Analysis on aggregation outbreaks of pulmonary tuberculosis in a private middle school in Minhang District of Shanghai / 复旦学报（医学版）

Objective To analyze the epidemiological characteristics of aggregation outbreaks of pulmonary tuberculosis (TB) in a private middle school in Minhang District of Shanghai.Methods Symptom and radiographic screening were performed on the students of Grade 3 in this senior high school.Epidemiological survey,sputum smear,culture and molecular epidemiological examination were conducted on suspected patients.Whole genome sequencing was completed on positive strains.Results In the screening of 49 close contacts with one TB patient (index case) in the school,a total of 10 patients with pulmonary TB were diagnosed,of which 3 cases were positive for culture.Another case was diagnosed and positive for culture after expanding the scope of screening.The genotype of the isolated strains from index case and the 4 patients positive for culture was identical to that of the first case of the classoneyear before,suggesting the transmission within the grade of Senior Three.Conclusions This is an aggregation outbreak that may be attributable to the first patient with positive bacteria.Therefore,timely diagnosis and effective treatment of pulmonary TB patients,as well as timely screening of close contacts with pulmonary TB patients are significant to control potential outbreaks in schools.

Analysis on direct medical expenses and relief items service package of pulmonary tuberculosis patients in Minhang District of Shanghai / 复旦学报（医学版）

Objective To investigte the direct medical expense for diagnosis and treatment of pulmonary tuberculosis (TB) patients and its financial burden on family in Minhang District,Shanghai,and to provide evidence for improving TB derating policy and reducing the economic burden.Methods A total of 347 pulmonary TB patients who had completed treatment were investigated by questionnaire.Their receipts on diagnosis and treatment of TB were collected.Ranksum test,linear regression and x2 test were used to analyze medical expenses,influencing factors and social economic burden.Results The median of TB patients' direct medical expenses was 5 657 yuan/person.Linear regression showed that direct medical expenses were related with census,main medical institutions and complications.The main medical institutions have a greater impact on direct medical expenses (β'=-0.217).In the patients,7.5 ％ had high medical expenditures after the deduction of medical reimbursement and derating.And they were mainly distributed among low-income people.Conclusions The diagnosis and treatment expenses of TB patients were relatively high,which resulted in a heavier financial burden to the patient's family.The elderly tuberculosis patients,patients with complications and poor groups should become the focus of medical reimbursement and derating policy.

Analysis on aggregation outbreaks of pulmonary tuberculosis in a private middle school in Minhang District of Shanghai / 复旦学报（医学版）

Objective To analyze the epidemiological characteristics of aggregation outbreaks of pulmonary tuberculosis (TB) in a private middle school in Minhang District of Shanghai.Methods Symptom and radiographic screening were performed on the students of Grade 3 in this senior high school.Epidemiological survey,sputum smear,culture and molecular epidemiological examination were conducted on suspected patients.Whole genome sequencing was completed on positive strains.Results In the screening of 49 close contacts with one TB patient (index case) in the school,a total of 10 patients with pulmonary TB were diagnosed,of which 3 cases were positive for culture.Another case was diagnosed and positive for culture after expanding the scope of screening.The genotype of the isolated strains from index case and the 4 patients positive for culture was identical to that of the first case of the classoneyear before,suggesting the transmission within the grade of Senior Three.Conclusions This is an aggregation outbreak that may be attributable to the first patient with positive bacteria.Therefore,timely diagnosis and effective treatment of pulmonary TB patients,as well as timely screening of close contacts with pulmonary TB patients are significant to control potential outbreaks in schools.

Analysis on direct medical expenses and relief items service package of pulmonary tuberculosis patients in Minhang District of Shanghai / 复旦学报（医学版）

Objective To investigte the direct medical expense for diagnosis and treatment of pulmonary tuberculosis (TB) patients and its financial burden on family in Minhang District,Shanghai,and to provide evidence for improving TB derating policy and reducing the economic burden.Methods A total of 347 pulmonary TB patients who had completed treatment were investigated by questionnaire.Their receipts on diagnosis and treatment of TB were collected.Ranksum test,linear regression and x2 test were used to analyze medical expenses,influencing factors and social economic burden.Results The median of TB patients' direct medical expenses was 5 657 yuan/person.Linear regression showed that direct medical expenses were related with census,main medical institutions and complications.The main medical institutions have a greater impact on direct medical expenses (β'=-0.217).In the patients,7.5 ％ had high medical expenditures after the deduction of medical reimbursement and derating.And they were mainly distributed among low-income people.Conclusions The diagnosis and treatment expenses of TB patients were relatively high,which resulted in a heavier financial burden to the patient's family.The elderly tuberculosis patients,patients with complications and poor groups should become the focus of medical reimbursement and derating policy.

Preventive effect of transcutaneous electro-acupuncture on the intratracheal extubation stress response in general anesthesia of patients with breast cancer undergoing modified radical mastectomy / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the regulatory effect of transcutaneous electro-acupuncture (TCEA) for preventing intratracheal extubation stress response (IESR) in general anesthesia.</p><p><b>METHODS</b>Sixty patients with breast cancer scheduled to receive mastectomy were numbered according to their sequence of hospitalization, patients of odd number were assigned to the control group and those of even number to the treated group, 30 in each group. They were anesthetized by the same anesthesia approach, but TCEA was applied on patients in the treated group in the narcotic process by stimulating at Hegu (LI4) and Neiguan (PC6) of the diseased side for 20 min before induction; then on bilateral points of Hegu, Neiguan, Chize (LU5) and Lieque (LU7) all through the whole course of operation, but at time of 30 min before ending operation, stimulus at Chize and Lieque points stopped and turned to bilateral Shuitu (ST10) and Qishe (ST11) points. No management other than conventional anesthesia was applied on patients in the control group. Changes of blood pressure (MAP), heart rate (HR), plasma catecholamine and cortisol as well as the respiratory tract response occurred after extubation were observed and compared.</p><p><b>RESULTS</b>HR, MAP, plasma levels of catecholamine and cortisol increased after extubation in both groups (P < 0.05), but the changes were more obvious in the control group than in the treated group (P < 0.05). Besides, the adverse reaction of respiratory tract occurred in the treated group was milder (P < 0.05).</p><p><b>CONCLUSIONS</b>TCEA can alleviate the IESR to attenuate the adverse reaction of respiratory tract. It is definitely valuable in clinical practice.</p>

Effect of Status Epilepticus on Learning and Memory and Expression of Hippocampal Phosphorylated c-AMP Response Element Binding Protein in Developmental Rats / 实用儿科临床杂志

Objective To explore the effect of status epilepticus(SE) on learning and memory and expression of phosphorylated c-AMP response element binding protein(pCREB) in hippocampus in developmental rats.Methods Developmental male SD rats were assigned randomly to two groups:the SE rats,induced by intraperitoneal injection of pentylenetetrazole(PTZ);normal saline(NS) control group,received saline intraperitoneal.Learning and memory test with the Morris water maze and Y maze were performed at 7 days after SE.After testing,a subset of rats were killed and the brain was evaluated for pCREB immunostaining,an important transcription factor underlying learning and memory.Results In SE group,the mean escape latency of searching the platform significantly prolonged(P

Induction of Apoptosis and Upregulation of Fas Ligand and Fas - Associated Death Domain by Doxorubicin in Human Jurkat Leukemia T- Cells / 实用儿科临床杂志

Objective To investigate the dose and time kinetics of induction of apoptosis induced by doxorubicin in J urkat leukemiacells, and to explore its pertinent molecular mechanisms. Methods Human Jurkat leukemia T - cells were treated with doxorubicin at theconcentration of 0.1 mg/L, 0.2 mg/L, 0.5 mg/L and 1.0 mg/L for 6,12,24 and 36 hours, respectively, of which one sample was pre-treated with zVAD- fmk (benzyloxycarbonyl - Val -Ala - Asp - fluoromethylketone) prior to addition of doxorubicin 0.2 mg/L. Apop-tosis was detected with both annexin V - FITC and propidium iodide ( PI ) staining and annexin V FITC and PI double positive cellswere analyzed by flow cytometry. Western blot was used to evaluate the level of Fas ligand (FasL) and FADD (Fas - associated death do-main) expression. Results The differences of apoptotic cells induced by all dose of doxorubicin were not significant (P＞0.05 ) at 6hour;at 12 hour, only the highest dose, 1 mg/L, significantly induced cell apoptosis;while the lowest dose,0.1 mg/L, did not significantlycaused cell apoptosis for all time points. After exposure to the doses of 0.2 and 0.5 mg/L for 24 or 36 hours,a significant increase in per-centage of apoptotic cells was observed (P ＜ 0.001 ). Apoptosis induced by doxorubicin was completely inhibited when the cells were incu-bated with doxorubicin in the presence of zVAD - fmk (P ＜ 0. 001 ). The level of FasL and FADD expression correspondingly increasedwith exposure time to doxorubicin. Conclusions Doxorubicin induces apoptosis in a dose - and time - dependent manner; upregulatedFasL may initiate the activation of the Fas signaling pathway and caspases are the ultimate executioner in the induction of leukemia cellapoptosis by doxorubicin.

Effect of Qingkailing on Distribution and Level of Neuropeptide Y in Brain of Epileptic Rats / 实用儿科临床杂志

Objective To explore the effect of Qingkailing on the distribution and contents of neuropeptid Y(NPY)in hippocampus of epileptic rats.Methods Adopt abdominal cavity injection pentetrazole was used to establish the model of epileptic rats.Then content of NPY was assayed by radio-immunity and the distribution was observed by immunohistochemistry.Results The content of NPY in kindling group was significantly higher than that in control group(P

Induction of Apoptosis and Upregulation of Fas Ligand and Fas-Associated Death Domain by Doxorubicin in Human Jurkat Leukemia T-Cells / 实用儿科临床杂志

0.05) at 6 hour;at 12 hour,only the highest dose,1 mg/L,significantly induced cell apoptosis;while the lowest dose,0.1 mg/L,did not significantly caused cell apoptosis for all time points.After exposure to the doses of 0.2 and 0.5 mg/L for 24 or 36 hours,a significant increase in percentage of apoptotic cells was observed(P