Percutaneous pedicle screw fixation combined expandable tubular retractor in the treatment of spinal metastases / 北京大学学报(医学版)

OBJECTIVE@#To investigate the effectiveness of percutaneous pedicle screw fixation combined expandable tubular retractor in the treatment of patients with spinal metastases.@*METHODS@#In the study, 12 patients of spinal metastases treated with percutaneous pedicle screw fixation combined expandable tubular retractor in our hospital were retrospectively reviewed between June 2017 and October 2019. Among the 12 patients, 9 were males and 3 were females; the median age was 62.5 years [(65.1±2.9) years]. The decompression segment of 7 patients was located at the lower thoracic spine (including 1 patient with incomplete paraplegia) and the decompression segment of 5 patients was located at the lumbar spine; Tomita score was 6.0±0.6. Perioperative data of the patients were reviewed. Visual analog scale (VAS score), Karnofsky score, and Eastern Cooperative Oncology Group (ECOG) score were compared before and after surgery. The patient's survival, adjuvant treatment, and internal fixation failure were observed in the follow-up period.@*RESULTS@#All the 12 patients had a successful operation with percuta-neous pedicle screw fixation combined expandable tubular retractor. The average operative time, blood loss, and blood transfused of the patients were (247.0±14.6) min, (804.2±222.3) mL and (500.0±100.0) mL, respectively. The average amount of drainage was (240.8±79.3) mL. Drainage tubes were pulled out early postoperative [(3.2±0.3) d], allowing early mobilization. The patients discharged (7.8±0.8) d postoperative. All the patients were followed up for 6-30 months, and the average overall survival time was (13.6±2.4) months. During the follow-up period, 2 patients experienced screw displacement, the internal fixation was stable after conservative treatment and no revision surgery was performed. The VAS of the patients was 7.1±0.2 before surgery, which decreased to 2.3±0.1 and 2.8±0.4 at 3 and 6 months after surgery (P < 0.05). The Karnofsky score of the patients was 59.2±1.9 before surgery, which increased to 75.0±1.9 and 74.2±3.1 at 3 and 6 months after surgery (P < 0.05). The ECOG of the patients was 2.3±0.2 before surgery, which decreased to 1.7±0.1 and 1.7±0.2 at 3 and 6 months after surgery (P < 0.05).@*CONCLUSION@#For selected patients with spinal metastases, minimally invasive surgical treatment of spinal metastases (percutaneous pedicle screw internal fixation combined with expandable tubular retractor) can effectively relieve the clinical symptoms and improve the quality of life, with satisfactory clinical outcome.

Evaluation of teaching effect of opening experiments on occupational health and occupational medicine / 中华医学教育探索杂志

Objective:To carry out opening experiments on occupational health and occupational medicine for students majoring in preventive medicine, reform the experimental teaching mode, and explore the teaching methods to improve students' professional quality and scientific research ability.Methods:Opening experiments were carried out in the experimental course of occupational health and occupational medicine for students of preventive medicine major. A total of 147 students majoring in preventive medicine of Batch 2016 were classified as the control group, and the routine confirmatory experiment was carried out in the group; 176 students majoring in preventive medicine of Batch 2017 were classified as the experimental group, and this group carried out opening experiment. The evaluation was made from three aspects: comprehensive evaluation results, teacher self-evaluation and student satisfaction survey. SPSS 22.0 software was used for analysis and comparison by independent-samples t-test and Chi-square test. Results:The theoretical scores of the experimental group and the control group students were (84.37±10.45) vs. (81.44±9.22) ( t=2.68, P=0.008), and the experimental skills scores were (93.66±3.89) vs. (88.41±5.67) ( t=9.51, P<0.001). Questionnaire investigation showed that the students in the opening experimental group were more satisfied with the courses arrangement ( χ2=8.31, P=0.004), group cooperation ( χ2=21.10, P<0.001), assessment form ( χ2 =7.92, P=0.005), improvement of the writing ability of scientific research papers ( χ2 =17.56, P<0.001), improvement of practical skills ( χ2=11.70, P=0.001), logical thinking, language organization and expression ability ( χ2=10.33, P=0.001). They considered the opening experiment was helpful to cultivate innovative thinking and ability, but it had limited effect on the cultivation of employment advantages. And the students considered the opening experiments of setting up professional courses was sufficient and necessary. Conclusion:Carrying out opening experiments for students majoring in preventive medicine is helpful to improve students' professional quality and cultivate their practical ability and scientific research ability.

Real-world study on the efficacy and prognostic predictive biomarker of patients with metastatic non-small cell lung cancer treated with programmed death-1/programmed death ligand 1 inhibitors / 中华肿瘤杂志

Objective: To describe the actual efficacy of programmed death-1 (PD-1)/ programmed-death ligand 1 (PD-L1) inhibitors in patients with metastatic non-small cell lung cancer (NSCLC) and explore potential prognostic predictive biomarkers. Methods: Patients with metastatic NSCLC who were treated with PD-1/PD-L1 inhibitors at Cancer Hospital, Chinese Academy of Medical Sciences from January 2016 to December 2019, either as monotherapy or in combination with other agents, were consecutively enrolled into this study. We retrospectively collected the data of demographics, clinical information and pathologic assessment to evaluate the therapeutic efficacy and conduct the survival analysis. Major endpoint of our study is progression-free survival (PFS). Secondary endpoints include objective response rate (ORR), disease control rate (DCR) and overall survival (OS). Results: The ORR of 174 patients who underwent PD-1/PD-L1 inhibitor was 28.7%, and the DCR was 79.3%. Immune-related adverse events (irAEs) occurred in 23 patients (13.2%). Brain metastasis, line of treatment, and treatment patterns were associated with the ORR of metastatic NSCLC patients who underwent immunotherapy (P<0.05). After a median follow-up duration of 18.8 months, the median PFS was 10.5 months (ranged from 1.5 to 40.8 months) while the median OS was not reached. The 2-year survival rate was estimated to be 63.0%. The pathologic type was related with the PFS of metastatic NSCLC patients who underwent immunotherapy (P=0.028). Sex, age, brain metastasis and autoimmune diseases were associated with OS (P<0.05). Analysis of the receptor characteristic curve (ROC) of neutrophil/lymphocyte ratio (NLR) predicting ORR of immunotherapy in metastatic NSCLC showed that the areas under the curve of NLR before immunotherapy (NLR(C0)), NLR after one cycle of immunotherapy (NLR(C1)) and ΔNLR were 0.600, 0.706 and 0.628, respectively. Multivariate logistic regression analysis showed that NLR(C1) was an independent factor of the ORR of metastatic NSCLC patients who underwent immunotherapy (OR=0.161, 95% CI: 0.062-0.422), and the efficacy of combination therapy was better than that of single agent (OR=0.395, 95% CI: 0.174-0.896). The immunotherapy efficacy in patients without brain metastasis was better than those with metastasis (OR=0.291, 95% CI: 0.095-0.887). Multivariate Cox regression analysis showed that NLR(C1) was an independent influencing factor of PFS of metastatic NSCLC patients after immunotherapy (HR=0.480, 95% CI: 0.303-0.759). Sex (HR=0.399, 95% CI: 0.161-0.991, P=0.048), age (HR=0.356, 95% CI: 0.170-0.745, P=0.006) were independent influencing factors of OS of metastatic NSCLC patients after immunotherapy. Conclusions: PD-1/PD-L1 inhibitors are proved to be efficacious and have tolerable toxicities for patients with metastatic NSCLC. Patients at advanced age could still benefit from immunotherapy. Brain metastasis is related to compromised response. Earlier application of immunotherapy in combination with other modalities enhances the efficacy without elevating risk of irAEs. NLR(C1) is an early predictor of clinical outcome. The OS of patients younger than 75 years may be improved when treated with immunotherapy.

Epidemiological characteristics of hemorrhagic fever with renal syndrome in Xi'an from 2009 to 2018 / 中华地方病学杂志

Objective:To analyze the epidemiological characteristics and tendency of hemorrhagic fever with renal syndrome (HFRS) in Xi'an, master its popular and development laws, and provide scientific basis for formulating targeted prevention and control measures.Methods:The retrospective method was used to collect HFRS epidemic data and demographic data from 2009 to 2018 in Xi'an. The descriptive epidemiological method was used to analyze the three distributions (time, region, population distributions) of HFRS.Results:There were 8 710 HFRS cases in Xi'an from 2009 to 2018, with an average annual incidence of 10.13/100 000 and an average annual mortality rate of 0.08/100 000; the incidence of HFRS had decreased year by year since the peak incidence in 2010 (19.46/100 000), and had rebounded in 2017 (9.14/100 000), 2018 (9.04/100 000). The time distribution of the onset of HFRS was bimonthly, with peak in autumn and winter (October to January of following year) each year, accounting for 74.08% (6 452/8 710) of the total number of cases; the peak in spring and summer (May to July) accounted for 14.33% (1 248/8 710). HFRS cases were mainly concentrated in Chang'an District (2 446 cases), Zhouzhi County (1 494 cases), Hu County (1 170 cases), and Lintong District (940 cases), accounting for 69.46% (6 050/8 710). The age of onset of HFRS cases was mainly concentrated in 15-59 years old, accounting for 74.06% (6 451/8 710); the incidence rate in males was 14.77/100 000, in females was 5.25/100 000, the difference was statistically significant between gender (χ 2=1 921.42, P < 0.05); the occupational distribution was mainly farmers, accounting for 68.38% (5 956/8 710). Conclusions:From 2009 to 2016, the HFRS epidemic situation in Xi'an has showed a downward trend, and the incidence of HFRS has rebounded in 2017-2018. Xi'an should continue to take active and effective comprehensive measures to intervene to further realize effective control of HFRS.

Treatment of pulmonary fibrosis in one convalescent patient with corona virus disease 2019 by oral traditional Chinese medicine decoction: A case report / 中西医结合学报

After one-month of oral treatment with traditional Chinese medicine decoction, without using other drugs, the lung inflammatory exudate, pulmonary fibrosis and quality of life of a 61-year-old female patient with corona virus disease 2019 (COVID-19) were significantly improved. No recurrence or deterioration of the patient's condition was found within seven weeks of treatment and follow-up, and no adverse events occurred, indicating that oral Chinese medicine decoction was able to improve the pulmonary inflammation and fibrosis in a patient recovering from COVID-19, but further research is still needed.

Diagnosis and treatment of 15 cases of idiopathic subglottic stenosis / 临床耳鼻咽喉头颈外科杂志

The aim of this study is to o explore the diagnosis, treatment and prognosis of idiopathic subglottic stenosis （ISS） The clinical data of 15 patients with idiopathic subglottic stenosis treated in our department were analyzed retrospectively. The degree of stenosis was classified by the Cotton Airway grading system of Myer, with 8 cases of gradeⅡ, 4 cases of grade Ⅲ and 3 cases of grade Ⅳ. The time of follow-up of HTSS was 0.5-10 years. All 15 patients were successfully extubated without asphyxia, decannulation and wound nonunion. For patients with idiopathic subglottic stenosis in the non-progressive stage, active surgical treatment strategy should be adopted and treated individually. The prognosis is satisfactory.

Diagnosis and treatment of 15 cases of idiopathic subglottic stenosis / 临床耳鼻咽喉头颈外科杂志

Objective@#The aim of this study is to o explore the diagnosis, treatment and prognosis of idiopathic subglottic stenosis （ISS） @*Method@#The clinical data of 15 patients with idiopathic subglottic stenosis treated in our department were analyzed retrospectively. The degree of stenosis was classified by the Cotton Airway grading system of Myer, with 8 cases of gradeⅡ, 4 cases of grade Ⅲ and 3 cases of grade Ⅳ. @*Result@#The time of follow-up of HTSS was 0.5-10 years. All 15 patients were successfully extubated without asphyxia, decannulation and wound nonunion. @*Conclusion@#For patients with idiopathic subglottic stenosis in the non-progressive stage, active surgical treatment strategy should be adopted and treated individually. The prognosis is satisfactory.

Analysis of influencing factors for pathogen culture result in patients with pyogenic spondylitis / 北京大学学报(医学版)

OBJECTIVE@#To investigate the effect of clinical factors on the pathogen culture results in the patients with pyogenic spondylitis, and to find out clinical controllable factors which could increase the positive rate of the pathogen culture.@*METHODS@#A retrospective study reviewed 40 patients who were diagnosed with pyogenic spondylitis in Peking University First Hospital from January 2011 to July 2017. The patients were divided into two groups depending on the culture results, culture negative or culture positive. The influence of clinical uncontrollable factors [the patient's age, gender, predisposing factors, infection site except spine, visual analogue score (VAS), course of disease, spinal segment, white blood cell (WBC), (neutrophilic granulocyte)% (NE%), the incidence of systemic inflammatory response syndrome (SIRS), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), the incidence of paravertebral abscess] and controllable factors (prior antibiotics exposure within 2 weeks, tissue homogenate, surgical approach) on pathogen culture results were analyzed.@*RESULTS@#Of the 40 patients, 18 patients were female and 22 patients were male. Causative germ was identified in 24/40 patients (60.00%) and dominant by gram positive cocci (68.00%). For clinical uncontrollable factors, there was no significant difference between the two groups in the patient's age, gender, predisposing factors, infection site except spine, VAS, course of disease, spinal segment, WBC, NE% and the incidence of SIRS. ESR [(94.38±6.91) mm/h, P=0.023)], CRP [(64.74±13.51) mg/L, P=0.040], and the incidence of paravertebral abscess (75%, P=0.018) in culture negative group were lower in contrast to culture positive group. For clinical controllable factors, prior antibiotics exposure within 2 weeks (P=0.058, OR=4.030, 95%CI: 0.956-16.993) and tissue homogenate (P=0.014, OR=0.171, 95%CI: 0.042-0.695) were significantly associated with the pathogen culture result. Surgical approach was not significantly associated with pathogen culture result.@*CONCLUSION@#Patients with high level of ESR, CRP, and paravertebral abscess, would have high positive rate of pathogenic culture. Prior antibiotics exposure was associated with lower positive pathogen culture rate. Culture with tissue homogenate was more likely to find the causative germ, especially for patients without paravertebral abscess who had low level of ESR, CRP and prior antibiotics exposure.

Perioperative clinical characteristics of patients with pathological fracture of proximal femur / 北京大学学报(医学版)

OBJECTIVE@#To investigate the perioperative clinical characteristics of patients with pathological fracture of proximal femur.@*METHODS@#A retrospective study reviewed 28 patients who received proximal resection and tumor hemiarthroplasty for malignant proximal femoral tumor in Peking University First Hospital from January 2011 to February 2017. According to the fracture, the patients were divided into two groups: pathological fracture group and non-pathological fracture group. We investigated the clinical characteristics during perioperative period between the two groups.@*RESULTS@#Of the 28 patients, 14 (50.0%) patients suffered pathological fracture, and there was no significant difference between the two groups in the patient's age, gender, limb involvement, and tumor source (P>0.05). There was no significant difference between the two groups in hemoglobin (HGB), hematocrit (Hct), and lower extremity thrombosis. The albumin (ALB) of pathological fracture group were lower in contrast to non-pathological fracture group (P=0.031). There was no significant difference between the two groups in decline of HGB and Hct on postoperation day 1, operative time, bleeding during operation, time for walking with help of ambulation aid postoperative, and postoperative hospital stay (P>0.05). On post-operation day 7, HGB (P=0.025) and Hct (P=0.039) of pathological fracture group were significant lower in contrast to non-pathological fracture group. Whereas, the total blood loss calculated by Gross equation of pathological fracture group was significant higher in contrast to non-pathological fracture group [(2 066.3±419.8) mL vs. (786.0±152.6) mL, P=0.039]. The patient needed blood transfusion during operation (7/14 vs. 1/14, P=0.033) and postoperative (8/14 vs. 1/14, P=0.013) in pathological fracture group were more than in non-pathological fracture group. At last, Barthel daily life ability score (P=0.009) of pathological fracture group was lower in contrast to non-pathological fracture group, and visual analogue scale (VAS) score was higher (P<0.001). They were almost equal when the patients were discharged (P>0.05).@*CONCLUSION@#Patients with pathological fracture had lower ALB during perioperative period. Pathological fracture had no effect on operative time, bleeding during operation and function outcomes. However, the patients with pathological fracture had more total blood loss and lower HGB, Hct in contrast to the patients without pathological fracture. Blood transfusion was more needed in pathological fracture patients.

Expressions of serum miRNA-126 and miRNA-30c in patients with pancreatic cancer and their clinical significances / 肿瘤研究与临床

Objective@#To investigate the expressions of serum miRNA-126 (miR-126) and miRNA-30c (miR-30c) in patients with pancreatic cancer, and to analyze the relationship with the occurrence of pancreatic cancer as well as the diagnostic value.@*Methods@#A total of 110 patients with pancreatic cancer diagnosed at the 928th Hospital of the Joint Service Support Force of PLA from January 2014 to December 2018 were selected, and 110 healthy people were also selected as the control group. The expression levels of serum miR-126 and miR-30c of 110 patients and the healthy controls were detected by using real-time quantitative polymerase chain reaction (qRT-PCR), and their relationship with clinicopathological features of pancreatic cancer was analyzed.@*Results@#The levels of serum miR-126 and miR-30c in pancreatic cancer group were lower than those in the healthy control group (0.43±0.12 vs. 1.02±0.27, t = 19.394, P < 0.01; 0.52±0.17 vs. 1.04±0.31, t = 15.426, P < 0.01). There was a positive correlation between levels of serum miR-126 and miR-30c in patients with pancreatic cancer (r = 0.399, P < 0.01). Expression levels of serum miR-126 and miR-30c were not correlated with age, gender and body mass index (BMI) of pancreatic cancer patients (all P > 0.05), but related with tumor size, differentiation degree, TNM stage and lymph node metastasis (all P < 0.05). High expression levels of serum miR-126 and miR-30c were protective factors for pancreatic cancer (all P < 0.05), while smoking, drinking and gallstones were risk factors for pancreatic cancer (all P < 0.05). The area under the curve of combined detection of serum miR-126 and miR-30c for diagnosis of pancreatic cancer was 0.906, the sensitivity was 90.80%, and the specificity was 82.20%.@*Conclusions@#The expression levels of serum miR-126 and miR-30c in patients with pancreatic cancer are low. Both of them may be involved in the occurrence and development of pancreatic cancer, and may be used as early diagnostic markers of pancreatic cancer.

Clinical Study on Middle-late Non-small Cell Lung Cancer Treated with Therapy of Strengthening Qi, Resolving Phlegm and Dissipating Mass / 广州中医药大学学报

Objective To observe the clinical effect of therapy of strengthening Qi, resolving phlegm and dissipating mass for middle-late non-small cell lung cancer. Methods Sixty patients with middle-late non-small cell lung cancer were randomly divided into 3 groups according to the results of intention-to-treat and genetic test. All of the 3 groups were given fundamental supportive and asymptomatic treatment, and additionally Group Ⅰ was mainly given oral use of Jinfuan Decoction with the actions of strengthening Qi, resolving phlegm and dissipating mass based on syndrome differentiation, group Ⅱ was treated with molecular targeted therapy with Gefitinib Tablets and /or Erlotinib Hydrochloride Tablets, and groupⅢ was only given the fundamental supportive and asymptomatic treatment. The 3 groups were treated for 3 cycles(84 days), and then we compared the tumor size, clinical symptoms, quality of life, distant metastasis, and the toxic and adverse effect in each group. Results (1) GroupⅠand group Ⅱhad stronger effect on relieving cough, shortness of breath and lassitude than groupⅢ(P<0.05); groupⅡand groupⅢwere more effective on relieving bloody sputum and chest pain than groupⅠ(P<0.05); groupⅠand groupⅢwere more effective on relieving fever than groupⅡ(P < 0.05). (2) In aspect of quality of life, KPS scores of groupⅠand group Ⅱwere much increased after treatment (P < 0.05), but the scores of group Ⅲ showed no obvious increase (P > 0.05). The improvement of KPS scores in groupⅠand groupⅡwas superior to that in groupⅢ(P<0.05). (3) GroupⅡhad a higher effective rate on stabilizing tumor size, the rate arrived to 65.0％, and was superior to that in groupⅠand groupⅢ(P <0.05) , and the effective rate in group Ⅰ was superior to that in group Ⅲ(P < 0.05). Group Ⅰ and group Ⅱhad a higher stabilizing rate than group Ⅲ(P < 0.05) , but the difference between group Ⅰ and group Ⅱ was insignificant (P>0.05). (4) GroupⅠhad less adverse reaction and higher safety. (5) The distant metastasis rate in groupⅠand groupⅡwas obviously lower than that in groupⅢ(P<0.05), but the difference of distant metastasis rate beetween group Ⅰ and group Ⅱ was insignificant (P > 0.05). Conclusion Therapy of strengthening Qi , resolving phlegm and dissipating mass is effective on relieving tumor-related symptoms , improving the quality of life, stabilizing the tumor, and controlling the distant metastasis in middle-late non-small cell lung cancer patients.

A single-team experience with robotic pancreatic surgery in 1010 cases / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the safety and advantages of robotic pancreatic surgery (RPS) based on the single-team experience with 1010 cases.</p><p><b>METHODS</b>The clinical data of 1010 cases of RPS performed by a single team from November, 2011 to September, 2017 in our hospital were collected prospectively and analyzed. In most of cases the surgeries were performed using the third-generation da Vinci robotic surgical system.</p><p><b>RESULTS</b>The 1010 cases receiving RPS included 417 cases of robotic pancreatoduodenectomy (RPD), 428 cases of robotic distal pancreatectomy, 60 cases of robotic central pancreatectomy, 53 cases of robotic pancreatic tumor enucleation, 3 cases of Appleby procedure, and 49 cases of other operations (including 4 cases of innovative robotic retroperitoneal laparoscopic surgery, 4 cases of robotic pancreatic tumor enucleation combined with main pancreatic duct bridging repair, 1 case of single incision robotic pancreatic tumor enucleation, and 2 cases of robotic central pancreatectomy combined with end-to-end anastomosis reconstruction). The median operative time was 210 min (30-720 min) with a median intraoperative blood loss of 80 mL (10-2000 mL), a conversion rate of 4.06% (41/1010), a blood transfusion rate of 6.7% (68/1010), a mean post-operative stay of 10.87∓6.70 days, a complication rate (beyond grade III according to Clavien-Dindo scoring system) of 8.0% (81/1010), and a pancreatic fistula rate (beyond) grade B of 9.21% (93/1010). The mortality rate of the patients was 0.69% (7/1010) in 30 days and 1.31% (12//934) in 90 days. The application of RPS in total pancreatectomy increased steadily from the rate of 10.44% in 2012 to 72.06% in 2017.</p><p><b>CONCLUSION</b>This represents to our knowledge the world largest series of robotic pancreatic resections. RPS is expected to gradually replace open procedure and laparoscopic procedure to become the primary choice of approach for pancreatectomy. After the learning curve, RPS procedure including distal pancreatectomy, robotic Appleby procedure and other operations can be safely performed, and the experiences from other centers can be beneficial to reduce severe complications in the early stage of learning.</p>

Risk factors of hemorrhagic fever with renal syndrome in children and adolescents in Xi'an City, Shaanxi Province: a case-control study / 中华地方病学杂志

Objective To study the risk factors of hemorrhagic fever with renal syndrome (HFRS) in children and adolescents in Xi'an City.Methods HFRS laboratory confirmed cases aged under 16 from January 2013-December 2015 were selected,which were reported by Information System of Disease Prevention and Control of the People's Republic of China.A 1:1 matched case-control study was adopted to retrospective investigate the risk factors.Logistic regression analysis was used to analyze relationships between various factors and HFRS in single factor analysis,the influence factors in the single factor analysis with statistical significances were further analyzed in the multiple factors analysis.Results Eighty-eight matched pairs were investigated.Single factor Logistic regression analysis found that non-nuclear family [odds ratio (OR) =20.25,95％ confidence interval (CI):2.32-76.80],less hand washing frequency before meals (OR =3.67,95％CI:1.40-9.62),the river or pond around the place (OR =1.55,95％CI:1.32-2.94),sit on the hay and play (OR =1.36,95％CI:1.17-1.80),eating in the snack bar (OR =8.33,95％CI:1.78-9.47),do not spray water when sweeping the floor (OR =2.22,95％CI:1.24-4.12),living in the edge of village (OR =1.55,95％CI:1.32-2.94),and keeping pets in the home (OR =12.00,95％CI:1.12-28.84) were associated with HFRS.In multiple factors Logistic regression analysis,risk factors according to the contribution value from high to low in the order were keeping pets in the home (OR =5.40,95％CI:1.78-16.32),less hand washing frequency before meals (OR =3.96,95％CI:1.89-7.23),living in the edge of village (OR =2.42,95％CI:1.82-5.50),and the river or pond around the place (OR =2.21,95％CI:1.86-2.49).Conclusion Risk factors as keeping pets in the home,less hand washing frequency before meals,living in the edge of village,the river or pond around the place are likely risk factors of HFRS.

Feasibility of constructing a scaffold for osteochondral tissue engineering using poly(lactide-co-glycolide) alone / 中国组织工程研究

BACKGROUND: To mimic physiological and functional requirements of cartilage and subcondral bone, some recent studies have fabricated bilayered scaffolds for osteochondral tissue engineering in cartilage repair. However, in cartilage repair, and little is reported on the use of a single biomaterial instead of composite biomaterials to fabricate bilayered porous scaffolds. OBJECTIVE: To investigate the biocompatibility of an integrated bilayered porous scaffold fabricated with poly(lactic-co-glycolide) (PLGA), and then to discuss its feasibility of constructing tissue-engineered osteochondral graft. METHODS: The integrated bilayered porous scaffolds were fabricated with PLGA by changing the ultrastructure of scaffold.In vitro,bone marrow mesenchymal stem cells(BMSCs)isolated from rabbits were seeded into the bilayered porous PLGA scaffold, co-cultured for 1 week and then observed under scanning electron microscope. After co-culturing 48 hours,the cells were stained by LIVE/DEAD Kit.In vivo,the composite of DiI-labeled BMSCs and the scaffold or the scaffold alone were implanted subcutaneously into the skin of nude mice, and the implants were taken out and stained by hematoxylin-eosin and DAPI staining at 4 and 8 weeks after implantation. RESULTS AND CONCLUSION: (1) We successfully obtained the bilayered porous scaffolds with different pore sizes (the upper layer:100-200 μm and the lower layer:300-450 μm)and 85% porosity.(2)In the in vitro experiment,the LIVE/DEAD staining showed that BMSCs survived well in the scaffold, and the cells adhered well to the wall of pores in all the scaffolds and extracellular matrix deposition was found under the scanning electron microscope.(3)In the in vivo experiment, shown by the hematoxylin-eosin staining, a small amount of chondrocytes formed in the fibrous tissue in the upper layer and a large amount of trabecular bones in the lower layer were found at 8 weeks after implantation in the experimental group. The close integration between the upper layer and the lower layer appeared. BMSCs could survive for 8 weeks in vivo shown by the DAPI staining.However,in the control group,a little fibrous tissue was found without chondrocytes and apparent trabecular bone, and the scaffold was partially degraded. To conclude, the integrated bilayered porous scaffold fabricated with PLGA alone has good biocompatibility, which is feasibly used in osteochondral tissue engineering.

Vaccine inoculation rate of hemorrhagic fever with renal syndrome in rural population and vaccination strategy in the Xi'an epidemic area / 中华地方病学杂志

Objective To describe the vaccine inoculation rate of hemorrhagic fever with renal syndrome (HFRS) and the movement characteristics of rural population in the Xi'an epidemic area.Methods This was a cross-sectional study.The study covered all the four HFRS traditional high incidence areas (counties):Zhouzhi,Huxian,Chang'an and Lintong.Three villages were selected in each county and 20 households were selected in each village in 2013.Participants included all the persons of these families.People 16-60 years old were interviewed face to face about their sociodemographic and environmental information,and at the same time related HFRS vaccine history and characters of migrant workers were collected.Results Nine hundred and ninety-six persons were investigated,69.3 percent (690/996) were vaccinate-age population.Of all,49.0 percent (338/690) had HFRS vaccine history and 53.9 percent (372/690) had worked away from home most of the year.The inoculation proportion of workers which worked in their own counties (56.8％,67/118) were higher than that of workers worked outside (37.0％,60/162;39.1％,36/92,x2 =10.74,6.44,all P ＜ 0.017).In the workers that went back home every week,60.3 percent (76/126) had vaccinated.Workers that went back home once a year had the lowest proportion of inoculation (16.7％,7/42).The morbidity of HFRS decreased significantly accompany with ascend of inoculation rate (Y =-0.524X + 38.319,t =-4.581,P ＜ 0.05).Conclusions After the free vaccinations,there is still a gap between the vaccine inoculation rate and prevention benefit.The current vaccination strategies need to be adjusted.

Treatment of multiple vertebral pathological fractures in multiple myeloma patients by percutaneous vertebroplasty: Analysis of 44 cases / 解放军医学杂志

Objective To investigate the clinical efficacy percutaneous vertebroplasty (PVP) for multiple vertebral pathological fracture (MVPF) in multiple myeloma (MM) patients. Methods PVP was performed for MVPF in 44 consecutive patients with MM from 2010 to 2014 in our hospital. All the patients had complete medical records. The clinical data were analyzed retrospectively. Preoperative and postoperative visual analog scale (VAS) scores for pain and ECOG scores were measured and analyzed statistically in all the patients. Then the changes of back pain, locomotor activity and life quality after surgery were compared. Results Technical success was achieved in all the 139 diseased vertebrae. The mean injected amount of PMMA was 3.0ml. The mean value of VAS was 7.8 ± 2.9 preoperatively, and significantly decreased to 4.1 ± 1.6(P<0.0l) 1 day after vertebroplasty, to 2.2 ± 1.6(P<0.0l) 1 week after vertebroplasty, and to 2.6 ± 1.9(P<0.0l) 1 month after vertebroplasty. The mean preoperative ECOG scores was 2.9 ± 0.7. One week after the operation, the mean ECOG scores decreased to 2.2 ± 0.3 (P<0.01). There were significant differences between preoperative and postoperative visual analog scale (VAS) scores and ECOG scores. Conclusion PVP is an effective and safe method for treating symptomatic MM with (MVPF).

Evaluation and consideration on animal model of allergic rhinitis in China / 中国耳鼻咽喉头颈外科

[ABSTRACT]OBJECTIVEThe purpose of the study is to put forward some ideas and suggestions for the future research of allergic rhinitis.METHODSThe experimental animal species, strains, methods of replicating animal model and the judging standard of allergic rhinitis in China from January 1998 to December 2014 were reviewed and analyzed.RESULTSThe experimental animal species, strains, methods of replicating animal model and the judging standard of allergic rhinitis used in 137 articles were different.CONCLUSIONOnly standardized and unified experimental animal model can ensure the implementation of scientific research successfully and the reliability of the experimental results.

Epidemic characteristics and tendency prediction of hemorrhagic fever with renal syndrome from 2005 to 2014 in Xi'an / 中华地方病学杂志

Objective To analyze the epidemiologic characteristics and tendency of hemorrhagic fever with renal syndrome (HFRS) in Xi'an from 2005 to 2014,and to grasp the epidemic regularity and predict the trend of HFRS for establishing effective prevention and control measures.Methods The descriptive epidemiological method was used to analyze the epidemic situation of HFRS in Xi'an from 2005 to 2014.The autoregressive integrated moving average (ARIMA) model was applied to analyze,fit and predict the epidemic data of 2015.Results There were 8 500 HFRS patients in Xi'an from 2005 to 2014,the incidence rate was 10.60/100 000.The morbidity increased at first and then decreased from 2005 to 2014;the incidence rate was 9.06/100 000 in 2005 and up to 19.46/100 000 in 2010,then down to 3.43/100 000 in 2014.More cases were reported in spring (15.85％,1 347/8 500) and autumn-winter seasons (72.91％,6 197/8 500).The high-risk age group of HFRS was between 15 to 59 years,accounting for 77.71％ (6 605/8 500) of the overall incidence rate;there were no significant differences in ＜ 15 years,15 to 59 years and ＞ 59 years groups (x2 =15.63,P ＞ 0.05).The male to female ratio was 3.01 ∶ 1.00,male incidence was 15.57/100 000 and female incidence rate was 5.41/100 000,and the difference was statistically significant between gender (x2 =1 948.84,P ＜ 0.05).The main occupation was farmers,accounting for 66.04％ (5 613/8 500) of the overall incidence rate.The top 4 districts were Chang'an,Zhouzhi,Huxian and Lintong;the incidence rate was 31.07/100 000,22.74/100 000,21.09/100 000 and 11.06/100 000,respectively,and the 10 years cumulative incidence rate was higher than the total incidence.The monthly incidence was predicted with ARIMA (1,1,0) × (0,1,1)12 models in Xi'an from 2005 to 2014,and the predicted number of cases was 235 in 2015 (lower than 2014).Conclusions The overall trend of the epidemic has continued to fall but slowly.Positive and effective comprehensive measures should be taken to maintain the incidence of hemorrhagic fever at a lower level.

Clinical characteristics of 3090 caes of hemorrhagic fever with renal syndrome and risk factor analysis / 中国地方病学杂志

Objective In this paper we analyzed the major risk factors of hemorrhagic fever with renal syndrome(HFRS) as well as its clinical manifestation,so as to provide a basis for clinical diagnosis and effective control of HFRS in Xi'an.Methods The method of retrospective study was used to collect clinical data of hospitalized patients with HFRS between 2005 and 2010 in the Hospitals for Infectious Diseases in Xi'an city,Zhouzhi and Huxian counties and then clinical manifestations of the patients with HFRS were analyzed and classified according to the national standards for clinical symptoms and test indicators of HFRS.HFRS patients matched by the ratio of 1 ∶ 2 healthy human controls were retrospectively investigated in order to obtain risk factors relevant to HFRS incidence using casecontrol study.Odds ratio(OR) method was used for single factor study.While for the multifactor study,we took the conditional Logistic regression approach.We also built models for both studies.Factor with OR ＞ 1 and P ＜ 0.05 was judged to be a risk factor.Results A total of 3090 cases information of patients with HFRS and 6018 healthy controls were collected.Of the 3090 cases of HFRS patients,sixty vaccinated patients showed atypical clinical manifestations and they were mild or moderate cases and no deaths.A total of 3030 nonvaccinated patients had obvious clinical symptoms.Severe or critical cases accounted for 39.07％(1184/3030)and 60 patients died and the fatality rate was 1.98％ (60/3030).The results of single factor Logistic regression analysis showed that of the 16 factors analyzed,the difference of 11 risk factors between the case group and the control group was statistically significant.Multivariate Logistic regression analysis showed that of the 11 factors,the difference of six factors between the case group and the control group was statistically significant.The main risk factors of suffering HFRS in the order were:exposure to rat pollutants,living in the affected areas,sitting or lying on grass fields in the affected areas,working in the affected areas,house rat infestation,and domesticated cats or dogs(OR =6.826,5.764,4.882,4.857,3.126 and 2.875; P ＜ 0.01 or P ＜ 0.05).Conclusions Vaccines are very useful in the sense that vaccinated HFRS patients tend to have mild symptoms and good prognosis.Health education in this area should be focused on the six risk factors in order to prevent the spreading of HFRS.

Characteristics of patients with hemorrhagic fever with renal syndrome in Xi'an / 中华传染病杂志

Objective To describe the clinical features of patients with hemorrhagic fever with renal syndrome (HFRS) in popular period and other period.Methods All the HFRS patients from epidemic areas in Xi' an were surveyed retrospectively.The sociodemographic data,symptom characteristics and laboratory test results were collected.Chi-square test,rank test were used to analyze the data.Results Totally 429 HFRS cases were recruited including 280 male (65.3％) and the male/female ratio was 1.9 ∶ 1.Adults with 16-60 years of age were the main group,which accounted for 74.8％ of the total cases.The constituent ratios of cases with 16-60 years of age in popular period and other period were 76.1％ (245/322) and 71.0％ (76/107),respectively; the sex ratios were 1.93∶1 and 1.74∶1,respectively; the time from fever onset to hospitalization was 3 d and 4 d,respectively; the time of hospitalization was both 10 d; the proportions of emergency cases were 59.8％ (189/316) and 67.6％ (71/105),respectively; the proportions of cured cases were 56.4％ (181/321) and 43.4％ (46/106),respectively.The clinical features were not significantly different between popular period and other period (all P＞0.05).The immunoglobulin M (IgM) antibody positive rate was 85.4％ (315/369) and those in popular period and other period were 88.4％ (251/ 284) and 75.3％ (64/85),respectively (x2 =8.968,P＜0.01).There was a positive correlation between symptom severity and outcome of discharge (x2=18.558,P＜ 0.01),the more slight symptoms were related with the better outcome.Conclusion The clinical features are similar in cases from popular period and other period from Jan 2008 to Jun 2011.