No nasal packing could relieve the discomfort caused by nasal packing and avoid the rebleeding and pain when removing the nasal stents. No nasal packing has obvious superiority than common nasal packing, and is effective in the treatment of depression. It is be appropriate for type I and type II chronic sinusitis patients without systemic disease with limited economic conditions.