Status of child health services in less developed areas in Sichuan province, 2014-2018 / 中华流行病学杂志

To understand the status of child health services by primary medical institutions in less developed areas in Sichuan province and provide evidence for the development of health policy for poverty alleviation. Annual child health records in the primary medical institutions selected through multistage stratified sampling in 21 prefectures in Sichuan were extracted during 2014-2018. Field survey and telephone interview were used to evaluate the performance of child health services provided and the child guardian's satisfaction degree. Sample descriptive statistics, pair sample -test, (2) test, trend (2) test, Pearson correlation analysis were used for statistical analysis. Except child system management rate, the other indicators reflecting the status of child health service in less developed areas in Sichuan were on rise (<0.05), and close to average level of whole province in 2018. Except child system management rate, the other indicators reflecting the status of child health management in less developed counties were lower than those in developed counties in Sichuan, most differences were significant (<0.05). Except child health management rate of traditional Chinese medicine, the other indicators reflecting the status of child health management in less developed counties were higher than those in poverty-stricken counties in Sichuan, most differences were not significant (≥0.05). Except child systematic management rate, the gap in indicators reflecting child health service status between less developed area and developed area was in reduction, some difference were significant (<0.05). The child guardian satisfaction degree was associated with true child health management rates (=0.947, =0.015), and child health management rate of traditional Chinese medicine (=0.996, <0.001). Some achievements have been made in child health services provided by primary medical institutions in less developed areas in Sichuan. To achieve the 2020 poverty alleviation goal, it is necessary to take measures to increase input and improve service level.

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.

Expressions of CXCL13, CD10 and bcl-6 in angioimmunoblastic T-cell lymphoma and peripheral T-cell lymphoma, not otherwise specified / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the value of immunomarkers CXCL13, CD10, bcl-6 in pathologic diagnosis of angioimmunoblastic T-cell lymphoma (AITL).</p><p><b>METHODS</b>One hundred and fifteen cases of AITL, 30 cases of peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS) and 30 cases of reactive lymph nodes with paracortical hyperplasia (RH) encountered during the period from January, 1990 to January, 2008 were retrieved from the archival files of the Department of Pathology, West China Hospital of Sichuan University, China. The morphologic features were reviewed and compared. Immunohistochemical study was performed by SP method for CXCL13, CD10, bcl-6, CD21, CD3epsilon, CD3, CD45RO, CD20 and Ki-67. TCR-gamma gene rearrangement study was also carried out.</p><p><b>RESULTS</b>Regressed follicles were evident in 7.8% (9/115) of AITL cases, 6.7% (2/30) of PTCL, NOS cases and 83.3% (25/30) of RH cases, respectively. A marked increase of number of arborizing venules was shown in 98.3% (113/115) of AITL cases, 63.3% (19/30) of PTCL, NOS cases and 76.7% (23/30) of RH cases, respectively. In lymph nodes with paracortical hyperplasia, the expression of CXCL13, CD10 and bcl-6 were restricted to the germinal centers. In AITL, 96.5% (111/115) of cases showed CXCL13 expression, in contrast to 26.7% (8/30) of PTCL, NOS. Expression of CD10 and bcl-6 were found in the neoplastic cells in 50.4% (58/115) and 78.3% (90/115) of AITL, and 3.3% (1/30) and 3.3% (1/30) of PTCL, NOS, respectively. Irregular meshworks of CD21-positive follicular dendritic cells were found in all the AITL cases. Clonal TCR-gamma rearrangement was detected in 83% (83/100) of the AITL cases.</p><p><b>CONCLUSIONS</b>AITL is a type of lymphoma originated from the follicular helper T cells. Detailed morphologic assessment and use of immunohistochemical markers are essential for accurate diagnosis.</p>

Splenic lymphangioma: clinicopathologic and immunohistochemical study of 18 cases and review of literature / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features and differential diagnosis of splenic lymphangioma.</p><p><b>METHODS</b>Eighteen cases of splenic lymphangioma were retrieved from the pathology archives during the period between January 1990 to December 2005. The clinicopathologic features were analyzed. Immunohistochemical study was performed on the paraffin sections of 16 cases.</p><p><b>RESULTS</b>The age of the patients ranged from 9 to 72 years (median = 40 years). Thirteen patients were males and 5 were females. Clinically, the tumor could be asymptomatic or present with abdominal symptoms and hypersplenism. Follow-up information was available in 13 patients (72.2%) and the duration varied from 5 months to 15 years. All 13 patients had an uneventful clinical course, with no evidence of residual disease, local recurrence or metastasis. Gross examination showed splenic enlargement. The tumor appeared as cystic (8/18), solid (5/18) or honeycomb mass (5/18), either solitary (5/18) or multifocal (13/18). Histologically, splenic lymphangioma could be subclassified as cavernous (9/18), cystic (5/18) or mixed (4/18). Immunohistochemical study showed that the positivity rates for CD9 and D2-40 were 100% and 43.8% respectively.</p><p><b>CONCLUSIONS</b>Splenic lymphangioma is a rarely encountered entity that can be misdiagnosed as a splenic hemangioma. A definite diagnosis depends on pathologic examination.</p>