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Objective:To investigate the types and distribution of non-polio enterovirus (NPEV) in acute flaccid paralysis (AFP) cases in Henan Province in 2019.Methods:A total of 513 cases of AFP were reported in Henan Province in 2019. Two stool specimens were collected from each case for virus isolation. The VP1 gene of NPEV-positive strains was amplified and sequenced. Sequence alignment and construction of the phylogenetic tree were completed by MEGA5.1 software. The epidemiological data of NPEV-positive strains were statistically analyzed by Excel 2016 and SPSS19 software.Results:A total of 39 NPEV strains were isolated from 513 AFP cases, with an isolation rate of 7.60% (39/513). Among them, 18 strains were group A viruses and 21 strains were group B viruses. Both group A and group B viruses contained seven serotypes. No viruses of group C and group D was isolated. Coxsackievirus A type 4 (CVA4) and CVA16 were the predominant types in group A, and echovirus type 11 (Echo11) was the predominant type in group B. The nucleotide identity between the NPEV-positive strains was 67.4%-100.0%, and their nucleotide identity with the prototype strain was 71.4%-85.6%. NPEV was mainly detected in scattered children under 7 years old with an isolation rate of 84.62% (33/39), and the ratio of male to female was 2.07∶1. No statistically significant difference in the isolation rate was found between different age groups or between different sexes ( P>0.05). Among the group A viruses, CVA2, CVA4 and CVA16 were widely distributed. Echo3, Echo11 and Echo30 were the widely distributed group B viruses. NPEV could be isolated throughout the year except for January. Group A virus infections mainly occurred from April to July, accounting for 66.67% (12/18) of the whole year. Group B virus infections mainly occurred in September, accounting for 28.57% (6/21) of the whole year. Conclusions:The main serotype of NPEV isolated in Henan Province in 2019 was Echo11. The pathogen spectrum and regional distribution of NPEV as well as the isolation rate in different age groups changed significantly compared with those in 2018. Therefore, it was necessary to strengthen monitoring and conduct targeted prevention and control to effectively reduce the occurrence of AFP.
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Objective:To evaluate the effect of maternal depressed mood at pregnancy and postpartum on the risk of emotional or behavioral disorders of offspring by meta-analysis. Methods:The following Mesh words and free words were searched in 7 online databases, including the PubMed, Embase, Web of Knowledge, PsycINFO, Cochrane, WanFang databases and China National Knowledge Infrastructure from January 1, 2000 to October 31, 2020: " maternal" AND " depression" AND " child OR offspring" AND " neuropsychology" . According to the inclusion and exclusion criteria, case-control and cohort studies reporting the effect of maternal depressed mood during pregnancy or postpartum on the risk of emotional or behavioral disorders of offspring were reviewed. Meta-analysis was performed by RevMan 5.3. Results:Fourteen studies involving 3 914 in the case group and 17 016 in the control group were included.Children whose mother with depressed mood during pregnancy or postpartum had 2.03 times risk of emotional or behavioral disorders than those whose mothers without depressed mood ( OR=2.03, 95% CI: 1.55-2.65). Both depressed mood at pregnancy and postpartum could increase the incidence of emotional or behavioral disorders in children, but there was no significant difference between these two periods ( Z=-0.371, 95% CI: 0.796-1.168). Moreover, the effect of maternal depressed mood on emotional or behavioral disorders in offspring could last to the preschool and school period, and the children in the school period may have higher incidence of emotional or behavioral disorders than those during the preschool period ( Z=-2.340, 95% CI: 0.643-0.962). Conclusions:Maternal depressed mood can increase the incidence of emotional or behavioral disorders in offspring, which are long-lasting and do not decrease with age.
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Objective:To investigate the serotypes and epidemic characteristics of non-polio enteroviruses (NPEV) in acute flaccid paralysis (AFP) cases in Henan Province in 2021.Methods:Fecal specimens of 529 AFP cases reported in Henan Province in 2021 were collected for virus isolation. The VP1 regions of NPEV were sequenced. MEGA5.1 software was used for sequence alignment and a phylogenetic tree was constructed as well. The epidemiological data were organized and statistically analyzed using Excel2016 and SPSS26 software.Results:A total of 30 strains of NPEV were isolated from the fecal specimens of 529 AFP cases, with an isolation rate of 5.67% (30/529). They were belonged to group A and group B with 15 strains in each group, and no group C or group D viruses were isolated. Group A contained six serotypes and was dominated by coxsackievirus A2 (CVA2) and CVA6. Group B contained tree serotypes and was dominated by CVB3. In the population distribution, the separation rate of NPEV was the highest among children under 5 years old, which was 76.67% (23/30), and the ratio of male to female was 1.51∶1. In the regional distribution, group A viruses were mainly distributed in the central, southern and southwestern parts of Henan Province with CVA2 and CVA4 being the most widely distributed, while group B viruses were relatively concentrated, mainly distributed in the central, northern and southwestern parts of Henan Province with CVB3 being the predominant. In terms of time distribution, NPEV could be isolated throughout the year except from January to February, showing the epidemic characteristics of high incidence in spring and summer and low incidence in autumn and winter. The peak of group A virus infection was in May and the peak period of group B virus infection was from June to July.Conclusions:CVB3 was the main serotype of NPEV isolated in Henan Province in 2021. The pathogenic spectrum and regional distribution of NPEV had changed significantly compared with those in 2018-2019. In order to provide reference for the diagnosis and surveillance of AFP and maintain the polio-free status in Henan Province, much attention should be paid to the current epidemic trend of NPEV.
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Objective@#To investigate the application value of real-time virtual sonography(RVS)in the diagnosis and treatment of complicated hepatolithiasis.@*Methods@#The retrospective and descriptive study was conducted. The clinical data of 10 patients with complicated hepatolithiasis who were admitted to Hunan Provincial People′s Hospital between October 2017 and March 2018 were collected. There were 3 males and 7 females, aged from 40 to 69 years, with an average age of 57 years. Patients received abdominal color Doppler ultrasound examination, magnetic resonance cholangiopancreatography, and upper abdominal spiral computed tomography (CT) thinly scanning + enhanced examination. Data of CT examination were imported into RVS. RVS was used to locate hepatolithiasis, relationship between stones and vessels, anatomy of bile ducts and vessels in hepatic hilus. Surgical methods included RVS-guided hilar cholangiotomy, biliary stricturoplasty, bilateral hepatojejunostomy, hepatic segmentectomy (lobectomy), and hepatolithotomy. Observation indicators: (1) surgical and postoperative situations; (2) typical case analysis; (3) follow-up. Follow-up using outpatient examination was performed to detect residual stones up to June 2019. Measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers.@*Results@#(1) Surgical and postoperative situations: 10 patients underwent RVS-guided surgeries successfully for complicated hepatolithiasis, with successful match in RVS (difference between CT images and ultrosound images <2 mm). No residual stone was identified by choledochoscope during operation. The operation time and volume of intraoperative blood loss were 285 minutes (range, 210-360 minutes) and 200 mL (range, 100-600 mL), respectively. No blood transfusion was needed during the operations. The duration of hospital stay was 20.5 days (range, 14.0-29.0 days). There was no perioperative death. One patient had postoperative biliary leakage and abdominal infection, and was cured after conservative treatment. (2) Typical case analysis: the tenth patient, female, 60 years old, was diagnosed with complicated hepatolithiasis, and was prepared to undergo hepatolithotomy+ quadrate lobectomy and hilar cholangioplasty+ bilateral hepatojejunostomy. Preoperative CT images and intraoperative color Doppler ultrasound images of the patient were fused and matched on the sagittal section of the portal vein and the cross section of the right branch of portal vein, and stones and important vessels were marked on the images. After accurate positioning, a curette was used to remove the stones. Removal of biliary stones through hepatic parenchyma and peripheral dilated bile ducts was conducted at the site where stones obviously existed. After the stones were removed, the intrahepatic bile duct and hilar bile duct merged. The left end of the bile duct split was confirmed by real-time ultrasound. After location of portal vein was determined by ultrasound, vascular plastic surgery was perfomed to avoid stenosis. (3) Follow-up: 10 patients were followed up for 6-12 months, with a median follow-up time of 8 months. One of 10 patients was suspected residual stones at the right peripheral hepatic anterior lobe by postoperative angiography at 2 months after surgery, and was not removed stones by choledochoscope. The patient had no recurrent symptoms after T-tube removal. The other 9 patients had no residual stones.@*Conclusion@#RVS applied in complicated hepatolithiasis is helpful for the precise intraoperative diagnosis, and the surgical treatment can be safe and effective.
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Objective:To explore the risk factors for overall complications after laparoscopic pancreaticoduodenectomy(LPD) and to establish postoperative pancreatic fistula prediction model for LPD.Methods:The clinical data of 176 patients undergoing LPD from Jan 2014 to Mar 2018 were retrospectively analyzed.Results:One died within 30 days. Five patients underwent reoperation. Seventy-three patients (41%) had complications including pancreatic fistula in 30 cases(17.0%), postoperative hemorrhage in 16 (9.1%); bile leakage in 10 (5.7%); abdominal infection in 6 (3.4%); wound infection in 4 (2.2%); pulmonary infection in 4 (2.2%); gastric emptying disorder in 3 (1.7%). Age, intraoperative blood loss, diabetes mellitus were risk factors for overall postoperative complications of LPD(all P<0.05); Age, male gender, pancreatic duct diameter, pancreas texture, lesion size were risk factors for pancreatic fistula after LPD(all P<0.05). Conclusions:Age, intraoperative blood loss, diabetes mellitus were risk factors for overall postoperative complications of LPD; Age, male gender, pancreatic duct diameter, pancreas texture, and lesion size were risk factors for pancreatic fistula after LPD.
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Objective To investigate the application value of real-time virtual sonography (RVS)in the diagnosis and treatment of complicated hepatolithiasis.Methods The retrospective and descriptive study was conducted.The clinical data of 10 patients with complicated hepatolithiasis who were admitted to Hunan Provincial People's Hospital between October 2017 and March 2018 were collected.There were 3 males and 7 females,aged from 40 to 69 years,with an average age of 57 years.Patients received abdominal color Doppler ultrasound examination,magnetic resonance cholangiopancreatography,and upper abdominal spiral computed tomography (CT) thinly scanning +enhanced examination.Data of CT examination were imported into RVS.RVS was used to locate hepatolithiasis,relationship between stones and vessels,anatomy of bile ducts and vessels in hepatic hilus.Surgical methods included RVS-guided hilar cholangiotomy,biliary stricturoplasty,bilateral hepatojejunostomy,hepatic segmentectomy (lobectomy),and hepatolithotomy.Observation indicators:(1) surgical and postoperative situations;(2) typical case analysis;(3) follow-up.Follow-up using outpatient examination was performed to detect residual stones up to June 2019.Measurement data with skewed distribution were represented as M(range).Count data were described as absolute numbers.Results (1) Surgical and postoperative situations:10 patients underwent RVS-guided surgeries successfully for complicated hepatolithiasis,with successful match in RVS (difference between CT images and ultrosound images ＜ 2 mm).No residual stone was identified by choledochoscope during operation.The operation time and volume of intraoperative blood loss were 285 minutes (range,210-360 minutes) and 200 mL (range,100-600 mL),respectively.No blood transfusion was needed during the operations.The duration of hospital stay was 20.5 days (range,14.0-29.0 days).There was no perioperative death.One patient had postoperative biliary leakage and abdominal infection,and was cured after conservative treatment.(2) Typical case analysis:the tenth patient,female,60 years old,was diagnosed with complicated hepatolithiasis,and was prepared to undergo hepatolithotomy + quadrate lobectomy and hilar cholangioplasty+bilateral hepatojejunostomy.Preoperative CT images and intraoperative color Doppler ultrasound images of the patient were fused and matched on the sagittal section of the portal vein and the cross section of the right branch of portal vein,and stones and important vessels were marked on the images.After accurate positioning,a curette was used to remove the stones.Removal of biliary stones through hepatic parenchyma and peripheral dilated bile ducts was conducted at the site where stones obviously existed.After the stones were removed,the intrahepatic bile duct and hilar bile duct merged.The left end of the bile duct split was confirmed by real-time ultrasound.After location of portal vein was determined by ultrasound,vascular plastic surgery was perfomed to avoid stenosis.(3) Follow-up:10 patients were followed up for 6-12 months,with a median followup time of 8 months.One of 10 patients was suspected residual stones at the right peripheral hepatic anterior lobe by postoperative angiography at 2 months after surgery,and was not removed stones by choledochoscope.The patient had no recurrent symptoms after T-tube removal.The other 9 patients had no residual stones.Conclusion RVS applied in complicated hepatolithiasis is helpful for the precise intraoperative diagnosis,and the surgical treatment can be safe and effective.
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Objective To investigate the causes and countermeasures of reoperation following laparoscopic pancreatoduodenectomy.Methods The causes,approaches and outcome of reoperation were retrospectively analyzed in 10(4.0％,10/250) patients undergoing reoperations following pancreaticoduodenectomy with various complications in Hunan Provincial People's Hospital from April 2014 to April 2018.Results The causes of the 10 patients including intra-abdominal bleeding of seven cases (2 cases combined with pancreatic fistula,1 case with pancreatic and biliary fistula),1 patient with gastrointestinal anastomosis output perforation,1 patient with intra-abdominal abscess,and 1 case with postoperative pancreatitis.The time of reoperation was one day to 82 day after the first operation.The main methods of reoperation including suture and hemostasis,rebuilding the digestive tract,gastrostomy and enterostomy combined with abdominal cavity drainage.The mortality of reoperation following laparoscopic pancreatoduodenectomy was 20.0％ (2/10).Conclusions Intra-abdominal hemorrhage,pancreatic fistula and intra-abdominal abscess are the major causes of reoperation after laparoscopic pancreatoduodenectomy.Timely and decisive reoperation is an effective means to reduce postoperative morbidity and mortality after LPD.
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Objective@#To summarize our clinical experience and management of an anomalous proximal bile duct joining the cystic duct in laparoscopic cholecystectomy (LC).@*Methods@#A retrospective study was conducted on 8 patients who had an anomalous right anterior bile duct joining the cystic duct who were treated at the Hunan Provincial People's Hospital from March 2003 to January 2019.@*Results@#All the 8 patients were diagnosed to have gallstones cholecystitis on preoperative CT, MRI and abdominal ultrasound. There were no suggestions of an anomalous bile duct. A total of 6 patients underwent reoperation after LC due to abdominal pain and biliary peritonitis. These 6 patients were treated with drainage and T-tube insertion. In the other 2 patients, the anomalous bile duct opening which joined the cystic duct were detected during LC. There was one patient converted to open laparotomy with preservation of the cystic duct and underwent common bile duct T-tube drainage. The other patients continued with laparoscopic surgery. The cystic duct was partially resected with removal of gallbladder, followed by common bile duct drainage. The average follow-up period was 3.4 years and the results were satisfactory.@*Conclusions@#Biliary duct anomaly is the main cause of iatrogenic proximal bile duct injury during laparoscopic cholecystectomy. It is not uncommon to have the anomaly of insertion of right anterior segmental bile duct to the cystic duct. To avoid iatrogenic biliary tract injury, careful preoperative study of X-ray films, accurate identification of the intraoperative gallbladder triangle anatomical structures. Strict adherence to carry out the three-word procedure of " discrimination, cut, identify" will help to reduce the incidence of biliary tract complications in laparoscopic cholecystectomy.
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Objective@#Analyze the genetic characteristic of Hemagglutinin(H) gene of measles viruses isolated in Henan Province in 2017.@*Methods@#Swab samples collected from 7 lab confirmed measles cases, and we got the measles virus by Vero/Slam inoculation. Fragment of H genes were amplified by reverse transcription polymerase chain reaction(RT-PCR), then the PCR products were sequenced and analyzed.@*Results@#The age of the 7 measles confirmed cases were between 1 and 50 years old, and all of them were males. All the 7 measles viruses were identified as H1a genotype, and the average distance of the nucleotides and the amino acids was 0.005, respectively. Compared with the Shanghai-191/China-vaccine, there were some changes in isolated virus, such as 240th, 397th and 381st sites in the amino acid sequence.@*Conclusion@#The measles genotype which isolated in Henan Province in 2017 was H1a. There were some difference from Shanghai-191/China-vaccine in the nucleotides sequence of H gene, which suggested that it′s necessary to strengthen the monitor the variation of measles virus.
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Objective To study the diagnostic value of endoscopic ultrasonography (EUS) in patients with cholangiopancreatic duct dilatation (CPDD).Methods Forty-five patients with CPDD and without any visual or detected obstructive lesions after traditional uhrasonography (US) were re-examined by EUS,CT and MRI.The diagnostic rates of EUS and the other imaging technologies were compared.Results All the 45 patients underwent successful EUS examination.Among them,there were 18 patients with periampullary tumor,10 patients with lower common bile duct stones,1 patient with pancreatic duct stones,3 patients with chronic pancreatitis,1 patient with an intrapancreatic choledochal cyst,4 patients with inflammatory strictures of papilla of duodenum and 2 patients with terminal bile duct inflammatory stenosis.However,1 patient with a lower common bile duct tumor,1 patient with a small pancreatic head carcinoma and 1 patient with sphincter of Oddi dysfunction (SOD) were not diagnosed.The diagnostic rates of obstructive lesions by US,EUS,CT and MRI were 7.1％,92.9％,33.3％,31.0％,respectively.The diagnostic rates of tumor were 10.0％,90.0％,35.0％,25.0％,respectively.As compared with the other examination methods,EUS was best in detecting small carcinoma.Conclusion EUS plays an important role in the diagnosis of lesions causing cholangiopancreatic duct dilatation.
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Objective To investigate the clinical effects of laparoscopic pancreaticoduodenectomy (LPD) for distal cholangiocarcinoma.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 37 patients who underwent LPD for distal cholangiocarcinoma in the Hunan Provincial People's Hospital between January 2013 and November 2016 were collected.LPD for distal cholangiocarcinoma was performed using the "en-block" procedure.According to the principle of "one axis,two planes and four zones",anatomy used posterior approach,anterior approach and medial approach,lymph node dissection was performed from carotid sheath outside,and en bloc specimens were resected.Observation indicators:(1) surgical and postoperative recovery situations;(2) postoperative pathological examination;(3) follow-up and survival situations.Follow-up using outpatient examination was performed to detect the patients' recurrence-free survival up to November 2017.Measurement data with normal distribution were represented as (x)±s.The survival curve and rate were drawn and calculated by the Kaplan-Meier method.Results (1) Surgical and postoperative recovery situations:all the 37 patients underwent successful LPD,without conversion to open surgery and perioperative death.The operation time,volume of blood loss and case with intraoperative blood transfusion were (326 ± 55) minutes,(176± 39)mL and 1,respectively.The time to initial exsufflation and time for diet intake were respectively (4.5± 1.6)days and (5.3±2.7)days.Of 37 patients,14 had postoperative complications,including 8 with pancreatic fistula (6 with biochemical fistula and 2 with grade B pancreatic fistula),1 with biliary fistula,3 with postoperative bleeding (2 with intra-abdominal bleeding and 1 with gastrointestinal anastomosis bleeding),2 with delayed gastric emptying (grage A),2 with intra-abdominal infection and 2 with pulmonary infection;the same patients can merge multiple complications.Three patients were in Clavien-Dindo classification ≥ Ⅲ.One patient received reoperation and other patients were improved by symptomatic treatment.Duration of hospital stay of 37 patients was 13.5 days (range,8.0-33.0 days).Eight patients underwent adjuvant chemotherapy of 4-6 cycles by taking orally tegafur or gemcitabine with cisplatin.(2) Postoperative pathological examination:tumor diameter and pancreatic duct diameter of 37 patients were (2.1±1.1)cm and (2.5±1.2) mm,respectively.Of 37 patients,9,13 and 15 were respectively detected in high-differentiated,moderate-differentiated and lowdifferentiated adenocarcinoma.Surgical margins:35 patients received R0 resection and 2 received R1 resection.Number of lymph node dissected,cases with lymph node metastasis and number of positive lymph nodes were respectively 18.5±4.9,16 and 1.7± 1.4.Analysis of lymph node metastasis location showed that the positive rates in 8a,12,13,14 and 17 groups lymph nodes were respectively 5.4％ (2/37),18.9％ (7/37),21.6％ (8/37),8.1％ (3/37) and 10.8％ (4/37);Perineural invasion (PNI),lymphovascular invasion (LVI),pancreatic invasion and duodenal invasion were identified in 14,9,16 and 6 patients,respectively.TNM stage:stage 0,Ⅰ A,Ⅰ B,ⅡA and Ⅱ B were respectively detected in 1,3,5,12 and 16 patients.(3) Follow-up situation:of 37 patients,36 were followed up for 6-45 months,with a median time of 26 months.The median recurrence-free survival time,1-and 3-year recurrence-free survival rates were respectively 28 months,80.6％ and 42.2％.Conclusion LPD is safe and effective for distal cholangiocarcinoma,and "en-block" resection not only helps to optimize the process of LPD for distal cholangiocarcinoma,but also has a significant effect on R0 resection and lymph node dissection.
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Objective To explore the risk factors for retreatment of spinal tuberculosis and to provide a theoretical basis for the formulation of clinical prevention and treatment measures. Methods the clinical data of 114 patients who received spinal tuberculosis operation from January 2011 to June 2014 were retrospectively analyzed. Among them, 13 cases were divided into group A after operation, and 101 cases without recurrence after operation were divided into B group. The clinical data of the two groups were compared and the multiple factor Logistic regression was used to analyze the risk factors for retreatment of spinal tuberculosis. Results In group A, preoperative albumin level, after standard anti-tuberculosis treatment, the proportion of complete removal of the lesion was significantly lower than that in group B, and tuberculosis in other parts of the proportion, the emergence of resistant strains, proportion of adverse conditions were significantly higher than those in group B (P＜0. 05). Multivariate Logistic regression analysis showed that preoperative albumin < 35g/L, without fusion, patients who did not receive regular anti-tuberculosis treatment, debridement is not complete, with other parts of tuberculosis, drug resistant strain and adverse conditions were risk factors of postoperative spinal tuberculosis retreatment (P＜0. 05). Conclusion Many factors can affect the incidence of relapse after spinal tuberculosis surgery, and clinical intervention should be carried out to reduce the risk of relapse after spinal tuberculosis operation.
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Objective To standardize the reporting system on hepatitis B in order to improve the quality of monitoring program in Henan province.Methods A total of 6 sites of Hepatitis B pilot surveillance were selected in Xinzheng of Zhengzhou city,Linzhou of Anyang city,Shanyang district of Jiaozuo city,Shaoling district of Luohe city,Yongcheng of Shangqiu city,Pingqiao district of Xinyang city in Henan province.Subjects under study were those reported hepatitis B cases,from 2012 to 2016.Cases diagnosed in 2011 were chosen as controls.Data on classification of hepatitis B,time that HBsAg became positive and ALT value of the cases were analyzed annually.5 ml venous blood was collected and anti-HBc IgM confirmed test was made for those suspected acute cases on hepatitis B.Based on the 2016 data from the monitoring system,the incidence of acute hepatitis B in Henan province was estimated.Results The number of reported hepatitis B cases had declined in 6 sites of Hepatitis B pilot surveillance substantially.A total of 17 436 hepatitis B reported in 2011 but only 2 632 cases were reported in 2016,with a reduction of 84.90％(14 804/17 436) in these six monitoring sites.The number of unclassified hepatitis B cases also dropped sharply.In 2011,36.87％ of the cases were unclassified,but the figure reduced to 0.08％ in 2016,from the six sites.The rate on ALT detection also gradually improved.The rate of misdiagnosis on HBV carrier from hepatitis B almost disappeared.From 2013 to 2016,777 blood samples were collected from six pilot sites.29.34％ (228/777) of the blood samples were tested positive for anti-HBc IgM after confirmed by the hepatitis laboratory of the China Center for Disease Control and Prevention.Conclusions Since the development of the pilot surveillance program,the quality of reporting system on hepatitis B had been improved,as well as the accuracy of diagnosis.Rate on the accuracy of reporting on hepatitis B and the methods of testing should be improved at the monitoring sites.
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Objective To standardize the reporting system on hepatitis B in order to improve the quality of monitoring program in Henan province.Methods A total of 6 sites of Hepatitis B pilot surveillance were selected in Xinzheng of Zhengzhou city,Linzhou of Anyang city,Shanyang district of Jiaozuo city,Shaoling district of Luohe city,Yongcheng of Shangqiu city,Pingqiao district of Xinyang city in Henan province.Subjects under study were those reported hepatitis B cases,from 2012 to 2016.Cases diagnosed in 2011 were chosen as controls.Data on classification of hepatitis B,time that HBsAg became positive and ALT value of the cases were analyzed annually.5 ml venous blood was collected and anti-HBc IgM confirmed test was made for those suspected acute cases on hepatitis B.Based on the 2016 data from the monitoring system,the incidence of acute hepatitis B in Henan province was estimated.Results The number of reported hepatitis B cases had declined in 6 sites of Hepatitis B pilot surveillance substantially.A total of 17 436 hepatitis B reported in 2011 but only 2 632 cases were reported in 2016,with a reduction of 84.90％(14 804/17 436) in these six monitoring sites.The number of unclassified hepatitis B cases also dropped sharply.In 2011,36.87％ of the cases were unclassified,but the figure reduced to 0.08％ in 2016,from the six sites.The rate on ALT detection also gradually improved.The rate of misdiagnosis on HBV carrier from hepatitis B almost disappeared.From 2013 to 2016,777 blood samples were collected from six pilot sites.29.34％ (228/777) of the blood samples were tested positive for anti-HBc IgM after confirmed by the hepatitis laboratory of the China Center for Disease Control and Prevention.Conclusions Since the development of the pilot surveillance program,the quality of reporting system on hepatitis B had been improved,as well as the accuracy of diagnosis.Rate on the accuracy of reporting on hepatitis B and the methods of testing should be improved at the monitoring sites.
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Objective To observe the interventional effect of Qingqihuatan Decoction on airway inflammation and inflammatory reaction of lung tissue in asthmatic mouse.Methods Forty-five BALB/c mice were randomly divided into the normal control group(CON),asthmatic model group(MOD),dexamethasone group(TRE),Qingqihuatan Decoction group(X1) and Qingqihuatan Decoction combined dexamethasone group(X2).The asthmatic mouse model was established by the sensitization and inhalation of OVA and aluminium hydroxide gel.The bronchoalveolar lavage fluid (BALF) was performed the cell counts and eosinophil counts,and the pathological changes of lung tissue were observed.Results Compared with CON group,BALF cell count and eosinophil count in the model group were increased obviously,which in the treatment group were significantly decreased.The effect of the X1 group and X2 group had statistical difference between on 5 d and 15 d.(P＜0.05 or P＜0.01);the treatment groups could reduce the pathogenical infiltration,lung bullae production and airway epithelial thickening of mouse lung tissue,especially the inflammation damage in X2 group was mild.Conclusion Qingqihuatan Decoction can relieve the airway inflammation and improves the lung tissue inflammatory response in model mouse.
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OBJECTIVE:To observe therapeutic efficacy and safety of carboprost tromethamine in the treatment of postpartum hemorrhage with two routes of administration. METHODS:285 patients with postpartum hemorrhage were randomly divided into control group(143 cases)and trial group(142 cases). Control group was given Carboprost tromethamine injection 250 μg on del-toid of arm;trial group was given same dose of Carboprost tromethamine injection via cervix uteri. Both groups received medicine after third stage of labor. The therapuetic efficacy,the amount of endometrorrhagia and colporrhagia within 2 h,the incidence of ADR after labor were observed in 2 groups. RESULTS:After treatment,the amount of postpartum hemorrhage was smaller than 400 ml in 2 groups and didn't exceed the standard,without statistical significance(P>0.05). The amount of endometrorrhagia in trial group was significantly higher than in control group,with statistical significance(P0.05). CONCLUSIONS:The intramuscular injection is selected for the prevention of postpartum hemorrhage caused by uterine inertia;the cervical injection is selected for the prevention of postpartum hemorrhage caused for the other patients.
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Objective To compare the diagnostic value of endoscopic ultrasonography (EUS) versus intraoperative cholangiography (IOC) for suspected common bile duct stones (CBDS).Methods 324 patients with suspected CBDS who were admitted to the Hepatobiliary Pancreatic Surgery Department of Shaoxing People's Hospital between June 2010 and June 2014 were retrospectively studied.Either EUS or IOC was used and the diagnostic value of these two imaging modalities was compared.Results The sensitivity, specificity, positive predictive value and negative predictive value of IOC in diagnosing suspected CBDS were 90.6％, 98.4％, 9.5％ and 97.7％ respectively.Its consistency rate was 96.9％.The sensitivity, specificity, positive predictive value and negative predictive value of EUS in diagnosing suspected CBDS were 97.1％, 100％, 100％ and 99.1％ respectively.Its consistency rate was 99.3％.Conclusions In diagnosing suspected CBDS, the sensitivity, specificity, positive predictive value and negative predictive value of EUS were significantly higher than IOC.When compared with IOC, EUS was more sensitive to detect occult CBDS and avoided unnecessary ERCP or bile duct exploration.Patients with negative EUS were less likely to have retained CBDS.
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Pancreatic adenosquamous carcinoma is a rare exocrine pancreatic cancer,and surgical treatment is the only promising method in survival time extension and life quality enhancement.In July 2013,1 patient with pancreatic adenosquamous carcinoma and sarcomatoid change was admitted to the Shaoxing People's Hospital.A cauda pancreatis cystic nidus was detected by computed tomography 1 year ago,and no any other clinical symptoms were detected.The left upper quadrant of the patient was glutted and unwell,and the levels of CA19-9 and CA125 were 3 630 kU/L and 645 kU/L,respectively.The results of computed tomography and magnetic resonance imaging showed that a huge cystic and solid tumor was located between the cauda pancreatis,the stomach and the spleen;the tumor was mainly cystic and rooted in the tail of the pancreas;the spleen,stomach and surrounding tissues were infiltrated by the tumor.The results of postoperative pathological examination showed that the tumor was pancreatic adenocarcinoma with squamous epithelial differentiation and sarcomatoid change;the invasive squamous carcinoma dominated stomach wall,and the sarcomatoid change dominated spleen and lymph nodes with partial squamous epithelial differentiation and surrounding lymph nodes metastases.Although the surgical resection was complete and the postoperative thymosin injection and traditional Chinese medicine were implemented,tumor recurred at postoperative month 5,and the patient was dead due to cachexia and pernicious anemia at postoperative month 8.The prognosis of patients with pancreatic adenosquamous carcinoma is poor,early detection and surgery are key points for curative effect enhancement.
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Objective:To study the transdermal characteristics of myrrh essential oil and its percutaneous penetration enhancement for ibuprofen. Methods:The content of ibuprofen was determined by HPLC. Ibuprofen was used as the model drug and mouse skin was used as the permeation barrier in vitro. The transdermal properties of myrrh essential oil and its effect on percutaneous absorption of ibuprofen were investigated using Franz diffusion cells. Results:Without myrrh essential oil or with 1%, 2% and 3% myrrh essential oil, the cumulative transdermal penetration amount in 12h of ibuprofen in vitro was (0. 427 05 ± 0. 069 82), (0. 315 04 ± 0. 032 24), (0.230 50 ±0.031 14) and (0.181 34 ±0.053 70) mg·cm-2, with Jss of(0.031 4 ±0.005 7), (0.020 8 ±0.002 8), (0.017 2 ±0.001 6) and (0.013 9 ±0.003 4) mg·(cm2·h) -1, respectively. Conclusion: Myrrh essential oil shows no transdermal en-hancement for ibuprofen in vitro, to the contrary, it shows inhibitory effect with positive correlation to the concentration.
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This study was aimed to objectively evaluate the validity and safety of normalized Tuina massage thera-py on the treatment of 240 infants with acute diarrhea, thus disseminate and promote the application of infantile Tuina massage therapy. This study is a multicenter, randomized, controlled trial of 240 cases with acute infantile diarrhea. The experimental group (180 cases) was treated with Tuina massage therapy. The main acupoints are Pi-jing, Da-chang, Lan-men. And the combining acupoint is San-guan. In the control group (60 cases), the pa-tients were orally administered with Smecta. The statistical analysis was conducted with SPSS 15.0. The compre-hensive curative effect, time point effect, safety and technical stability of infantile Tuina massage were evaluated in the treatment of acute diarrhea. The results showed that the comprehensive effect of cure rate in the experi-mental group was 75.6% (136/180), and that of the control group was 21.7% (13/60). It showed that the effect in the experimental group was significantly better than the control group (P 0 . 05 ) . Furthermore , there was no side effect in both groups. It was concluded that the infantile massage technique is an effective therapy for the treatment of acute diarrhea . Meanwhile , it is a safe and stable therapy and is worth popularizing .