Comparison of clinical outcomes of ophthalmic artery chemotherapy with systemic vein-eye artery chemotherapy for retinoblastoma in children / 中华实验眼科杂志

Objective:To compare the clinical efficacy, prognosis and complications between intravenous chemotherapy (IVC) combined with intra-arterial chemotherapy (IAC) and single IAC in the treatment of children retinoblastoma (RB).Methods:A cohort study was performed.A 4-year follow-up of 300 children (352 eyes) with intraocular RB enrolled in the Children's Hospital Affiliated of Zhengzhou University from June 2015 to June 2019 was conducted.According to the different treatment methods, the children were divided into IAC group (140 cases, 160 eyes) treated with IAC combined with local laser photocoagulation/cryotherapy and IVC+ IAC group (160 cases, 192 eyes) receiving IVC combined with IAC treatment.The clinical efficacy (eye salvage rate), survival and complication incidence of the two groups were compared.The survival analysis was performed by Kaplan-Meier method.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Children's Hospital Affiliated of Zhengzhou University (No.20150503). Written informed consent was obtained from custodians of each child prior to their entering into the cohort.Results:All of the children were followed up for 2-60 months.Within the follow-up, the eye retention rate of the IAC group and IVC+ IAC group was 85.62%(137/160) and 81.21%(154/192) respectively, without statistically significant difference ( P>0.05). The recurrence rate and metastasis rate of IAC group were 18.75%(30/160) and 8.57%(12/140), which were significantly higher than 10.94%(21/192) and 3.13%(5/160) of IVC+ IAC group ( χ2=4.299, P=0.038; χ2=4.143, P=0.042). There was no significant difference in one-year survival rate between the two groups ( χ2=1.766, P=0.184), but the overall survival rate of IVC+ IAC group was 95.00%(152/160), significantly higher than 88.57%(124/140) of IAC group ( χ2=4.193, P=0.041). Kaplan-Meier analysis showed that the overall recurrence-free, metastasis-free and survival rate of IVC+ IAC group were better than those of IAC group, and the differences were statistically significant (all at P<0.05). There was no significant difference in the incidence of eyelid edema and/or ptosis, fundus hemorrhage, enophthalmos and cataract between the two groups (all at P>0.05). The incidence of myelosuppression was 32.14%(45/140) in IAC group, significantly lower than 43.75%(70/160) of IVC+ IAC group ( χ2=4.255, P=0.039). Conclusions:Compared with single IAC treatment, IVC combined with IAC can reduce the metastasis rate, recurrence rate in RB child patient and improve the survival rate, but it is with relatively high incidence of systemic complications.

Epidemiological investigation of a case with SARS-CoV-2 infection associated with overseas countries at an international harbor / 预防医学

Objective@#To investigate the origin of infection and risk factors of a case with SARS-CoV-2 infection associated with overseas countries in the Ningbo-Zhoushan Port, Zhejiang Province, so as to provide the evidence for improving the COVID-19 control measures at ports.@*Methods@#Ningbo Center for Disease Control and Prevention ( CDC ) and Beilun CDC conducted case finding and epidemiological surveys immediately after being informed. The general information, history of vaccination and the travel during the latest 14 days were collected from the positive case, and all close contacts were tracked. Saliva samples were collected for SARS-CoV-2 nucleic acid testing and whole-genome sequencing, and the sequencing results were aligned with the GISAID's EpiCoV database. The origin of infection and transmission route of the positive case was investigated.@*Results@#A case was identified positive for SARS-CoV-2 nucleic acid during company M's routine screening in the Ningbo-Zhoushan Port on August 10, 2021, and was confirmed positive for SARS-CoV-2 nucleic acid by Beilun CDC and Ningbo CDC on August 11. Whole-genome sequencing showed SARS-CoV-2 B.1.617.2 ( Delta ) variant, which shared the highest homology with the virus sequence uploaded by Russia on June, 2021 ( Russia/MOW-RII-MH27356S/2021 ). The case was a bundling worker for overseas container ships, and reported communicated with foreign boatmen and contacted materials without protected interventions on the SINOKOR AKITA Container Ship between August 4 and 5, 2021. This ship anchored at Vladivostok, Russia from July 27 to 29, anchored at Ningbo Harbor on August 4, and departed on August 5. Then, 11 boatmen from this ship were tested positive for SARS-CoV-2 nucleic acid on August 8. One asymptomatic case was reported in this epidemic; 254 close contacts and 617 secondary close contacts were identified, and all were tested negative for SARS-CoV-2 nucleic acid. No new cases with SARS-CoV-2 infections were detected until August 25, 2021, and the emergency response was therefore terminated.@*Conclusions@#The infection was a sporadic COVID-19 epidemic associated with overseas countries, which was caused by Delta variant infection through contacts with foreign boatmen or materials by a bundling worker in Ningbo-Zhoushan Port; fortunately, no epidemic spread occurred. Intensified closed-loop management and increased frequency of SARS-CoV-2 nucleic acid test among high-risk populations, and improving the precision and rapid emergency treatment of COVID-19 epidemics are required for the containment of COVID-19 at ports.

Disease burden of influenza in schools and child care settings in rural areas of Hangzhou, 2016-2018 / 中华预防医学杂志

Objective@#The objective of this study was to analyze the disease burden of influenza in schools and child care settings in rural areas of Hangzhou.@*Methods@#Hospital visit influenza cases aged 3-17 years in hospitals that reported based on influenza surveillance system from 2016 to 2018 in Chun′an county, Hangzhou city were selected as study subjects and a total of 294 confirmed cases of influenza were selected using system sampling method. Questionnaires were designed to investigate the basic information and data on inpatients and outpatients among, health care and life quality, etc.. Direct and indirect economic burden and disability adjusted life year (DALY) were analyzed and compared among different age groups.@*Results@#The mean age of investigated subjects was (8.88±3.92) years. A total of 143 (48.64%) investigated cases were male. In total of 283 (96.26%) cases were outpatients. The total economic burden was 124 743.95 CNY. The mean economic burden was 424.30 CNY per person. The mean direct and indirect economic burden was 361.33 and 62.97 CNY per person respectively. The difference of the mean direct, indirect and total economic burden per person between different age group was statistically significant (P<0.001). The 3-5 years age group showed the highest economic burden with the median value of direct, indirect and total economic burden per person being 276.24, 50.98 and 321.26 CNY, respectively, while the 12-17 years age group showed the lowest values with 175.30, 26.54, 201.79 CNY, respectively. The DALY of 294 influenza cases was 1.18, and the median of burden strength was 3.21 DALY/thousand. The difference of the burden of strength between different age group influenza case was statistically significant (P<0.001), of which the 12-17 years age group showed the highest value with 4.25 DALYs/thousand while the 3-5 years age group showed the lowest value with 2.60 DALY/thousand.@*Conclusion@#The disease burden of influenza was heavy in schools and kindergartens in rural areas of Hangzhou city, with the cases aged from 3 to 5 years showing higher economic burden and cases aged from 12 to 17 years showing greater burden strength.

Mechanism of GPR119 in regulating lipid metabolism and anti-atherosclerosis by hypoxia-inducible factor-1α/ vascular endothelial growth factor pathway / 中华内分泌代谢杂志

Objective@#To investigate the effect and mechanism of G protein coupled receptor 119 (GPR119) in regulating lipid metabolism.@*Methods@#(1) Macrophage THP-1 was induced by oxidized low density lipoprotein (oxLDL) to the formation of lipid foam cells, protein expression of GPR119, hypoxia-inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF) were detected by Western blotting. (2) Constructing GPR119 over-expressed and low-expressed plasmids, the plasmids were transfected into THP-1 cells which induced by oxLDL. The lipid content in macrophages was observed by oil red O staining. Cholesterol efflux was detected by liquid scintillation counter. The mRNA and protein expressions of HIF-1α, VEGF were detected by reverse transcription PCR and Western blotting. (3) Constructing GPR119, HIF-1α, and VEGF over-expressed plasmids, then co-transfection of GPR119 and HIF-1α/VEGF plasmids. The lipid content in macrophages was observed by oil red O staining. Cholesterol efflux was detected by liquid scintillation counter.@*Results@#Compared with the control group, the lipid droplets were densely distributed in macrophages, with a large number and volume. The protein expression of GPR119 was significantly decreased and HIF-1α, VEGF were significantly increased in macrophages induced by oxLDL (P<0.05). After over-expression of GPR119, the lipid droplets were sparsely distributed and the number was significantly reduced in macrophages, the lipid droplets were mostly located in the area around the cells. The cholesterol efflux was significantly increased (P<0.01). The mRNA and protein expressions of HIF-1α and VEGF were significantly decreased (P<0.01). On the contrary, in the GPR119 inhibition group, the lipid droplets were densely distributed in macrophages, with a large number and volume. The lipid droplets even covered the nuclei. The cholesterol efflux was significantly reduced (P<0.05). The mRNA and protein expression of HIF-1α, VEGF were significantly increased (P<0.05). After GPR119 were co-expressed with HIF-1α and VEGF, the number of lipid droplets was increased, lipid droplets were dense and bulky in oxLDL-induce macrophages. The cholesterol efflux was inhibited.@*Conclusion@#GPR119 can regulate lipid metabolism and possibly by down-regulating the expression of HIF-1α and VEGF.

Mechanism of GPR119 in regulating lipid metabolism and anti-atherosclerosis by hypoxia-inducible factor-1α/ vascular endothelial growth factor pathway / 中华内分泌代谢杂志

Objective To investigate the effect and mechanism of G protein coupled receptor 119 ( GPR119) in regulating lipid metabolism. Methods ( 1) Macrophage THP-1 was induced by oxidized low density lipoprotein ( oxLDL) to the formation of lipid foam cells, protein expression of GPR119, hypoxia-inducible factor-1α(HIF-1α), vascular endothelial growth factor (VEGF) were detected by Western blotting. (2) Constructing GPR119 over-expressed and low-expressed plasmids, the plasmids were transfected into THP-1 cells which induced by oxLDL. The lipid content in macrophages was observed by oil red O staining. Cholesterol efflux was detected by liquid scintillation counter. The mRNA and protein expressions of HIF-1α, VEGF were detected by reverse transcription PCR and Western blotting. (3) Constructing GPR119, HIF-1α, and VEGF over-expressed plasmids, then co-transfection of GPR119 and HIF-1α/VEGF plasmids. The lipid content in macrophages was observed by oil red O staining. Cholesterol efflux was detected by liquid scintillation counter. Results Compared with the control group, the lipid droplets were densely distributed in macrophages, with a large number and volume. The protein expression of GPR119 was significantly decreased and HIF-1α, VEGF were significantly increased in macrophages induced by oxLDL ( P<0.05). After over-expression of GPR119, the lipid droplets were sparsely distributed and the number was significantly reduced in macrophages, the lipid droplets were mostly located in the area around the cells. The cholesterol efflux was significantly increased ( P<0. 01 ) . The mRNA and protein expressions of HIF-1α and VEGF were significantly decreased ( P<0.01) . On the contrary, in the GPR119 inhibition group, the lipid droplets were densely distributed in macrophages, with a large number and volume. The lipid droplets even covered the nuclei. The cholesterol efflux was significantly reduced (P<0.05). The mRNA and protein expression of HIF-1α, VEGF were significantly increased ( P<0.05) . After GPR119 were co-expressed with HIF-1αand VEGF, the number of lipid droplets was increased, lipid droplets were dense and bulky in oxLDL-induce macrophages. The cholesterol efflux was inhibited. Conclusion GPR119 can regulate lipid metabolism and possibly by down-regulating the expression of HIF-1αand VEGF.

Post-marketing safety analysis of inactivated enterovirus A71 vaccines / 中华预防医学杂志

Objectives@#To evaluate the safety of inactivated enterovirus A71(EV-A71) vaccines after large-scale immunization in the community.@*Methods@#We selected EV-A71 susceptible people (healthy children) aged 6-59 months in vaccination clinics from 89 counties in Zhejiang Province between April 2016 and March 2018. All local and systematic adverse actions were collected by 30 min on-site inspection, within 3 days and 4-30 days follow-up. Chi-square test and Fisher′s exact test were used to compare the difference of AEs incidence in various characteristics among two groups.@*Results@#A total of 71 663 doses of vaccines were included for active safety analysis, which included 37 331 doses in boys and 34 332 doses in girls. Among all the doses, children aged 6 to 11 months, 12 to 23 months and 24 to 59 months were received 13 707, 32 639 and 25 317 doses respectively. The incidence of adverse reactions within 30 min, 3 days and 4-30 days were 0.33% (239 doses), 1.58% (1 133 doses) and 0.34% (244 doses) respectively. Adverse reactions within 3 days were 1 372 doses, with a incidence of 1.91%; among all the cases, 539 doses (0.75%) were grade 1, 677 doses (0.94%) were grade 2 and 156 doses (0.22%) were grade 3, no grade-4 adverse reaction was reported. The common local adverse reactions were redness, swelling and pruritus, with the incidence rates were 0.05% (39 doses), 0.02% (16 doses) and 0.02% (12 doses), respectively, while the most common systemic adverse reaction was pyrexia with an incidence of 1.19% (856 doses), followed by diarrhea and anorexia with the incidence rates were 0.15% (104 doses) and 0.13% (90 doses) respectively.@*Conclusion@#Most adverse actions of EV-A71 vaccines were mild and moderate and majority of them were common adverse actions. No new adverse reactions were found in the study.

Post-marketing observation on safety of inactivated enterovirus A71 vaccine (human diploid cell) / 中华预防医学杂志

Objective@#To evaluate the post-marketing safety of inactivated Enterovirus type 71 (EV-A71) vaccine (human diploid cell) .@*Methods@#A total of 20 191 healthy children aged 6 to 59 months were invited to receive 2 doses of EV-A71 vaccine in Zhejiang Province from September 2016 to December 2017. Child caregivers were followed up on the 4th or 5th day after each EV-A71 vaccination, and the incidence of local, systemic, and other adverse events within 3 days after vaccination was recorded to assess vaccine safety. Describe the differences in adverse events among children with different characteristics.@*Results@#A total of 32 230 doses were observed in this study, of which 20 191 and 12 039 were vaccinated for the first and the second dose, respectively; and the incidence of adverse events within 3 days was 2.045% (413 doses) and 1.611% (194 doses), respectively. After the first and the second dose, the number of systemic adverse events was the highest, 371 and 175 cases, respectively, with an incidence of 1.837% and 1.454%, respectively; the number of local adverse events was the lowest, 14 and 2 doses, respectively, with an incidence of 0.069% and 0.017%. Local adverse events occurred after vaccination were generally mild, and only 2 patients had level of 3; among the systemic adverse events, 39 patients had a fever level of 3 or higher, accounting for 8.2% of the total fever. Most of the symptoms in the local adverse events did not require treatment, only 3 cases of vaccination site rash and 2 cases of pruritus were self-purchased drugs or outpatient treatment; except for 5 cases of fever, the other symptoms were not hospitalized in the case of systemic adverse events.@*Conclusion@#The incidence of adverse events within 3 days after vaccination with EV-A71 vaccine was low in children, mainly systemic adverse events, and the prognosis was good.

Post-marketing multi-center safety surveillance of inactivated enterovirus A71 vaccine (Vero cell) / 中华预防医学杂志

Objective@#To evaluate the post-marketing safety profiles of the inactivated enterovirus type 71 (EV-A71) vaccine (Vero cell) after routine inoculation.@*Methods@#Eleven cities of Zhejiang Province, Fengtai district of Beijing, Qinnan district, two counties as Pingle and Pingguo of Guangxi Zhuang Autonomous Region, and Dongtai city of Jiangsu Province were selected as the field sites. A total of 45 239 subjects were enrolled in this study from children who seeked the vaccination of EV-A71 vaccine during the period from July, 2016 to June, 2018. Different sampling method were adopted in different sites. All vaccinated children were invited to participate in the study in Fengtai and Dongtai, however, systematic sampling method were adopted in other sites. Active surveillance was conducted and information about adverse reactions (ARs) occurred in 30 min, 3 d and 30 d following each dose of EV-A71 immunization was collected by field observation, phone-call or face-to-face interview. The incidence of ARs in different types, symptoms and grades were described.@*Results@#In total, there were 45 239 children who received 71 243 doses EV-A71 vaccine. The overall incidence of ARs was 1.079% (769 doses), with the highest incidence of 1.182% (177/14 973) in 5-11 month group and the lowest incidence of 0.849% (18/2 119) in ≥ 36 month group among different age groups. There was a higher incidence in solicited ARs, which was 1.047% (746 doses). The incidences of grade 1 and grade 2 ARs were also higher, which were 0.404% (288 doses) and 0.554% (395 doses), respectively. No grade 4 ARs occurred. The doses of the first and the second vaccination was 40 736 and 30 507, respectively, and the incidences of ARs were 1.281% (522 doses) and 0.810% (247 doses). Also, the incidences of ARs were 0.091% (37 doses) and 0.043% (13 doses) in local, and 1.168% (476 doses) and 0.760% (232 doses) in system. The symptoms of ARs after the two doses of vaccination were basically the same. Redness at the injection site was the most common local ARs after each dose vaccination, with doses of 24 and 11, while fever was the most common systemic ARs, with doses of 362 and 190. Moreover, ARs mainly occurred in 30 min to 3 d after each dose vaccination, with incidence of 1.016% (414 doses) and 0.698% (213 doses) in the first and second dose, respectively.@*Conclusion@#The ARs had a low incidence after vaccination in children and most were mild or moderate. EV-A71 vaccine with good safety is suitable for inoculation in a large scale.

Prognostic analysis of world health organization gradeⅡgliomas / 中国肿瘤临床

Objective:To assess the prognostic factors of World Health Organization(WHO)grade Ⅱ gliomas.Methods:A total of 146 patients diagnosed with WHO grade Ⅱ gliomas were treated at Jiangxi Province Tumor Hospital between June 1997 and April 2015,in-cluding 90 gross total resections(GTRs)and 56 partial resections.According to the 2007 WHO grading system of gliomas,there were 96 astrocytomas,30 oligodendrogliomas,and 20 oligoastrocytomas.Results:The median follow-up time was 88 months.Five-year overall survival(OS)and progression-free survival(PFS)rates were 75.7% and 60.0%,respectively,and 10-year OS and PFS rates were 57.4% and 37.8%,respectively.Univariate analysis of OS revealed statistically significant differences in age,sex,subventricular zone (SVZ) invasion, peritumoral edema, residual tumor volume, preoperative tumor size and numbers, and the extent of resection (P<0.05). Compared with astrocytoma patients, oligodendroglioma patients had better OS and PFS (P=0.040 and 0.049, respectively). Among those factors,sex,SVZ invasion,residual tumor volume,preoperative tumor numbers,and the extent of resection were like-wise significant for PFS (P<0.05). Multivariate analysis revealed that the extent of resection, SVZ invasion, and peritumoral edema were independent prognostic factors for OS(P<0.05)and the extent of resection and tumor numbers were independent prognostic fac-tors for PFS(P<0.05).Sixty patients developed recurrences,including 53 tumor bed failures and 7 intracranial disseminations.Conclu-sions:The extent of resection,SVZ invasion and peritumoral edema may be independent prognostic factors for OS in low-grade glio-mas.Postoperative radiotherapy would improve PFS for patients who underwent GTRs.The major pattern of failure was tumor bed re-currence.

Antibody persistence following on different vaccination strategies of domestic measles, mumps and rubella combined attenuated live vaccine: a 3-year follow-up study / 中华预防医学杂志

Objective@#To assess the 3-year antibody persistence after vaccination of domestic measles, mumps and rubella combined attenuated live vaccine (MMR) with different program.@*Methods@#Children from three different vaccination strategies (Group 8 m MR: 8 months and 18 months vaccinated with measles-rubella combined attenuated live vaccine and domestic MMR,respectively; Group 8 m MMR: 8 months and 18 months both vaccinated with domestic MMR; Group 12 m MMR: 12 months and 22 months both vaccinated with domestic MMR ) were followed up in Zhejiang province in July 2015. There were 170 participants in Group 8 m MR, 171 participants in Group 8 m MMR and 173 participants in Group 12 m MMR selected by simple random sampling method .Blood samples (venous blood 2-3 ml) were collected 1 month after the first dose vaccination of MMR (only in Group 8 m MMR and Group 12 m MMR) and 3 years (36-38 months) after the last dose vaccination of MMR and tested for antibody IgG against Measles, Mumps and Rubella using ELISA. Seropostive rate and Geometric mean concentration (GMC) were calculated and compared among different groups by Chi-square test or Fisher exact test and Kruskal-Wallis H test.@*Results@#A total of 514 participants (8 m MR: 170; 8 m MMR:171; 12 m MMR:173) were enrolled. The overall seropositivity rate of measles, mumps and rubella was 98.1% (504), 93.4% (480) and 88.1% (453), respectively, with corresponding GMC was 1 012.33 mU/ml, 502.87 U/ml and 50.53 U/ml respectively. There was no significant difference of seropositivity rate for measles among three groups (all groups were>97%). The highest seropositivity rate for mumps was found in the Group 12 m MMR with the rate of 98.8% (171/173), followed by Group 8 m MMR and Group 8 m MR with 93.0% (159/171) and 88.2%(150/170) respectively (Fisher exact test, P<0.001). The highest seropositivity rate for rubella was also found in the Group 12 m MMR with the rate of 94.8% (164/173), followed by Group 8 m MMR and Group 8 m MR with 86.6%(148/171) and 82.9%(141/170) respectively (Fisher exact test, P=0.002). The highest GMC of antibody against measles, mumps and rubella were all found in Group 12 m MMR, with 1 217.30 (1 119.35-1 323.82) mU/ml, 717.07 (643.83-798.65) U/ml and 62.54(56.21-69.58) U/ml respectively. The lowest GMC of antibody against measles and mumps were both in Group 12 m MR with 812.01 (734.52-897.67) mU/ml and 363.28 (305.42-432.11) U/ml respectively. The lowest GMC of antibody against rubella was in Group 8 m MMR with 44.10 (39.08-49.76) U/ml. These differences of GMCs among three groups were all reach significant means (P<0.05).@*Conclusion@#High level seropostive rates and GMCs were exist against measles and rubella after 3-year vaccination of domestic MMR among different program. Higher antibody level against mumps were found in those children with two doses vaccination of MMR.

Comparison of the curative effect and safety of rifapentine and rifampicin in smear positive pulmonary tuberculosis patients / 中国生化药物杂志

Objective To compare the clinical therapeutic effect and safety of rifapentine and rifampicin in smear positive pulmonary tuberculosis patients.Methods A total of 80 patients with smear positive pulmonary tuberculosis were chosen in Changshan People's Hospital from June 2015 to July 2016,the patients were randomly divided into control group(n=40)and observation group(n=40).The control group used rifampicin treatment,observation group were treated with rifapentine therapy,the therapeutic effect and incidence of complications between two groups were compared.Results Proportion of the sputum smear negative,cavity closure and lesions absorption in the observation group after 6 months of treatment were significantly higher than those in the control group; peripheral blood T lymphocyte subsets CD3+,CD4+,CD8+ levels in two groups before treatment had no statistically significant differences; peripheral blood of T lymphocyte subsets CD3+,CD4+,CD8+ levels in the observation group after treatment were significantly higher than those in the control group(P<0.05); incidence of complications in observation group(7.5％)after treatment was significantly lower than that in the control group(17.5％)(P<0.05).Conclusion Compared with rifampicin in treatment of smear positive pulmonary tuberculosis patients,rifapentine has ideal treatment effect,can improve the immune function,low incidence of complications.

Efficacy of Hybrid Therapy and Bismuth Quadruple Therapy in Treatment of Helicobacter pylori Infection / 胃肠病学

Bismuth quadruple therapy is recommended as a first-line therapeutic regimen for Helicobacter pylori (Hp) infection in China.However, the renal toxicity induced by bismuth resulted in limitation of its clinical use.Aims: To assess the efficacy and safety of hybrid therapy for initial eradication of Hp infection.Methods: One hundred and fifty-two patients proved to be positive for Hp infection and treatment-na(i)ve at the Fuzhou General Hospital of Nanjing Military Command of Chinese PLA from Jan.2014 to Dec.2015 were enrolled and randomized to receive either hybrid therapy (esomeprazole and amoxicillin for 7 days, followed by esomeprazole, amoxicillin, clarithromycin and metronidazole for 7 days) or bismuth quadruple therapy (esomeprazole, amoxicillin, clarithromycin and colloidal bismuth pectin for 14 days).Hp eradication was assessed by 14C/13C-urea breath test at a minimum of 4 weeks after the end of treatment.Results: No significant differences were found in general status between the two groups at baseline (P>0.05).A total of 149 patients completed the therapy.In hybrid therapy group the eradication rate was 97.4% (75/77) by ITT analysis and 98.7% (75/76) by PP analysis;while in bismuth quadruple therapy group the eradication rates by ITT and PP analyses were 89.3% (67/75) and 91.8% (67/73), respectively.Hybrid therapy was superior to bismuth quadruple therapy (P all <0.05).Although the incidence of adverse events was higher in hybrid therapy group than in bismuth quadruple therapy group (29.9% vs.16.0%, P<0.05), none of the patients discontinued the therapy because of severe adverse events.Conclusions: Hybrid therapy showed better efficacy than bismuth quadruple therapy for treatment of Hp infection, and the adverse events were well tolerated.Hybrid therapy might be used as first-line treatment for Hp infection.

Rowell's syndrome: a clinical observation and a follow-up analysis / 中华皮肤科杂志

Objective To investigate the characteristics,treatment and prognosis of Rowell's syndrome.Methods Clinical data were collected from 6 inpatients with Rowell's syndrome from July 2009 to July 2015,and retrospectively analyzed.Results All the patients were female,of them,2 developed skin lesions after sun exposure,2 had medication history,1 had Staphylococcus aureus infection before occurrence of skin lesions,and 1 had no obvious precipitating factor.Skin lesions spread from the face to the whole body in 4 cases,from the dorsal hauds to the whole body in 1 case,and were confined to the face,both hands and feet in 1 case.All the 6 patients had chilblain-like lesions in the digit tips,and 5 patients had fever.Among these patients,6 were positive for antinuclear antibodies (granular pattern),4 for anti-Sm antibodies,5 for anti-U 1RNP antibodies,4 for anti-SSA antibodies,2 for anti-dsDNA antibodies,and 1 was positive for both anti-SSA and anti-SSB antibodies.Histopathological examination revealed hyperkeratinization,mild hyperplasia,partial necrosis,many dyskeratocytes,liquifaction degeneration of basal cells in the epidermis,and perivascular infiltration of lymphocytes in the superficial dermis.After admission,1 patient was finally diagnosed with subacute cutaneous lupus erythematosus (SCLE),and 5 with systemic lupus erythematosus (SLE).All the 6 patients were treated with prednisone at a dose of 0.6-1.0 mg·kg-1 ·d-1,and 1 was also treated with gamma globulin (200 mg/d).During the process of glucocorticoid tapering,hydroxychloroquine was administered at 0.2 g twice a day.During 1-year follow-up,neither erythema multiform nor chilblain-like lesions recurred in 5 patients,and 1 patient was lost to follow-up.Conclusions Rowell's syndrome frequently occurs in women.Glucocorticoids are a mainstay of its treatment,and their tapering should be slower in patients with Rowell's syndrome than in those with lupus erythematosus.

Risk assessments and control strategies of plague in five key surveillance counties, Zhejiang province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the epidemiology data on plague in five counties in Zhejiang province and to evaluate the risk of plague in theses areas.</p><p><b>METHODS</b>We selected five monitoring stations as a risk assessment (Qingyuan county, Longquan city, Yiwu city, Wencheng county, and Ruian city) in Zhejiang province where the plague epidemic more serious in the history. At least one constant site and 1-4 variable sites where plague occurred in history were selected for monitoring. We collected the five counties (cities) surveillance data of indoor rat density, indoor Rattus flavipectus density, the Xenopsylla cheopis index of rat, the Xenopsylla cheopis index of Rattus flavipectus in 1995-2014. Isolation of Yersinia pestis was conducted among 171,201 liver samples and F1 antibody were detected among 228,775 serum samples. Risk matrix, Borda count method, and Delphi approach were conducted to assess risk of the plague of five counties (cities) in Zhejiang province.</p><p><b>RESULTS</b>Indoor rat density in Qingyuan county, Longquan city, Yiwu city, Wencheng county, Ruian city was 1.58%-5.50%, 1.13%-9.76%, 0.56%-3.67%, 2.83%-16.08%, 7.16%-15.96%, respectively; Indoor Rattus flavipectus density of five counties (cities) was 0.08%-2.23%, 0-2.02%, 0-0.54%, 0.71%-5.58%, 0.55%-4.92%, respectively. The Xenopsylla cheopis index of rat in Qingyuan county and Wencheng county was 0.011-0.500 and 0.015-0.227, respectively; The Xenopsylla cheopis index of Rattus flavipectus of Qingyuan county and Wencheng county was 0.119-3.412 and 0.100-1.430, respectively; Ruian City and Yiwu city cannot collected Xenopsylla cheopis, Long quan city only collected the Xenopsylla cheopis index of rat in the five years. Yersinia pestis were not isolated in five counties (cities).There were 3 Apodemus agrarius samples positive of plague F1 antibody test, in Longquan city and Yiwu city in 2005. Borda count method to assess the Longquan city, Yiwu (Borda point were both 321) plague risk was higher than three other regions; Delphi approach to evaluation five counties (cities) belong to the plague had a lower risk areas, according to the level of risk score (Pf) Longquan city and Yiwu (Pf was 0.314, 0.292, respectively) plague risk were higher than three other regions (Pf were all 0.292).</p><p><b>CONCLUSION</b>The main host and media were lower in five key plague surveillance counties (cities) of Zhejiang province; The result of Borda count method and Delphi approach for risk assessment indicated that endogenous plague recrudescence was at lower level, but Longquan city and Yiwu city risk were higher than other counties (cities).</p>

Diagnosis and classification of abdominal enterogenous cysts in infant / 实用放射学杂志

Objective To explore the definition,classification and imaging characteristics of abdominal enterogenous cysts in in-fant.Methods 18 patients with abdominal enterogenous cyst in infant,confirmed by surgical pathology,with complete imaging data (including ultrasonography,CT and enhanced CT),have been enrolled in the study.The imaging findings and pathological character-istics have been analyzed,and the classification of diagnosis has been conducted.Results According to the positions and imaging fea-tures of the pathological changes,abdominal enterogenous cysts could be further classified as:gastrointestinal wall type,mesenteric type and retroperitoneal type.In this study,gastrointestinal wall type in 1 1 patients (outside intestinal wall in 2,inside intestinal wall in 8,and outside gastric wall in 1);mesenteric type in 4 and retroperitoneal type in 3 were identified.Conclusion Classification of diagnosis can be conducted according to the enterogenous cyst’s special imaging findings,which provides a reference for the surgical operation.

Interbody cages combined with pedicle screw system for spondylolisthesis / 中华创伤杂志

Objective To investigate the clinical effect of interbody cages combined with pedicle screw system in treatment of spondylolisthesis. Methods Of 20 patients with spondylolisthesis, interbody cages combined with 10pedicle screw system was performed in 10 patients and spinal decompression combined with intervertebral bone grafting in another 10. Results All the patients were followed up for 8-12 months (average 10 months), which showed significant improvement in the syndrome. Of 10 patients treated with interbody cages combined with pedicle screw system, seven patients were evaluated excellent, two good and one fair. Of 10 patients treated with spinal decompression combined with intervertebral bone grafting, five patients were evaluated excellent, two good and three fair. Conclusion Interbody cages combined with pedicle screw system is an safe and effective surgery for spondylolisthesis.

Expression of inducible co-stimulator in peripheral blood T lymphocytes in the patients with systemic lupus erythematosus / 华中科技大学学报（医学）（英德文版）

The expression of inducible co-stimulator (ICOS) in peripheral blood T lymphocytes from the patients with systemic lupus erythematosus (SLE) and the role in the pathogenesis of SLE was investigated. By using two-color immunofluorescent staining and flow cytometric assay, the expression levels of ICOS in peripheal blood T lymphocytes from 33 patients with SLE and 16 healthy volunteers were detected. SLE diseases activity index (SLEDAI) of the patients with SLE was used to evaluate the disease activity. The correlation between the ICOS expression and SLEDAI was analyzed among the groups. The results showed that the expression levels of ICOS in T lymphocytes in active SLE group was markedly higher than those in the control and inactive SLE groups (both P0.05). In active SLE and inactive SLE groups, positive linear correlation was found between the levels of the ICOS expression in T lymphocytes and SLEDAI (r=0. 711, P=0.001; r=0.561, P=0.03). It was suggested that the expression of ICOS in peripheral blood T lymphocytes from the patients with active SLE was up-regulated and and ICOS might be related to the pathogenesis of SLE.

Expression of Inducible Co-stimulator in Peripheral Blood T Lymphocytes in the Patients with Systemic Lupus Erythematosus / 华中科技大学学报（医学）（英德文版）

Summary: The expression of inducible co-stimulator (ICOS) in peripheral blood T lymphocytes from the patients with systemic lupus erythematosus (SLE) and the role in the pathogenesis of SLE was investigated. By using two-color immunofluorescent staining and flow cytometric assay, the expression levels of ICOS in peripheal blood T lymphocytes from 33 patients with SLE and 16 healthy volunteers were detected. SLE diseases activity index (SLEDAI) of the patients with SLE was used to evaluate the disease activity. The correlation between the ICOS expression and SLEDAI was analyzed among the groups. The results showed that the expression levels of ICOS in T lymphocytes in active SLE group was markedly higher than those in the control and inactive SLE groups (both P<0.01). There was no significant difference in the expression levels of ICOS between the inactive SLE and the control groups (P>0.05). In active SLE and inactive SLE groups, positive linear correlation was found between the levels of the ICOS expression in T lymphocytes and SLEDAI (r=0.711, P＝0.001; r=0.561, P＝0.03). It was suggested that the expression of ICOS in peripheral blood T lymphocytes from the patients with active SLE was up-regulated and and ICOS might be related to the pathogenesis of SLE.

The role of vasoactive substances in hyperhemodynamics after orthotopic liver transplantation in cirrhotic rats / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the role of endogenous vasoactive substances in hyperdynamic circulation after orthotopic liver transplantation (OLT) in cirrhotic rats.</p><p><b>METHODS</b>Male SD rats were randomly divided into 4 groups: normal controls (NL, n = 10), rats with intrahepatic portal hypertension (IHPH, n = 10), normal rats with OLT (NL-OLT, n = 9), and IHPH rats with OLT (IHPH-OLT, n = 16). IHPH-OLT rats were divided into 2 subgroups: Group A (3 days after OLT, n = 9) and Group B (7 days after OLT, n = 7). IHPH was induced by injection of CCI(4) and OLT was performed using cuffs for the anastomosis of suprahepatic inferior vena cava, infrahepatic vena cava and portal vein. Radioactive microsphere method was used for hemodynamic study. The concentrations of plasma glucagon (Glu), nitric oxide (NO), prostaglandin (PGI(2)), thromboxaneA(2) (TXA(2)) and endothelin (ET) were measured by radioimmunoassay.</p><p><b>RESULTS</b>No significant difference in hemodynamic changes was observed between NL-OLT and NL rats, except for mean arterial blood pressure. No significant changes in NO and PGI(2) were seen between NL-OLT and NL rats. Glu, ET and TXA(2) were significantly elevated in NL-OLT rats compared with NL rats (P < 0.05). Characteristics of systemic and splanchnic hyperdynamic circulatory states were observed in IHPH, IHPH-OLT A, IHPH-OLT B rats. Both the magnitude of hyperhemodynamics and increasing concentrations of Glu and NO occurred in the order of IHPH > IHPH-OLT A > IHPH-OLT B rats. The level of plasma PGI(2) in IHPH rats was significantly elevated compared with NL rats, while PGI(2) in IHPH-OLT A and B rats was found to be lower than in IHPH rats (P < 0.05). There was no obvious difference in PGI(2) between IHPH-OLT B and NL rats. Vasoconstrictors including ET and TXA(2) were found elevated in IHPH-OLT rats.</p><p><b>CONCLUSIONS</b>OLT does not induce postoperative hyperhemodynamics per se. Vasodilators including NO and Glu, especially NO, play an important role in the hyperhemodynamics of IHPH and IHPH-OLT rats. The results of the present study demonstrate that the persistence of systemic and splanchnic hyperkinetic circulation in the early stages after OLT may result from those non-eliminated factors that caused hyperhemodynamics in liver cirrhosis patients with portal hypertension before OLT.</p>

Expression of ET-1 mRNA in the lung of hepatopulmonary syndrome rats / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the expression of ET-1 mRNA in the lung of rats with hepatopulmonary syndrome.</p><p><b>METHODS</b>Male Sprague-Dawley rats were divided into four groups: SO, IHPH, PHPH and PCS. Two weeks after production of rat models, all measurements were performed. Arterial blood gas was analyzed. The concentrations of NO and ET-1 in lungs were measured by using radioimmunoassay. In situ hybridization, ET-1 mRNA expressions were detected in lung tissue sections with digoxin-labeled ET-1 oligonucleotide probes. Liver and lung tissues and all the results of in situ hybridization were analyzed by one pathologist. At a magnification of 10 x 40, percent areas of positive stains were detected to indicate the expressions of ET-1 mRNA in the arteries, capillaries and branches.</p><p><b>RESULTS</b>Arterial blood gas analysis showed that PaO(2) (mmHg) decreased more significantly in IHPH (73.85 +/- 6.51) rats than in PHPH (97.39 +/- 1.33), PCS (95.23 +/- 2.22) and SO rats (99.05 +/- 0.75). Alveolar-arterial oxygen gradient (A-aG) (mmHg) increased more significantly in IHPH rats (32.99 +/- 6.57) than in PHPH (4.98 +/- 1.69), PCS (6.51 +/- 2.04) and SO rats (3.23 +/- 0.81). Changes of vascular active substance in plasma and lung indicated that the level of lung NO of IHPH (19.78 +/- 5.33) was increased significantly more than that of PHPH (13.21 +/- 3.99) and PCS (13.89 +/- 3.16). These levels in lung homogenate increased more significantly than those SO (8.71 +/- 1.68). The levels of ET-1 in IHPH rats (195.1 +/- 36.2) was significantly lower than in PHPH (234.8 +/- 71.0), PCS (240.4 +/- 66.5) and SO rats (271.8 +/- 40.6). ET-1 mRNA in situ hybridization showed that there was no significant difference in positive expression of ET-1 mRNA in alveolar arteries and small bronchi. The expression of ET-1 mRNA was significantly lower in alveolar capillary endothelia (5.12 +/- 1.27) than in PHPH (7.43 +/- 0.83), PCS (7.07 +/- 0.86) and SO (7.81 +/- 1.98) rats.</p><p><b>CONCLUSION</b>The low expressions of ET-1 mRNA in HPS rat alveolar capillary endothelia accompanied by decreased ET-1 levels in lung may play an important role in the mechanism of HPS.</p>