Influencing factors for first cases of varicella aggregation outbreaks in primary school in Pudong New Area of Shanghai / 上海预防医学

Objective To investigate influencing factors of the first cases of varicella outbreaks in primary school in Pudong New Area of Shanghai and to provide scientific evidence for effective prevention and control measures against it. Methods The first 80 cases of varicella outbreaks in primary school in Pudong New Area were included for the case-control study.Immunization history, outing activities and information of out-of-school training were gathered.Univariate and multivariate conditional logistic regression analysis were adopted for data analysis. Results Multivariate analysis revealed that varicella vaccination period(OR=0.08, 95%CI:0.01-0.44)was the protective factor for the first case in a varicella outbreak, while weekly frequency of visits to large commercial/supermarkets (OR=4.79, 95%CI:1.86-12.34)and weekly attendance at out-of-school training(OR=1.84, 95%CI:1.01-3.35)were risk factors of the disease. Conclusion It is important to promote the current varicella vaccine immunization strategy, to strengthen the disinfection and health education of large commercial/supermarkets and to strengthen infectious disease management, disease prevention guidance and supervision in out-of-school training institutions.

Study on the etiology of rash and fever illness in Pudong New Area of Shanghai from 2010 to 2017 / 中华疾病控制杂志

Objective To investigate the pathogens spectrum and epidemiological characteristics of rash and fever illness (RFIs) from January 2010 to December 2017 in Pudong New Area, in order to provide scientific evidence for the prevention and control ofRFIs.Methods Enzyme-linked immunosorbent assay and real-time fluorescence quantitative polymerase chain reaction were used to detect the pathogens of enterovirus, measles virus, rubella virus and others from 2 831 clinical samples, and statistical analysis was performed.Results Pathogens were found in 1 633 samples in total, accounting for 68.59%. The top 4 viruses in the pathogen spectrum were enterovirus (52.54%), measles virus (28.54%), rubella virus (13.04%), and varicella-zoster virus (3.37%). There was significnat difference in the detection rate of rubella pathogens among patients of different genders(P=0.026). In the pathogen spectrum of infections of different age groups, the detection rate of enteroviruses at the age of 3-6 years was higher than that of other age groups. The detection rate of varicella-zoster virus at the age of 6-18 years old was higher than that of other age groups. The detection rate of virus including measles virus, rubella virus, dengue virus and small DNA virus in age of 18 and older was higher than that of other age groups. There was significant difference in the detection rate of pathogens in different age groups (all P<0.05).The incidence of RFIs was the highest in spring (41.52%) and the lowest in winter (15.00%). There was a statistical difference in the detection rate of enterovirus, measles, rubella and dengue virus in different seasons (P<0.05).Conclusions Enteroviruses and measles viruses are the main pathogens leading to RFIs in Pudong New Area, and the activity level of RFIs pathogens should be monitored for a long time.

Progress on medication-related osteonecrosis of the jaw / 华西口腔医学杂志

Medication-related osteonecrosis of the jaw (MRONJ) is a severe complication of bisphosphonates (BPs) or other targeted agent therapies. MRONJ appears as exposed bone, pus, and swelling in the oral and maxillofacial regions. However, neither surgery nor conservative therapy can eliminate symptoms thoroughly. In addition to BPs, several antiresorptive and antiangiogenic agents, such as denosumab and bevacizumab, as well as targeted agents, such as sunitinib and temsirolimus, can cause osteonecrosis of  the  jaw according to the literature. This review aims to summarize the research progress on these new drugs.

Risk factors for recurrence of large atherosclerotic cerebral infarction / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the risk factors for recurrence of large atherosclerotic cerebral infarction in first?episode patients.</p><p><b>METHODS</b>The consecutive patients with acute cerebral infarction diagnosed in the Department of Neurology were screened for large atherosclerotic cerebral infarction by CTA/MRA examination, and all the confirmed patients were followed up for 1 year. The patients were divided into recurrent ischemic stroke group and non?recurrent group according to occurrence of cerebrovascular events during the follow?up.</p><p><b>RESULTS</b>A total of 256 eligible patients were included in this study, and all of them completed the follow?up. During the 1?year follow?up, 30 (11.7%) patients had ischemic cerebrovascular stroke events. Univariate analysis showed significant differences in alcohol drinking (P=0.028), smoking (P=0.007), high?density lipoprotein cholesterol (HDL; P=0.045), ischemic heart disease (P=0.002), antihypertensive agents (P=0.036) and statin use (P=0.016) between the recurrent group and non?recurrent group. Cox regression analysis showed that irregular use of statins (RR=0.410, P=0.043), smoking (RR=2.253, P=0.043), HDL (RR=0.327, P=0.029), and ischemic heart disease (RR=8.566, P<0.001) were correlated with recurrent ischemic stroke.</p><p><b>CONCLUSION</b>The first?episode patients with irregular use of statins, low HDL levels, smoking and ischemic heart disease are at higher risks for having ischemic stroke recurrence.</p>

Antireflux anastomosis following resection of esophageal cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the antireflux effects of a modified Nissen fundoplication following esophagectomy for cancer.</p><p><b>METHODS</b>From March 2006 to March 2007, 70 patients with esophageal cancer were divided into two groups randomly. Esophagogastrostomy with a stapler only was perform in 35 patients as controls (group C), and a modified Nissen fundoplication was added after esophagogastrostomy with stapler in the other 35 patients as observed group (group O). There were 48 male and 22 female, ranging in age from 47 to 77 years (mean 60.1 years). The operative morbidity and mortality were recorded. Fourty-nine patients were followed at 3 months after surgery, and the questionnaire of life quality (EORTC QLQ C-30) was conducted in 24 patients in group C and 25 patients in group O. Thirty patients were examined with esophageal manometry, 24 h pH monitoring and gastroscopy. There were 16 patients in group C and 14 patients in group O.</p><p><b>RESULTS</b>There was no significant difference in postoperative morbidity between the two groups (P > 0.05). However, the scores of heart burn and regurgitation in the group O were less than in group C (P = 0.041 and 0.034 respectively), but there was no difference in scores of dysphagia between the two groups (P = 0.677). The pressure at the anastomotic site was higher than that in the stomach in group O (P = 0.032), but not in group C (P = 0.448). DeMeester score in group O was 53 ± 46, compared to 140 ± 103 in group C (P = 0.043). The score of esophagitis was 0.9 ± 0.8 in group O, which was lower than 1.6 ± 1.0 in group C (P = 0.041).</p><p><b>CONCLUSIONS</b>Addition of modified Nissen fundoplication after esophagectomy and esophagogastrostomy for cancer significantly increases the pressure at the anastomotic site, thus reduces the extent of gastroesophageal reflux, which leads to the reduction of the extent of reflux esophagitis and the improvement of the quality of life.</p>

Biochemical pathways in the antiatherosclerotic effect of berberine / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>This study investigated the inhibitory effect of berberine (BBR) on lipopolysaccharide (LPS) induced cyclooxygenase-2 (COX-2) expression via the mitogen activated protein kinase (MAPK) signalling cascade pathways in human peripheral blood monocytes (PBMC).</p><p><b>METHODS</b>PBMC from whole blood were isolated and cultured for up to 24 hours after division into 5 groups treated with LPS, LPS + BBR 25 micromol/L, LPS + BBR 50 micromol/L or LPS + BBR 100 micromol/L and untreated. Monocytes were extracted for RT-PCR and Western blot analyses to examine COX-2 mRNA and protein activated expression of p38 mitogen activated protein kinase (p38MAPK), Jun N-terminal kinase (JNK) and extracellular regulated kinases 1/2 (ERK1/2) signalling pathways.</p><p><b>RESULTS</b>COX-2 mRNA and protein expression decreased to a minimum at 12 hours after BBR treatment (P < 0.05). With the increasing concentration of BBR treatment, the COX-2 expression decreased progressively (P < 0.01). With BBR treatment for 6, 12 or 24 hours at three doses, ERK1/2 protein expression was significantly inhibited. For the JNK pathway, only with the treatment of BBR at the concentration of 100 micromol/L was JNK protein expression inhibited compared with the LPS stimulation group (P < 0.01). Irrespective of the BBR concentration, no difference was shown between the BBR group and the LPS group for p38MAPK protein expression. Human monocytes COX-2 mRNA, by RT-PCR, and protein expression, by Western blot analysis, were inhibited when incubated with PD98059, SP600125 and SB203580 (P < 0.05).</p><p><b>CONCLUSIONS</b>Berberine inhibits COX-2 expression via the ERK1/2 signalling pathway and, possibly, at a high dosage via the JNK pathway. P38MAPK may have no relationship with the effect of BBR in PBMC. Berberine inhibited COX-2 mRNA and protein expression in a dose dependent manner and suppressed COX-2 expression to a minimal level after 12 hours of berberine treatment.</p>

Effects of aspirin on atherosclerosis and the cyclooxygenase-2 expression in atherosclerotic rabbits / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Atherosclerosis is a complex vascular inflammatory disease. Aspirin is a mainstay in the prevention of vascular complications of atherosclerosis. In this study, the effectiveness of aspirin in suppressing atherosclerosis and the inflammation process was evaluated in rabbits fed with a high fat diet.</p><p><b>METHODS</b>Eighteen male New Zealand rabbits were randomly divided into 3 groups: control group, untreated cholesterol-fed group, aspirin treated cholesterol-fed group, which were fed for 12 weeks. After 12 weeks, the aorta was harvested for pathologic morphology observation. Immunohistochemical analysis of cyclooxygenase-2 (COX-2), macrophage and vascular smooth muscle cell (VSMC) was performed. The statistical analysis was performed by the statistical program SPSS10.0.</p><p><b>RESULTS</b>The aorta plaque/intima size (P/I) by pathologic morphology observation was 0%, (59.6 +/- 13.7)% and (36.3 +/- 16.5)% in the control, untreated cholesterol-fed group and aspirin treated group, respectively. The maximum plaque thickness, the degree of artery stenosis and the proportion of the intimal circumference occupied by atheroma of the 3 groups were significantly different from each other (P < 0.01). The expression of COX-2 and macrophage in plaque of the aspirin treated group were decreased compared with that in untreated cholesterol-fed group. However, no difference was found in the expression of VSMC between the aspirin treated and the untreated cholesterol-fed group.</p><p><b>CONCLUSION</b>The mechanism of atherosclerosis suppression by aspirin in cholesterol-fed rabbits is related to the inhibition of COX-2 expression together with the reduced inflammation followed by, but not related to the hypolipidemic effects.</p>

Long-term outcome of antireflux surgery for gastroesophageal reflux disease / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the long-term outcomes of various antireflux procedures for gastroesophageal reflux disease (GERD).</p><p><b>METHODS</b>Between November 1988 and January 2004, 129 patients with GERD underwent antireflux procedures. Six kinds of antireflux procedures were performed including Nissen fundoplication, cardiac oblique invagination (COI) procedure, Belsey Mark IV, Toupet, Thal and Dor procedures. One hundred and sixteen patients were followed up. Esophageal manometry study was carried out in 95 patients preoperatively and 51 postoperatively. 24-hour esophageal pH monitoring were carried out in 56 patients preoperatively and 35 postoperatively. Esophagoscopy were performed in all patients before operation and 48 cases after operation.</p><p><b>RESULTS</b>Clinical symptom scores reduced significantly from 4.1 +/- 0.4 before surgery to 1.1 +/- 1.0 after surgery (t = 27.21, P < 0.01). The outcome of surgery showed excellent in 42 cases (36.2%), good in 60 (51.7%), fair in 7 (6.0%), poor in 7 (6.0%). The long-term follow-up showed excellent or good results in 87.9% of patients. There was no significant difference in Nissen fundoplication, COI procedure and Belsey Mark IV.</p><p><b>CONCLUSIONS</b>There are significant differences in symptom score, esophageal manometry, 24-hour esophageal pH monitoring and esophagoscopy pre- and post-operatively. There is no significant difference in Nissen fundoplication, COI procedure and Belsey Mark IV.</p>

Meta-analysis of defibrase in treatment of acute cerebral infarction / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Fibrinogen-depleting agents are promising in the treatment of cerebral ischemic disease. They were studied by many trials, and the outcomes were different because of different regimens and different doses. In this study, we assessed the efficacy and safety of defibrase on acute cerebral infarction in China.</p><p><b>METHODS</b>A search using Chinese hospital knowledge database (CHKD) and MEDLINE database for randomized controlled trials was carried out. A CHKD (1994 June 2005) search was performed with the keyword "defibrase", then a second search for the keyword "acute cerebral infarction"; a MEDLINE search (1950 June 2005) was performed with the following keywords: [(cerebral ischemia), OR (acute cerebral infarction), OR (stroke)], AND [defibrase]. Meta-analysis was performed with RevMan software 4.2.</p><p><b>RESULTS</b>Included were 14 studies comparing the efficiency and safety of defibrase with other drugs in the treatment of acute cerebral infarction. Patients' records were pooled (total 646 patients; defibrase, n = 328, no defibrase n = 318). Neurological deficit score (NDS) before treatment showed weighted mean differences (WMD) = 0.95, 95% confidence interval (CI) = (-0.60, 2.50), P = 0.23; NDS after treatment showed WMD = -2.20, 95% CI = (-4.21, -0.18), P = 0.03; Barthel index at 3 months showed WMD = 4.45, 95% CI = (-0.13, 9.03), P = 0.06; the plasma fibrinogen level before treatment showed WMD = 0.02, 95% CI = (-0.16, 0.19), P = 0.86; plasma fibrinogen level after treatment showed WMD = -1.51, 95% CI = (-1.88, -1.15), P < 0.00 001.</p><p><b>CONCLUSIONS</b>With the given dose and regimen of defibrase in China, defibrase may play a role of anticoagulation. It might inhibit the progression of stroke and prevent the recurrence of stroke.</p>

Surgical treatment for esophageal perforation or rupture / 中华胸心血管外科杂志

Objective To review the experience of surgical therapy for 113 patients with esophageal perforation or rupture re- suiting from different causes.Methods The causes resulting in esophageal perforation or rupture were summarized and the outcome of conservative and operative therapy were compared.Meanwhile,the outcome and mortality of operative therapy within or beyond 24 hours were compared.Results Twenty-eight patients with esophageal perforation or rupture occurring in the neck were all cured sue- cessfully.As for 85 patients with esophageal perforation or rupture in the chest,the curative rate of operative therapy(83.0%)was greater than that of conservative therapy(68.7 %)(P