Retrospective analysis on the effect of prevention and treatment of senile pulmonary tuberculosis in Hubei Province / 公共卫生与预防医学

Objective To retrospectively analyze the prevention and control effect and epidemic characteristics of elderly tuberculosis in Hubei Province from 2016 to 2020, and to provide a scientific basis for the prevention and treatment of elderly tuberculosis in Hubei Province． Methods The data on tuberculosis patients aged 60 and above who registered their current address in Hubei Province from 2016 to 2020 were collected and analyzed. The registration rates and composition ratios were analyzed using χ2 test and χ2 test for trend. Results A total of 135 976 tuberculosis patients were reported in Hubei from 2016 to 2020. The annual average registration rate of elderly tuberculosis among the elderly registered residence population (referring to the registration rate of elderly registered residence population aged 60 and above as the denominator, and tuberculosis patients aged 60 and above as the numerator) was 263.51/100 000. The highest rate was 300.02/100,000 in 2017, and the lowest was 188.19/100,000 in 2020 (χ2=70,227.603, P2trend=40.448，P2trend=740.911, P2trend=380.557, P2trend=323.764, P<0.001). Conclusion The elderly population with pulmonary tuberculosis in Hubei Province shows a downward trend. It is necessary to focus on the efforts of designated hospitals to proactively identify cases, increase the proportion of confirmed cases, maintain a high tracking in place, reduce medical delays, and ensure the effectiveness of tuberculosis prevention and treatment for the elderly.

Evaluation and analysis of the effectiveness of syphilis prevention and control in Hubei in 2011-2020 / 公共卫生与预防医学

Objective To evaluate the implementation and effectiveness of syphilis prevention and control in Hubei Province from 2011 to 2020, to summarize the experience and practice, to analyze the existing problems and causes, and to study and put forward policy and strategy suggestions, so as to provide reference for formulating the national “14th five-year plan” and carrying out the next step of prevention and control work. Methods The National STD Prevention and Control Management Information System, STD Prevention and Control New Media Health Service Platform, National AIDS Comprehensive Prevention Information System, and National Management Information System for the Prevention of AIDS, Syphilis, and Mother-to-Child Transmission of Hepatitis B were used to analyze and evaluate the completion of main prevention and control indicators in Hubei Province. Results Among the 16 evaluation indexes, 10 indexes including the effectiveness of syphilis promotion and training for various groups of people, the proportion of pregnant women undergoing syphilis testing in the monitoring and testing work, and the effectiveness of syphilis prevention and treatment, all met the requirements of the plan. In addition, some of the 5 indexes failed to meet the requirements of the plan. Conclusion Hubei Province has fairly fulfilled the work requirements of the Plan. It is still necessary to strengthen the syphilis prevention and control to ensure the urban pregnant women infected with syphilis and their infants to receive standardized STD diagnosis and treatment services, and the drug users in the drug maintenance treatment clinic to receive free syphilis testing, and to provide referral services for the syphilis antibody positive patients at AIDS voluntary counseling and testing points.

A cohort study on treatment outcomes of 1 447 cases with multidrug-resistant pulmonary tuberculosis / 公共卫生与预防医学

Objective To analyze the treatment outcomes of multidrug-resistant pulmonary tuberculosis (MDR-TB) cases in Hubei Province. Methods From October 2006 to June 2017, a retrospective cohort analysis of treatment outcomes for 1 447 patients with MDR-TB who were included in treatment was performed. Excel worksheet was created to establish database by monthly and quarterly reports. The statistical analysis of data was conducted using SPSS 21.0 software. Results Among 1 447 MDR-TB patients, 1 076 were males and 371 were females, with an average age of 44.44±14.28 years. 798 patients were cured, 63 patients completed the course of treatment, and the overall treatment success rate was 59.50% (861/1 447). The treatment success rate was68.02% (268/394) in newly diagnosed cases, and 56.32% (593/1 053) in relapse cases. There was a significance difference between the two groups (χ2=16.30，P2=26.65，P2=1.34，P=0.25). Conclusion It is extremely important to screen drug-resistant individuals for smear-positive patients, and to detect and treat drug-resistant patients timely. The negative conversion of sputum bacteria at the end of 6th month had important predictive significance for the treatment outcomes of MDR-TB patients. The patients with continued positive sputum at the end of 6th month should be closely monitored to adjust treatment according to the progress of the patient's condition and to explore a way to shorten the treatment course.

Analysis of post-marketing safety monitoring of split influenza virus vaccine based on large samples / 公共卫生与预防医学

Objective To evaluate the safety of a Chinese thimerosal-free trivalent split influenza virus vaccine after being marketed in a large population. Methods Through the information management system of adverse event following immunization (AEFI), the adverse events in healthy people aged 6 months and above who were vaccinated with split influenza virus vaccine in Hubei Province from October to December 2015 were collected. The data was analyzed by descriptive methodology. Results From October 1, 2015 to June 30, 2016, among the 227 920 people in Hubei Province who were vaccinated with split influenza virus vaccine, the common adverse reactions were mainly fever, redness, irritability, pain and itching. Four cases of AEFI were passively observed and reported in the system, with a reporting rate of 1.76/100 000, among which 3 cases were anaphylactic rash and 1 case was optic neuritis. Conclusion The Chinese thimerosal-free trivalent split influenza virus vaccine used in Hubei Province had a good safety record and is suitable for the general vaccination of people without vaccination contraindications.

The fMRI study of brain inhibitory control function difference between DRD2 gene subtype of heroin addicts / 实用放射学杂志

Objective To explore the difference in inhibitory control ability between DRD2 gene subtype of heroin addicts with fMRI.Methods Thirty-seven heroin-dependent patients were divided into DRD2 Taq IA+ group (A+,22)and matched DRD2 Taq IA-group (A-,15).Functional MRI was performed in all patients while they were executing an event-related go/nogo task at 3.0T MR scanner.The differences of brain activated images and behavioral data between the two groups were analyzed with SPM8 and SPSS1 6.0 software,respectively.Results There were no significant differences in reaction time,accuracy and false alarm rates between the two groups (P>0.05).Compared with A-group,weaker activation in the medial prefrontal cortex,dorsal anterior cingulate,middle cingulate,supplementary motor area,temporal lobe,fusiform gyrus,lingual gyrus,hippocampus and parahippocampal gyrus in response inhibition condition were demonstrated in A+ group (voxel number>228,t=2.11,Alphasim correction,P<0.05).There was no corrlation between the intensity within the activated brain regions and the usage of heroin,morphine urine test positive number(P>0.05).Conclusion DRD2 Taq IA+ group exist deactivation of the brain area on memory,inhibitory control,visual spatial attention. It may be the neural basis that contribute to easy addiction and relapse for A+ carriers.

The technical investigation of 3.0T multi-modal quantitative MR imaging in rabbit liver / 实用放射学杂志

Objective To investigate the technical requirements for the 3.0T multi-modal quantitative MR imaging of the rabbit liver.Methods A total of 8 rabbits were scanned and T1 mapping,T2 mapping,MT and Gd EOB-DTPA dynamic enhancement images were acquired.For the dynamic enhanced scanning,injecting contrast medium was followed by saline flush with different combinations of injection flow rate (1.5 mL/s and 2 mL/s) and injection volume(6 mL and 8 mL).The quality of the images was assessed and analyzed statistically.Results The total scanning time was about 20-25 min.High-quality images were acquired by T1 mapping,T2 mapping and MT sequences.There was no significant difference in image quality among different groups in Gd-EOB-DTPA dynamic enhanced scanning(P＞0.05).Two rabbits died when the combination of injection flow rate of 2 mL/s and injection volume of 8 mL was used.Conclusion 3.0 T multi-modal quantitative MR scanning of rabbit liver can be achieved successfully if scanning parameters are properly chosen.

Efficacy of intrathecal injection of vancomycin and dexamethasone in treating refractory purulent meningitis in children / 重庆医学

Objective To observe and investigate the efficacy and safety of combining with intrathecal injection of vancomycin and dexamethasone based on intravenous meropenem for treating refractory purulent meningitis in children.Methods Ninety children cases of refractory purulent meningitis from June 2014 to March 2015 were randomized into the observation group (45 cases) and control group (45 cases) according to the random number table method.The control group was given intravenous meropenem therapy,on this basis the observation group was added with intrathecal injection of vancomycin and dexamethasone.The changes of serum inflammatory markers and clinical efficacies after 7 d treatment were compared between the two groups,and the incidence rate of sequelae in the two groups were recorded after 3-months follow up.Results The descend ranges of TNF-a,CRP and PCT after 7 d treatment in the observation group were (87.3±21.8)pg/mL,(47.9±10.7)mg/L and (348.9J67.3)pg/mL,which were significantly higher than (61.5±18.5)pg/mL,(33.0± 7.9)mg/L,(263.7 ± 61.5)pg/mL in the control group(P＜0.05).There was statistically significant difference in clinical efficacy between the two groups (Z=2.086,P=0.037),the total effective rate in the observation group was 93.3 ％,which was higher than 82.2 ％ in the control group (x2 =2.589,P =0.108);the average treatment duration in the observation group was(12.8 ± 3.9)d,which was significantly less than (16.7 ± 4.7)d in the control group,the difference was statistically significant(t=4.216,P＜0.01).There were no statistically significant differences in the incidence rate of adverse drug reactions and sequelae between the two groups (P＞0.05).Conclusion With intrathecal injection of vancomycin and dexamethasone based on intravenous meropenem therapy for treating purulent meningitis,can further inhibit the inflammatory reaction,and increases clinical efficacy without significantly increasing adverse drug reactions.

Influence of Levetiracetam adjunctive therapy on cognitive function and life quality in school-age children with refractory epilepsy / 中国神经精神疾病杂志

Objective To examine the influence of LEV adjunctive treatment on cognitive function and life quality in RE school-age children. Methods Fifty-five cases of RE children were selected from our hospital from June 2013 to December 2015. Based on original treatment all children were added with LEV treatment for 16 weeks. The initial dose was 8~10 mg/(kg·d),and gradually increased to 50 mg/(kg·d). maintenance dose was 30 mg/(kg·d). Adverse drug reac?tions were recorded and clinical efficacies were determined after treatment. Wechsler Intelligence Scale for Children re?vised in China (WISC-CR) and quality of life in children with epilepsy (QOLCE) was used to evaluate children's cogni?tive function and children's life quality, respectvely. Results Average epilepsy attack frequencies after treatment (3.8± 1.3 vs. 6.6±2.3) times/month decreased significantly compared with before treatment (P<0.05). Clinical control ratio, ex?cellent ratio, effective ratio and ineffective ratio after treatment were 9.1%, 36.4%, 43.6%, 36.4%respectively and total effective ratio was 89.1%. The arithmetic score (10.9 ± 2.6 vs. 9.2 ± 2.1) and mapping score (15.1 ± 3.9 vs. 13.8 ± 3.3) in WISC- CR evaluation increased significantly (P<0.05). Life quality score (65.7 ± 5.7 vs. 62.8 ± 4.9) , cognitive function score (60.0 ± 5.7 vs. 57.4 ± 6.2) and social function score (65.0 ± 6.3 vs. 62.5 ± 5.5) after treatment in QOLCE evaluation in?creased significantly (P<0.05). During medication, the incidences of dizziness, fatigue, lethargy, irritability, euphoria and transient aminotransferase elevation were 12.7%, 9.1%, 20.0%, 9.1%, 3.6%and 3.6%respectively. Sixteen week medica?tion retention rate was 96.4%. Conclusion LEV adjunctive treatment can significantly reduce epilepsy attacks and im?prove cognitive function and life quality in RE children, but attention should be paid to LEV's influence on mental behavior.

The effects of methadone in functional connectivity of nucleus accumbens on heroin addicts:a resting state fMRI study / 实用放射学杂志

Objective To explore the effect of methadone maintenace treatment (MMT)in functional connectivity (FC)of nucleus accumbens (Nacc)on heroin addicts,and to identify the potential neuromechanism of MMT performing on heroin craving.Methods Craving scores and resting-state fMRI (rs-fMRI)were performed in 37 heroin addicts under MMT and 26 matched heroin addicts (HA) without any treatment.The rs-fMRI data preprocessing was performed by data processing assistant for rs-fMRI (DPARSF)soft-ware based on Matlab 2009a.Bilateral Naccs were set as regions of interesting (ROIs)respectively,and then the mean time series and other voxels within whole brain were analyzed by the rs-fMRI data analysis toolkit (REST).Intra-and inter-group analysis was performed with a single sample t-test and two sample t-test respectively.The partial correlation between the intensity of FC in brain regions showed abnormal FC and the duration/doses of methadone consumption was further investigated by SPSS.Craving scores were tested with two sample t-test.Results Inter-group analysis showed the FC of the right Nacc with left dorsal medial/lateral prefrontal cortex and right dorsal anterior cingulate was significantly increased in the MMT group in comparisonwith HA group,how-ever,it was decreased with right medial orbitofrontal cortex.The FC between the left Nacc and left dorsal medial/lateral prefrontal cortex,right dorsal lateral prefrontal cortex,right dorsal anterior cingulate and left insular cortex was also significantly increased in the MMT group (P 26,t=2.91).There were no regions with induced FC.The craving scores of MMT were signifi-cantly lower than those of HA (t = - 2.03,P <0.05 ).There was no significant correlation between the abnormal FC and the duration/doses of methadone consumption in MMT group.Conclusion MMT may influence the function of the nucleus accumbens through cognitive control and motivation/drive circuits,thereby reduce drug craving of heroin addicts.

Analysis of epidemiological characteristics of human rabies in Hubei Province from 2003 to 2007 / 中华疾病控制杂志

Objective To analyze the surveillance data from 2003 to 2007 for Hubei province,investigate the epidemic characteristics of human rabies in these years,so as to provide scientific basis for its control and prevention.Methods Rabies data collected from the National Disease Surveillance Reporting System from 2003 to 2007 in Hubei province and 134 Rabies cases investigated in 2007 were analyzed in detail.Results The results showed that the trend of the number of rabies reported cases in Hubei province was obviously increased from 2003 to 2007.The involved counties and districts of the epidemic situation were widely expanded accordingly.Each month had Rabies case,but a lot of cases were dominated in August to November for every year.Most of the cases were farmers and students.The sex ratio of male to female was 2.38∶1.The age of the cases were mainly ranged from 5 to 15 and from 40 to 70 years old.Investigation of 134 cases indicated that the median of the incubative period was 66 days;94.78% of cases were injured by the dog;only 15.67% of injured cases were treated by the medical institution;the vaccinate ratio was 14.93%;the proportion of patients who received wound treatment,vaccinate and passive immunization were 5.80% of all the grade-Ⅲ-exposed patients.Conclusions The epidemic situation of Rabies was serious from 2003 to 2007 for Hubei province.The main reasons of the increase of rabies cases in Hubei province are absence of the effective management of the dog,the lack knowledge of rabies prevention,low rate of vaccine and passive immunization after exposure,and the lack of the standardized management for some of the low level medical institutions.

MR Diffusion-Weighted Imaging and ADC Value Measurement in the Diagnosis of Breast Axillary Lymph Node Cancer / 医疗卫生装备

Objective To value diffusion-weighted imaging and ADC value measurement of benign and malignant axillary lymph node identification value. Methods From 2006-06 to 2008--02, by collecting in the hospital for breast dynamic con-trast-enhanced scans and diffusion-weighted imaging, 217 lesions in 56 cases with a clear outcome of the surgery and pathology and/or needle biopsy results were retrospectively analyzed.Results The DWI could accurately show the lymph node of the armpit abnormality, 163 cases of 47 breast cancer cases with lymph node metastasis showed high signal in DWI image that did not decrease with increasing b value, similar to the 54 cases of 9 benign enlarged responsive prolifer-ative lymph nodes. But the former showed higher signal than the later. The ADC values were(1.017±0.114)×10-3mm2/s and (1.905±0.136)×10-3mm2/s respectively, and showed significant difference between two groups (P<0.05). Conclusion The dynamic contrast-enhanced subtraction MR technology benign and malignant breast lesions has high diagnosis and differ-ential diagnosis importance. DWI and ADC value measurement is a safe, non-invasive, accurate and rapid diagnosis of metastasis axillary lymph nodes and benign proliferative response of the lymph nodes means.

Breast Cancer:The Early Enhanced Morphology in Three Dimensional Dynamic Contrast-Enhanced and Digital Subtraction MRI / 实用放射学杂志

Objective To study the value of the early enhanced morphology in three dimensional dynamic contrast-enhanced and digital subtraction MRI in diagnosing breast cancer.Methods Three dimensional dynamic contrast-enhanced and digital subtraction MRI of breast neoplasm in 46 patients(52 lesions)verified by histopathology were performed before operations.MR imaging data were analysed.On the base of early-phase enhanced rate,peak time,blood vessel morphology and time-signal intensity curve,the diagnostic values of the early enhanced morphology of lesions were evaluated.Results In the 37 malignant breast lesions,31 lesions were enhanced from the center to the margin(83.8%,31/37),14 benign breast lesions were enhanced from the margin to the center(93.3%,14/15).The special features of breast cancer in three dimensional dynamic contrast-enhanced and digital subtraction MRI were circular enhancement and the contrast medium filled from the margins to the centre of lesions in middle-later phase,its diagnostic sensitivity,specificity and accuracy were 97.3%,93.3% and 96.2% respectively.Conclusion The morphological features of three dimensional dynamic contrast-enhanced and digital subtraction MRI has obvious advantages in diagnosing breast cancer.

MRI Diagnosis of Bone Giant Cell Tumor / 实用放射学杂志

Objective To analse MRI appearances and diagnostic value of giant cell tumor of bone.Methods MRI features of giant cell tumor of bone proved by pathology in 14 cases were reviewed.Results The lesions located at distal femur in 7 cases,at approximal tibia in 3 cases,at distal humerus,approximal femur,thoracic vertebrae and sacrum in 1 case respectively.The characteristic appearances of MRI were cystic and solid masses,there was fluid-fluid level within tumors in company with bleeding.Tumors were slight low or low signal intensity on T1WI,slight high signal intensity on T2WI.Conclusion MRI is of significant value in diagnosis of bone giant cell tumor.

Clinical Applications of MR Whole Spine Imaging with Total Imaging Matrix / 医疗卫生装备

Objective To study the values of MR whole spine imaging with TIM(Total Imaging Matrix) technique in diagnosing spine and spinal cord diseases.Methods Eighty-five patients who were suspected having spine diseases underwent whole spine MR.High resolution MR is performed when a local lesion was found on a Avanto 1.5T MR system(Siemens Company) by using different TIM in coils combination with automatic moving table and no-gap composing techniques.Results All 75 cases can be obtained clear images of total spine and spinal cord.In the all of 75 cases whole spine MR,the results show that normal in 15 cases,vertebral diseases in 41 cases,and spinal cord diseases in 19 cases.Conclusion The MR whole spine imaging with total imaging matrix has shorter scanning time and better image quality,position and nature of high accuracy,resolved the controversy of imaging covering and resolution.It can be improved the accuracy in diagnosing spine and spinal cord diseases.

Diagnostic Value on Mammary Gland Focal Benign and Malignant with MRI Digital Subtraction / 医疗卫生装备

Objective To study the diagnostic value on mammary gland focal benign and malignant with MRI digital sub- traction. Methods By analyzing 109 histopathology cases of breast neoplasm which can be use three dimensional dynamic contrast and MRI digital subtraction. Based on early-phase enhancement rate peak time, time-signal intensity curve and enhanced lesions way, the diagnostic value on it was evaluated. Results The specificity signs of breast carcinoma are en- hanced ways on MRI enhancement scanning. The filling type is contrast agent filled from edge to centre. The sensitivity is 82.9%; specificity is 79.0%; accurate rate is 80.7%. Conclusion The aggrandizement form on filling type of breast MRI digital subtraction scanning focus has obvious advantages in breast carcinoma diagnosis.