New understanding and research opportunities of metabolically healthy obesity / 中华预防医学杂志

The paradox of obesity and metabolically healthy obesity are being challenged. More and more studies have disputed the potential mechanism and prognostic value of metabolically healthy obesity. The study of metabolically healthy obesity is helpful to clarify the potential causes of obesity paradox and the potential mechanism of different degrees of obesity harm to the population. From the perspective of evidence-based medicine, combined with the relevant literature at home and abroad, this study reviewed the new understanding of metabolically healthy obesity, lifestyle factors, the impact of fat factors on metabolically healthy obesity, and the new opportunities of metabolically healthy obesity research, in order to explore whether metabolically healthy obesity can maintain and gradually reduce weight for a long time, so as to improve cardiovascular disease In order to achieve the purpose of primary prevention of related diseases.

Influence of bandage contact lens on corneal refractive status and postoperative complications in patients with pterygium / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To analyze the influence of bandage contact lens on corneal refractive status and postoperative complications in patients with pterygium. <p>METHODS: Totally 116 patients with pterygium treated in the hospital between January 2018 and December 2019 were recruited in the study. They were divided into control group and observation group by random number table method, 58 cases in each group. The control group received extended pterygium resection and autologous corneal limbal stem cell transplantation. On this basis, the observation group was treated with bandage contact lens. The best corrected visual acuity(BCVA), surface asymmetry index(SAI)of corneal topography, surface regularity index(SRI), corneal refractive power and postoperative complications in the two groups were compared. <p>RESULTS: Compared with preoperation, the BCVA of the two groups was significantly higher 1mo and 3mo after operation(<i>P</i><0.05), without statistically significant difference between the groups(<i>P</i>>0.05). Corneal horizontal and vertical curvature of the two groups were significantly higher, while corneal astigmatism was significantly lower at 1mo and 3mo after surgery. Meanwhile, the observation group had significantly lower corneal astigmatism than the control group(<i>P</i><0.05). SAI and SRI of the two groups significantly decreased, which were significantly lower in the observation group than in the control group(<i>P</i><0.05). No complications such as infection, poor healing of grafts and subconjunctival cysts were observed. The incidence of eye irritation was significantly lower in the observation group than in the control group, and lower at 2wk than at 1wk before operation(<i>P</i><0.05).<p>CONCLUSION: Extended pterygium resection combined with autologous corneal limbal stem cell transplantation and bandage contact lens is more conductive to the improvement of corneal refraction in patients with pterygium, which also can reduce the incidence of eye irritation.

Research progress on uranium-induced renal injury / 中国职业医学

Kidney is the main target organ of uranium after acute and chronic ingestion. Due to the lack of reliable biomarkers in the study of uranium-induced renal injury, the epidemiological data are not enough to quantify the effects of uranium on human health, and it leads to the inconclusive and inconsistent research results. This paper is focused on the analysis on research progression of domestic and foreign biomarkers of renal injury in uranium drinking water residents, uranium occupational exposure population and Gulf War veterans. The indicators including small molecular proteins and enzymes that reflect the damage of proximal and distal tubules and glomerular, such as β_2-microglobulin, α-microglobulin, retinol binding protein, micro albumin, kidney injury molecule-1, neutrophil gelatinase associated lipocalin, alkaline phosphatase, N-acetyl-β-D-glucosaminase, γ-glutamyltransferase, and lactate dehydrogenase, etc. It is suggested that molecular epidemiology should be applied to long-term cohort studies, and molecular biological detection and analytic techniques should be combined with cohort data information to clarify the dose-effect relationship of biological indicators.

Effect of the local application of stem cells on repairing facial nerve defects: a systematic review / 华西口腔医学杂志

OBJECTIVE@#To systematically evaluate the repairing effect of stem cells on facial nerve defects.@*METHODS@#Articles regarding the regenerating effect of stem cells on facial nerves in animals were collected from the databases of Pubmed, Cochrane Library, Web of Science, Embase, Scopus, and CBM. Two professionals independently completed the article screening, data extraction, and bias risk assessment. RevMan 5.3 and random-effects models were used for the statistical analysis, and the results were presented in the form of mean differences (MD) with a 95%CI. The results of functional evaluation (vibrissae movement, facial paralysis) and histological evaluation (density of myelinated fibers, diameter of fibers, thickness of myelin sheath, G ratio) of facial nerve were Meta-analyzed.@*RESULTS@#A total of 4 614 articles were retrieved from the 6 databases, and 15 of these articles were included in the Meta-analysis. For vibrissae movement and facial paralysis, the stem cell group scored significantly higher than the non-stem cell group (P<0.05). The density of myelinated fibers and thickness of the myelin sheath in the stem cell group were higher than those in the non-stem cell group (P<0.05). The G ratio in the stem cell group was smaller than that in the non-stem cell group (P=0.001). There was no significant difference in fiber diameter (P=0.08).@*CONCLUSIONS@#Stem cells have potential in promoting facial nerve regeneration.

Variation Pattern Analysis of Momordin Ⅰc Content and High-quality Germplasm Screening in Kochiae Fructus from Various Origins / 中国实验方剂学杂志

Objective:To provide evidence and lay a foundation for quality control and resources utilization of Kochiae Fructus. Method:A total of 23 samples of Kochiae Fructus were collected from the main distribution areas in China. Momordin Ⅰc content was determined via HPLC-ELSD method, and its correlation with growth traits and habitat factors was analyzed using SPSS 23.0 software,as well as the principle component and clustering analysis. Result:Momordin Ⅰc content had a benign linear relationship with HPLC-ELSD peak area within the range between 29.8 mg·L-1 and 178.8 mg·L-1 (R2=0.999 8),with the quantitation limit at 5.79 mg·L-1 and the detection limit at 2.36 mg·L-1. Significant differences (PChinese Pharmacopeia published in 2015.Origin,growth traits,and habitat factors could impact momordin Ⅰc content accumulation in Kochiae Fructus. Moreover,the content had a negative correlation with plant height,stem diameter,leaf length,leaf width,fruit diameter and longitude,and a positive correlation with ratio of length to width of leaves,altitude and latitude. Those from Shanxi,Jilin,and Shandong provinces had a higher momordin Ⅰc content. The characters tested could be simplified to four principle components, and their cumulative contribution rate was 95.831%. Kochiae Fructus samples tested could be divided into four groups,and those from group Ⅰ had superior growth traits, and those from group Ⅲ had higher momordin Ⅰc content. Conclusion:The optimized HPLC-ELSD method for determining momordin Ⅰc content of Kochiae Fructus is convenient,accurate and reproducible,and could be used to control the herbs quality. Those cultivated in a lower longitude,higher altitude,and higher latitude region could accumulate more momordin Ⅰc content. More attention shall be paid to germplasm in Shanxi and Zhejiang with superior resources screening of Kochiae Fructus.

Prevalence and influencing factors of deciduous caries in preschool children in Chongqing city / 华西口腔医学杂志

OBJECTIVE@#This study aimed to determine the prevalence and related factors of deciduous caries in 3-5-year-old preschool children in Chongqing city. Results will be used to provide a basis for the establishment and adjustment of prevention and intervention of caries in preschool children.@*METHODS@#We referred to the Fourth National Oral Health Epidemiological Survey. Data included caries prevalence in preschool children, and the questionnaires were distributed to children' parents in Chongqing city. Results were inputted by Epidata 3.1 and statistically analyzed using SPSS 21.0.@*RESULTS@#A total of 1 350 preschool children were included in the study. We found that maxillary deciduous central incisor and mandibular deciduous molars were susceptible to decay. The prevalence of primary teeth caries in preschool children in Chongqing city was 51.4% (694/1 350). The mean decayed-missing-filled-teeth (dmft) index was 2.34. The caries prevalence and mean dmft between age groups were statistically significant (P0.05). Approximately 61.7% of caries cases were concentrated in a small number (36.1%) of individuals. Multivariate Logistic regression analysis showed that age, highest educational level of parents, intake frequency of sweetened beverages and carbonated drinks, toothache or similar discomfort experience over the past year, dentist visits, and parents' assessment of teeth and oral health status of children were the factors influencing the prevalence of deciduous caries (P<0.05).@*CONCLUSIONS@#More than half of the preschool children had dental caries. Majority of caries were concentrated in a small number of individuals. The age of children, highest educational level of parents, intake frequency of sweetened beverages and carbonated drinks, toothache or discomfort experience over the past year, dentist visits, and parents' assessment of teeth and oral health status of children were associated with the prevalence of deciduous caries.

An investigation on the need, the utilization, and the influencing factors of dental services for pre-school children in selected areas in Chongqing province / 华西口腔医学杂志

OBJECTIVE@#The aim of this study is to survey the need, the utilization, and the influencing factors of dental services for children in selected areas in Chongqing province by investigating their oral health status. The survey will provide references for preventive oral health care in targeted Chongqing areas, which may improve the level of oral health among pre-school children.@*METHODS@#Random cluster sampling was utilized according to standards of the Fourth National Oral Health Epidemiological sampling survey, and 1 300 children between the ages of three and four years old from 24 kindergartens in 12 subdistricts of three areas in Chongqing were interviewed for free dental checkups and to participate in the survey. The questionnaires were designed according to the Anderson model and were answered by the children's parents. The results were analyzed utilizing Chi-square test logistic regression.@*RESULTS@#The prevalence rate of caries among the pre-school children in selected areas of Chongqing was 55.4%, the decay, missing, filled surface (dmfs) was 6 696, the mean dmfs was 5.2, and the caries filling constituent ratio was 2.3%. A total of 1 173 questionnaires were analyzed. The ratio for seeing a dentist for therapeutic reasons was 6.31% (74/1 173) and for prevalence was 22.93% (269/1 173).@*CONCLUSIONS@#The oral health service needs of pre-school children in selected areas of Chongqing are large and the oral health service utilization rate is low. Oral health care processes are arduous; thus, targeted oral prevention policies should be created.

Evaluation Methods Commonly Used in Rodent Spasm Models (review) / 中国康复理论与实践

In order to explore the mechanism and physiological and pathological changes of spasm, it is often necessary to establish corresponding experimental animal spasm models. The quantitative evaluation of rodent spasm model can not only evaluate the success of modeling, but also can be one of the main quantitative indicators of the effect of intervention. This paper summarized the commonly used methods of rodent spasm evaluation.

Growth and Adhesion to Cells of Candida albicans Labeled by Calcofluor White and Fluorescent Concanavalin A / 中山大学学报(医学科学版)

@#【Abstract】 【Objective】To assess effect of calcofluor white and fluorescent dye labeled concanavalin A in Candida albicans growth and adhesion of cells.【Methods】Yeast cells of 20 strains of Candida albicans were labeled by calcofluor white and Alexa fluor 488 conjugated concanavalin A respectively. The growth of labeled Candida albicans were tested by counts of colony forming unit. Then yeast cells of Candida albicans were co-cultured with macrophages and enterocytes for half an hour. The adhesion of labeled Candida albicans to macrophages and enterocytes were observed by fluorescence microscopy.【Results】No difference was observed on the number of colony forming units between calcofluor white-labeled groupand control group(P=0.942). Also,no difference was observed on the number of colony forming units between Alexa fluor 488 conjugated concanavalin A-labeled group and control group. However,either the number of calcofluor white-labeled Candida albicans or Alexa fluor 488 conjugated concanavalin A-labeled Candida albicans that bound to macrophages was less than that in control group(P=0.000,respectively). Either the number of calcofluor white-labeled Candida albicans or Alexa fluor 488 conjugated concanavalin A-labeled Candida albicans that bound to enterocytes was less than that in control group(P = 0.000,respectively). Hyphae were observed in control group but not in calcofluor white group after yeast cells of Candida albicans were co-cultured with cells for half an hour.【Conclusions】Growth of Candida albicans was not changed,while its adhesion to cells was reduced after its labeling by calcofluor white and Alexa fluor 488 conjugated concanavalin A.The germination of Candida albicans was affected when it had been labeled by calcofluor white.

Assessment of an accident of small amount uranium hexafluoride gas leakage on the influence of human health / 中国职业医学

OBJECTIVE: To estimate the amount of the uranium hexafluoride( UF_6) gas leakage in a nuclear fuel element production line,and assess the effect of the leakage on human health. METHODS: The hypothetical accident model was set that the leakage of UF_6 was caused by the hose breakage between valve and pipeline in the UF_6 vaporization process. It took8 seconds for the aerosol to get to the staffs and the staffs needed 1-4 minutes to evacuate. The leakage amount of UF_6 gas and intake of uranium and hydrogen fluoride( HF) were calculated using the estimation formula of gas leakage and internal radiation dose. Its influence on human health was assessed. The radiation hazard and kidney damage induced by the UF_6 exposure,and the chemical hazards to human health caused by HF inhalation were assessed. RESULTS: It is supposed that the staffs need 1 minute to evacuate,the leakage amount of UF_6 within 1 minute is 88. 20 g,and the uranium content is about 59. 64 g. The committed effective dose of internal exposure is 0. 40 mSv. The predicted intake of uranium is4. 57 mg. The average inhalation concentration of HF is calculated to be about 90. 33 mg /m~3,which is below the promptly life-threatening or health-threatening acute concentration( 136. 93 mg /m~3). In this case,it has little impact on human health. If the staffs need 2-4 minutes to evacuate,the leakage amount of UF_6 within 1 minute is 176. 40-352. 80 g,and the uranium content is about 119. 27-238. 54 g,the committed effective dose of internal exposure is 0. 81-1. 62 mSv. In that case,it has a small radiation hazard caused by UF_6. However,the predicted intake of uranium is 9. 26-18. 51 mg,which might lead to a short-term kidney damage. If the evacuation time is 2,3 or 4 minutes,the average inhaled mass concentrations of HF are 83. 98,82. 03 and 81. 03 mg /m~3,respectively,which are close to or higher than the immediately dangerous to life or health concentration( 96. 82,79. 06 and 68. 46 mg /m~3,respectively),and it might lead to an acute HF poisoning,even sudden death. CONCLUSION: When the UF_6 leakage accident happens,the staffs should evacuate in 1minute. If the evacuation time is longer than 2 minutes,it will increase the risk of kidney damage,acute HF poisoning and sudden death.

QTc interval predicts outcome of catheter ablation in paroxysmal atrial fibrillation patients with type 2 diabetes mellitus / 华中科技大学学报（医学）（英德文版）

Catheter ablation has been recommended as a treatment option for paroxysmal atrial fibrillation (PAF) patients complicated with type 2 diabetes mellitus (T2DM). PAF patients with T2DM have a higher recurrence rate after catheter ablation. Prolongation of corrected QT (QTc) interval has been linked to poor outcomes in T2DM patients. Whether the abnormal QTc interval is associated with the ablation outcome in the PAF patients with T2DM remains unknown. In this study, 134 PAF patients with T2DM undergoing primary catheter ablation were retrospectively enrolled. Pre-procedural QTc interval was corrected by using the Bazett's formula. Cox proportional hazards models were constructed to assess the relationship between QTc interval and the recurrence of AF. After a 29.1-month follow-up period, 61 patients experienced atrial tachyarrhythmia recurrence. Recurrent patients had a longer QTc interval than non-recurrent patients (425.2±21.5 ms vs. 414.1±13.4 ms, P=0.002). Multivariate Cox regression analysis revealed that QTc interval [hazard ratio (HR)=1.026, 95% confidence interval (CI) 1.012-1.040, P=0.005] and left atrial diameter (LAD) (HR=1.125, 95% CI 1.062-1.192, P=0.003) were independent predictors of recurrent atrial tachyarrhythmia. Receiver operating characteristic analysis demonstrated that the cut-off value of QTc (418 ms) predicted arrhythmia recurrence with a sensitivity of 55.7% and a specificity of 69.9%. A combination of LAD and QTc was more effective than LAD alone (P<0.001) in predicting arrhythmia recurrence after the procedure. QTc interval could be used as an independent predictor of arrhythmia recurrence in T2DM patients undergoing AF ablation, thus providing a simple method to identify those patients who likely have a better outcome following the procedure.

Application of high frequency electrical capsulotomy in maturation period cataract surgery / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To explore the clinical effects of high frequency electrical capsulotomy in maturation period cataract surgery. ●METHODS: A total of 68 cases of maturation period cataract were selected and underwent the surgery of continuous circular capsulorhexis using the high frequency electrical capsulotomy. ●RESULTS: The success rate was 91% in 68 cases with the high frequency electrical capsulotomy. ● CONCLUSION: The high frequency electrical capsulotomy in maturation period cataract surgery has significant advantages and brilliant clinical values.

Determination of salidroside and crenulatin in Rhodiolae Sacrae Herbra by HPLC-ELSD / 中草药

Objective: To establish a determination method for the contents of salidroside and crenulatin in Rhodiolae Sacrae Herbra, and to compare the content differences of the two compounds in Rhodiolae Sacrae Herbra from different batches. Methods: Using HPLC-ELSD method and Kromasil C18 column (250 mm × 4.6 mm, 5 μm), with acetonitrile and water as mobile phase, gradient elution at flow rate of 1.0 mL/min, column temperature of 30°C, nitrogen flow rate of 2.0 L/min, drift tube temperature of 45°C, and gain of 2. Results: The linear of salidroside was 0.806-8.06 μg (r = 0.9996, n = 6), and the average recovery rate was 100.56%. The linear of crenulatin was 2.142-21.42 μg (r = 0.9999, n = 6), and the average recovery rate was 100.40%. Conclusion: This method is simple, and accurate, and has better reproducibility for the determination of the two compounds in Rhodiolae Sacrae Herbra. It could be used as a quantitative determination method for salidroside and crenulatin in Rhodiolae Sacrae Herbra.

Clinical characteristics and resistance of wound surface infections causing by Bacillus cereus in the department of orthopaedics / 中国骨伤

<p><b>OBJECTIVE</b>To study clinical characteristics and resistance of wound surface infections, so as to guide clinical diagnosis and rational administration.</p><p><b>METHODS</b>The clinical setting and laboratory results were collected by analyzing 20 strains of Bacillus cereus isolated from clinical samples in patients from our hospital from October 2011 to June 2012, including 18 males and 2 females,ranging in age from 22 to 67 years old, averaged (47.30 +/- 11.16) years old. The courses of disease ranged from 5 to 20 days. All the patients were treated with nutrition support therapy, debridement and the corresponding antibiotic therapy. The patients had anemia, low protein hyperlipidemia and wound contamination history while Bacillus cereus infected. Thirty people were selected as normal group, including 23 males and 7 females,with an average age of (45.20 +/- 15.05) years old. Infection control condition was assessed by comparing culture for pathogens and patients wound redness or exudation cases before and after treatment. Antimicrobial susceptibility test was conducted by K-B method.</p><p><b>RESULTS</b>A total of 20 stains of Bacillus cereus were isolated from wound surface infections in department of orthopedics of our hospital. Among them,the infections were correlated with the wound contamination (16/20), malnutrition (20/20), and open-fracture (20/20), operation time (15 cases > 3 h). The laboratory blood test showed that the levels of TP [(49.94 +/- 8.24) g/L], ALB [(29.54 +/- 5.45 ) g/L] and Hb [(103.20 +/- 11.79) g/L] in the infection group was lower than those of control group; in the contrast, the levels of WBC [(8.35 +/- 2.31) x 10(9)/L], NEUT [(6.98 +/- 1.99) x 10(9)/L], hs-CRP [(73.60 +/- 55.14) mg/L] and CK [(900.10 +/- 1 259.12) IU/L] were higher in the infection group than those of control group, and the differences were statistically significant (P < 0.01). The diameter of inhibition zone in penicillin, cefazolin, cefuroxime, ceftazidime, cefepime, cotrimoxazole, erythromycin were less than 15 mm, and suggested that Bacillus cereus resisted to these antibiotics. However, the diameter of inhibition zone in clindamycin, vancomycin, gentamicin, ciprofloxacin, imipenem were larger than 20 mm and this data indicated that the bacteria were highly sensitive to these antibiotics.</p><p><b>CONCLUSION</b>Orthopedic patients who immunocompromised, hypoproteinemia and accompanied by open wounds and contaminated wound susceptible to infect Bacillus cereus; sensitive antimicrobial drugs should be selected on the basis of supplement albumin, symptomatic and supportive treatment.</p>

Effects of pulmonary stretch reflex on lung injury in rabbits with acute respiratory distress syndrome / 世界急诊医学杂志（英文）

BACKGROUND: Pulmonary stretch reflex plays an important role in regulation of respiratory movement. This study aimed to evaluate the effect of pulmonary stretch reflex on lung injury in rabbits with acute respiratory distress syndrome (ARDS). METHODS: ARDS rabbits were given intratracheal infusion of hydrochloric acid and ventilated with neurally adjusted ventilatory assistance (NAVA) with a tidal volume (VT) of 6 mL/kg and the electrical activity of diaphragm (EAdi)-determined positive end expiratory pressure. After isolation of the bilateral vagusnerve trunk, the rabbits were randomized into two groups: sham operation (SHAM) group (n=5) and bilateral vagotomy (VAG) group (n=5). Gas exchange and respiratory mechanics were detected at baseline, after lung injury and 1, 2, and 3 hours after ventilation respectively. Pulmonary permeability index, pathological changes and inflammatory response were also measured. RESULTS: Compared with the SHAM group, PaO2/FiO2 in the VAG group decreased significantly 2 and 3 hours after ventilation (P<0.05). There was no significant difference in PaCO2 between the SHAM and VAG groups (P>0.05), and the VAG group had a high VT, peak pressure (Ppeak), and mean pressure (Pm) compared with the SHAM group 1, 2, 3 hours after ventilation (P<0.05). Compared to the SHAM group, dead space fraction (VD/VT) and respiratory system elastance (Ers) in the VAG group increased (P<0.05) and static pulmonary compliance (Cst) decreased markedly (P<0.05) after ventilation for 3 hours. Lung wet/dry weight ratio (W/D) (8.4±1.2 vs. 6.6±1.0), lung injury score (6.3±1.8 vs. 3.8±1.3), tumor necrosis factor-α (TNF-α) (779±372 pg/mL vs. 355±130 pg/mL) and interleukin-8 (IL-8) (169±21 pg/mL vs. 118±17 pg/mL) increased significantly in the VAG group compared with the SHAM group (P<0.05). CONCLUSION: Lung injury is aggravated after bilateral vagotomy, demonstrating that pulmonary stretch reflex may have protective effect on the lung.

Significance of detecting the EBV-DNA level in peripheral blood mononuclear cells and the EBV-infected cell type in patients with chronic active EBV infection / 中华儿科杂志

<p><b>OBJECTIVE</b>To study the difference in the EBV-DNA level in peripheral blood mononuclear cells (PBMC) and the type of Epstein-Barr virus (EBV)-infected cells in pediatric patients with chronic active EBV (CAEBV) infection, acute EBV infection (AEBV) and healthy children, and to analyze the relationship between the above difference and the clinical manifestation of CAEBV.</p><p><b>METHOD</b>Real-time fluorescent quantitative polymerase chain reaction (PCR) was used to detect the EBV-DNA levels in peripheral blood mononuclear cells (PBMC) in 12 normal children, 10 pediatric patients with CAEBV infection and 13 pediatric patients with AEBV infection in our hospital between March 2004 and April 2008. Immunomagnetic bead cell fractionation and fluorescent in situ hybridization (FISH) by EBV encoding RNA-1 ( EBER-1) probe were used in the healthy children, EBV-DNA positive CAEBV patients and AEBV patients to detect the type of EBV-infected cells.</p><p><b>RESULT</b>The average EBV-DNA level in CAEBV patients' PBMC was (6.8 x 10(7) +/- 1.1 x 10(8)) copies/ml, while the average EBV-DNA level of AEBV patients' PBMC was (1.3 x 10(6) +/- 1.6 x 10(6)) copies/ml. The average EBV-DNA level of CAEBV infected patients' PBMC was significantly higher than that of AEBV infected patients' PBMC (P<0.01). The cell fractionation and FISH in seven CAEBV patients showed that EBV in CAEBV patients infected not only B cells, but NK cells and CD4+ and CD8+ T cells to different degree, and these patients presented recurrent and persistent infectious mononucleosis (IM)-like symptoms. In 6 CAEBV patients infection mainly occurred to T cells, in one case, infection occurred mainly in CD8+ T cells, and the patient died from fulminant and deadly T lymphocytes proliferative syndrome except presenting firstly high fever, enlargment of the liver, spleen, lymphnode and the severe decrease of one or three kinds of blood cells. In 1 CAEBV patient the infection was mainly found in NK cells, who presented with hypersensitivity to mosquito biting and high IgE level (2500 U/ml). But EBV in seven AEBV patients infection was found only in B cells who presented with only IM for one time and no EBV-infected PBMC were found in the remaining 6 healthy children.</p><p><b>CONCLUSION</b>There are much more EBV replications and different EBV-infected cell types in CAEBV patients. Detection of EBV-DNA level by real-time fluorescent quantitative PCR and the detection of the type of EBV-infected cells may help in diagnosis, treatment and development evaluation of children with CAEBV infection.</p>

Outbreak of cholera associated with consumption of soft-shelled turtles, Sichuan province, China, 2009 / 中华流行病学杂志

Objective Vibrio cholera was extremely rare in Sichuan province (no cases in 2008). Any outbreak could indicate contamination through the food supply system. In July 2009, a hospital reported a cluster of 7 diarrhea patients; all attended the same banquet. One patient was confirmed to have Vibrio cholera (O139). We conducted this investigation to identify the source of this possible cholera outbreak. Methods We defined a suspect case as any banquet attendee with diarrhea ( ≥3 times/day). A confirmed case was a suspect case with a positive Vibrio cholera culture. We took stool samples or rectal swabs from all attendees for cholera culture and interviewed 272 banquet attendees about foods they ate at the banquet and kitchen workers about food preparation. Results 7.1% (24/337) of attendees developed cases within an average of 65 hours after eating. Three meals were served. All patients had the lunch whereas no patients only ate breakfast and/or dinner. Of 180 attendees who ate turtle meat 12% were case-patients, compared to 3.3% of 92 attendees who did not (RR=3.6,95%CI: 1.1-12). Of the 150 attendees who ate peanuts 13% were cases compared to 4.1%of 122 attendees who did not eat peanuts (RR=3.1,95%CI: 1.2-8.0). During preparation, the same utensil was used for fresh turtle meat and peanuts without washing in-between the process. Turtle meat and peanuts were stored for ＞ 16 hours at room temperature after cooking before consumption. All 33 turtles originated from commercial production in another province. Conclusion This outbreak was likely caused by poor food handling of commercially produced turtles. We proposed that to improve microbiologic monitoring of aquatic food animals, and raise the awareness of good handling practices at mass gathering in rural China.

Mortality of a cohort of employees in a certain factory / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To follow up the cohort of a certain factory and analyze the death cause of the employees.</p><p><b>METHODS</b>A dynamic cohort was adopted and the study population consisted of all workers stayed at the factory for more than 1 year. The cohort data was mainly from the personnel ministry in the factory,the death data provided by the personnel ministry,the labour union and the hospital. All cause of death of the all employee and the death condition of radiation group and no-radiation group were analyzed and compared.</p><p><b>RESULTS</b>The mortality of the workers in the factory was significantly lower than national population, the SMR of all cause of death in all employee, radiation group and no-radiation group were 0.41 (95% CI: 0.37-0.45), 0.24, 0.75 respectively; all cancer death in the three group was 0.59, 0.40 and 0.92. But the death order was different in radiation group and no-radiation group,the order of liver cancer was list first in radiation group, which was unlike that of the nation order and the no-radiation order.</p><p><b>CONCLUSION</b>There have no excess death in the factory, but the order of liver cancer is precedence.</p>

Clinical characteristics and follow-up of 12 cases with severe chronic active Epstein-Barr virus infection / 中华儿科杂志

<p><b>OBJECTIVE</b>There are two different types of chronic active Epstein-Barr virus (CAEBV) infection: chronic EBV (CEBV) having persistent infectious mononucleosis (IM)-like illness with relatively good prognosis, and severe CAEBV (SCAEBV)infection that has rather severe manifestations and generally poor prognosis with many life-threatening complications, such as EBV-associated malignant lymphoma and hemophagocytic syndrome (HPS). The purpose of this study was to clarify the clinical and prognostic characteristics in 12 cases with SCAEBV infection.</p><p><b>METHOD</b>Data of 12 cases with SCAEBV infection were analyzed retrospectively, which included clinical and auxiliary examination, pathological data, especially EB virus (EBV)-antibodies and DNA in peripheral blood mononuclear cells (PBMC) and infected tissue, and follow-up information.</p><p><b>RESULT</b>Of the 12 cases, 7 were male and 5 were female. The age at the onset of diseases ranged from 35 months to 14 years (median, 11 years). The major manifestations were fever (100%), splenomegaly (91.7%), hepatomegaly (83.3%), lymphadenopathy (75.0%), and others, including skin rash, development retardation, jaundice, ascites, pulmonary hypertension, oral ulcer, cholecystitis and pleural effusion. The abnormalities of auxiliary examination were as follows: elevated LDH level (91.7%), liver dysfunction (83.3%), anemia (75.0%), leukopenia (58.3%), neutropenia (50.0%), thrombocytopenia (25.0%) and abnormal chest X-ray findings. At the time of onset, 58.3% of the patients had an IM-like illness. In all of the 12 cases, EBV serologic tests revealed high IgG antibody levels against EB viral capsid antigen (VCA). The patients often had positive IgM and IgA antibodies against VCA (33.3% and 66.7%) as well. Elevated IgG antibody level to early antigen (EA) (100.0%), occasionally positive IgA antibody (40.0%) were also seen. The mean load of EBV-DNA detected by real-time polymerase chain reaction (PCR) in the PBMC was (8.12 x 10(6), median)copies/ml. Four of 12 cases presented a poor clinical course, two of whom died from EBV-associated HPS, 1 from severe multiple pathogens infection, and 1 from multiple organ failure. In addition, 1 case developed Hodgkin's T cell lymphoma and another case showed hepatopulmonary syndrome in 2 years after splenectomy.</p><p><b>CONCLUSIONS</b>The clinical feature of SCAEBV infection varied exceedingly. EBV-DNA load in PBMC of SCAEBV infected patients was significantly increased. More attention should be paid to the disease because of its severe complications, poor prognosis and high mortality.</p>

Characteristics of peripheral blood lymphocyte immune subsets in patients with chronic active Epstein-Barr virus infection / 中华儿科杂志

<p><b>OBJECTIVE</b>To study the characteristics of the peripheral blood lymphocyte subsets in pediatric patients with chronic active EBV (CAEBV) infection.</p><p><b>METHOD</b>Flow cytometry was used to detect the peripheral blood NK, B, T lymphocyte subsets and the functional, regulatory, naïve, memory and activatory subsets of T lymphocytes in 10 pediatric patients with CAEBV infection, 13 pediatric patients with acute Epstein-Barr virus infection (AEBV) and 12 healthy children in our hospital between March 2004 and April 2008.</p><p><b>RESULT</b>Compared with AEBV group, the number of white blood cells [3325 x 10(6)/L (median, just the same as the following)], lymphocytes (1078 x 10(6)/L), NK cells (68 x 10(6)/L), B cells (84 x 10(6)/L), total T cells (684 x 10(6)/L), CD4+ T cells (406 x 10(6)/L) and CD8+ T cells (295 x 10(6)/L) in CAEBV patients were lower (P<0.05). The functional subset of the CD4+ T cells in CAEBV group (94.5%) was lower than those of the healthy control group (98.7%) (P<0.05), but was still higher than those of AEBV group (74.0%) (P<0.05). While the functional subset of the CD8+ T cells in CAEBV (40.7%) was not dramatically different from the healthy control group (48.3%), but was still higher than that of AEBV group (21.0%) (P<0.05). Although the regulatory subset in CAEBV group (5.0%) was higher than the health control group (4.6%) (P<0.05), but lower than AEBV group (5.8%) (P<0.05). In CAEBV, the proportion of CD4+/CD8+ naïve T cells (32.3%/37.5%) was lower than that of normal group (58.3%/56.6%) (P<0.05), but the proportion of CD4+/CD8+ effective memory T cells in CAEBV group (23.9%/15.1%) was lower than that in AEBV group (36.5%/69.8%) (P<0.05), while the proportion of CD8+ fake naïve T cells in CAEBV (17.5%) was higher than the other 2 groups (P<0.05). The CD8+ activatory subset in CAEBV group (84.4%/34.0%) was higher than that of the healthy control group (44.1%/16.7%) (P<0.05), but still lower than AEBV group (96%/95%) (P<0.05).</p><p><b>CONCLUSION</b>There is an imbalance in lymphocyte subsets and disturbance in cellular immunity in CAEBV patients, which may be associated with EBV chronic active infection. Detecting the peripheral haematologic parameters and lymphocyte subsets may be helpful in the diagnosis and the differential diagnosis of CAEBV.</p>