Analysis of influenza surveillance results in Jingzhou， Hubei Province from 2016 to 2021 / 上海预防医学

ObjectiveTo understand the epidemiological characteristics of influenza in Jingzhou from 2016 to 2021， so as to provide scientific evidence for the formulation of influenza prevention and control policies in this region， and effectively protect people's health. MethodsData of influenza-like illness （ILI） and pathogen surveillance in Jingzhou during 2016‒2021 were collected and statistically analyzed. ResultsA total of 46 272 ILI cases were reported from two hospitals in Jingzhou City from 2016 to 2021. The difference in the constituent ratio of ILI was statistically significant among different age groups （P<0.05）. A total of 12 812 specimens were collected from two hospitals for influenza surveillance. A total of 1 513 cases were RNA positive，and the positive rate of influenza virus nucleic acid detection was 11.81％. The RNA positive specimens were mainly B （Victoria）， accounting for 39.33％. There were statistically significant differences in the positive rate of influenza virus nucleic acids and different types of influenza virus nucleic acids among different years （P<0.05）. ConclusionThe influenza epidemic in Jingzhou peaks in winter and spring， and the new A （H1），A （H3）， B （Victoria） and B （Yamagata） types alternate and mixed epidemics dominate.

Study on the effect of chlorine disinfectants on the destruction of New coronavirus nucleic acid / 公共卫生与预防医学

Objective To observe the destructive effects of chlorine disinfectants on the nucleic acid of novel coronavirus, and to assess the feasibility of real-time fluorescent quantitative PCR technology for the evaluation of the disinfection effect of novel coronavirus. Methods A suspension quantitative inactivation test was used to observe the inactivation effects of different concentrations of chlorine containing disinfectants and different action times on the novel coronavirus. RT-PCR method was used to detect novel coronavirus nucleic acid for the disinfection effect evaluation. Results The chlorine disinfectants of 1 000 mg/L and 2 000 mg/L could destroy the nucleic acid of ew coronavirusafter application for over 30s. The chlorine disinfectant of 750 mg/L could destroy the nucleic acid of new coronavirusafter application for over 15min. Chlorine disinfectant of 500 mg/L could not completely destroy the nucleic acid of new coronavirusafter 30 min action. Conclusion The disinfection method stipulated in the national prevention and control plan using 1 000mg / L effective chlorine for the epidemic sites of new coronavirus for 30 minutes could completely destroy the nucleic acid of new coronavirus. The Real-time quantitative PCR can be used to evaluate the disinfection effect of new coronavirus.

Risk factors and prognoses analysis of new-onset atrial fibrillation in patients with acute myocardial infarction / 中华内科杂志

Objective To explore the risk factors and prognoses of new-onset atrial fibrillation (NOAF) in patients with acute myocardial infarction (AMI).Methods A total of 468 patients with AMI were admitted into Beijing Anzhen Hospital for emergency pereutaneous coronary intervention (PCI).According to the NOAF occurred during hospitalization,the patients were divided into two groups:the NOAF (n=37) group and the non-NOAF (n=431) group.Parameters including general clinical conditions,coronary lesions,echocardiography,biochemical markers,C-reactive protein (CRP),N-terminal pro-brain natriuretic peptide (NT-pro-BNP),and myocardial markers were collected.In-hospital mortality and incidence of in-hospital main adverse cardiovascular and cerebrovascular events (MACCE) were compared between the two groups.Logistic multivariate regression analyses were performed for the association between the risk factors and NOAF.Results The incidence of NOAF was 7.9％ in AMI patients undergoing emergency PCI.There were no significant differences in door-to-balloon time,weight,platelet counts,baseline serum creatinine (SCr),postoperative SCr,triglyceride,total cholesterol,low density lipoprotein cholesterol,high density lipoprotein cholesterol,uric acid,glycosylated hemoglobin A1c,preoperative medication,number of lesions,thrombus aspiration,location of myocardial infarction,and history of hypertension,diabetes,peripheral vascular disease and old myocardial infarction between the two groups.The percentage of women was in the NOAF group (32.4％ vs.16.7％,P＜0.05) and subjects in this group were significantly elder than those in the non-NOAF groups [(66±10) years vs.(571±11) years,P＜0.001].Moreover,the levels of no-reflow rate (40.5％ vs.12.6％,P＜0.001),CRP [25.2 (15.43,29.97)mg/L vs.5.21 (2.33,16.98) mg/L,P＜0.001],white blood cell counts [(11.19±3.44)× 109 vs.(9.91 ±3.23)× 109,p=0.022],NT-pro-BNP [(652.6± 108.8) ng/L vs.(258.3±105.9) ng/L,P＜0.001],and troponin I (TnI) [20.41(1.78,87.89) μg/L vs.7.72(1.29,36.39) μg/L,P=0.006] were significantly higher in the NOAF group than in the non-NOAF group,while left ventricular ejection fraction [(47.70± 7.34)％ vs.(53.35 ± 8.05)％,P＜0.001],and hemoglobin [137.0(125.5,146.0) g/L vs.144.0(133.0,156.0) g/L,P=0.042] were significantly lower in the NOAF group than the non-NOAF group.Patients in the NOAF group had significantly longer hospital stay than those in the non-NOAF group [(8.7± 5.6) d vs.(6.0± 2.3) d,P=0.007].The in-hospital mortality (8.1％ vs 1.4％ P=0.004) and the incidence of in-hospital MACCE (37.8％ vs.7.7％,P＜0.001) in the NOAF group were significantly higher than those in the non-NOAF group.Logistic multivariate regression analyses showed that age (HR 1.083,95％CI 1.028-1.141,P=0.003),CRP (HR 1.116,95％CI 1.049-1.187,P=0.001),NT-pro-BNP (HR 1.463,95％CI 1.001-4.064,P=0.001) and no-reflow (HR 4.388,95％CI 1.006-19.144,P=0.049) were independent predictors of NOAF after AMI.Conclusions Age,elevated levels of CRP,NT-pro-BNP,and the absence of no-reflow are risk factors for incident NOAF in patients with AMI in hospital.

Safety and efficacy of different antithrombotic therapy regimens for atrial fibrillation after percutaneous coronary intervention in elderly patients / 中华老年医学杂志

Objective To evaluate the short-term safety,efficacy and prognosis of different antithrombotic therapy regimens in elderly patients with atrial fibrillation after coronary artery stenting.Methods A total of 272 atrial fibrillation patients with 121 males and a mean age of(67.1 ±5.2)years undergoing coronary artery stenting in our hospital from January 2013 to December 2015 were retrospectively analyzed and rondomized into two antithrombotic therapy regimens:a dual antiplatelet therapy with aspirin and clopidogrel(DT group,n=175)and a triple antithrombotic therapy with warfarin,aspirin and clopidogrel(TT group,n=97).The one-year risk of major bleeding and major adverse cardiac and cerebrovascular event (MACCE) were compared between two groups.Results After one year follow-up,the rate of major bleeding was lower in the DT group (0.6％,n=1)than in the TT group(5.2％,n=5)(x2 =5.92,P =0.01).Nevertheless,the rates of MACCE showed no statistical difference between two groups (all P ＞ 0.05).No statistically significant differences were found between DT group(n=175)and TT group(n=97)in six therapeutic efficacy indexes as the follow[n(％)in DT vs.n(％)in TT]:in in-stent thrombosis[1 (0.6)in DT vs.0 (0.0) in TT],in myocardial infarction relapse [35 (20.0) in DT vs.17 (17.5) in TT],in revascularization once more[28(16.0)in DT vs.17(17.5)in TT],in death[7(4.0)in DT vs.3(3.1)in TT],in adverse cardiac cerebrovascular events[90 (51.4) in DT vs.45 (46.4) in TT],and in ischemic stroke[19(10.9) in DT vs.8 (8.2) in TT] (all P ＞ 0.05).However,the rate of atrial fibrillationinduced ischemic stroke may be increased in patients treated with DT of aspirin and clopidogrel as compared with TT of warfarin,aspirin and clopidogrel.Conclusions For atrial fibrillation after coronary artery stenting,triple antithrombotic treatment can lead to increased risks for major bleeding with similar rate of MACCE to dual antiplatelet therapy,but dual antiplatelet therapy may result in the raised rate of atrial fibrillation induced ischemic stroke.

Treatment analysisin early postoperative inflammatory small bowel obstruction after abdominal surgery / 实用医学杂志

Objective To discusses the clinical features of early inflammatory bowel obstruction (EPIS-BO) after abdominal surgery,and analyze diagnosis and treatment. Methods The clinical data of 48 patients with early inflammatory bowel obstruction after abdominal surgery were analyzed retrospectively from July 2005 to July 2015. Results 45 patients were recovered after non-operative treatment including gastrointestinal decompression , total parenteral nutrition (TPN),antibiotics,glucocorticoid and somatostatin. The average time of treatment was 17.45 days. The other 3 patients underwent laparotomy respectively on 16,19 and 20 days after conservative treat-ment.Two cases were turned to intestinal fistula after operation ,and one of them died after reoperation because of severe abdominal infection 9 days later. Conclusion Conservative treatment should be regarded as the first choice for EPISBO in clinical practice due to less complications and better effect than operative treatment.

Clinicopathological characteristics and prognostic factors of rectal neuroendocrine neoplasms / 中华普通外科杂志

Objective To analyze the clinicopathological characteristics and the related factors influencing the prognosis of rectal neuroendocrine neoplasms.Methods The clinical and follow-up data of 442 patients with rectal neuroendocrine neoplasms admitted between Sep 1993 and Dec 2015 in 5 hospitals in southern China were analyzed retrospectively.The univariate and multivariate analysis of survival prognosis were analyzed statistically.Results Of the 442 patients,the median age was 50 years and 64.7％ were males.The average tumor size was (1.4 ± 0.7) cm.NENs ＜ 1 cm accounted for 66.1％ cases,1-2 cm accounted for 17.2％ and ＞2 cm accounted for 16.7％ of the tumors.Stage Ⅰ,Ⅱ,Ⅲ and Ⅳ accounted for 73.5％,8.6％,7.2％,10.6％ of the tumors;G1,G2,G3 accounted for 76.5％,14.7％,8.8％ of the tumors;The median survival time for all 442 patients was 35 months (range,1-224 months).The overall 5-year survival rate was 85％.The 5-year survival rates for patients in stage Ⅰ-Ⅳ were 95％,94％,52％,36％ respectively.The 5-year survival rates for patients with G1-3 were 94％,80％,19％respectively.Univariate analysis showed that G grade,T stage,N stage,M stage,TNM stage,functional,gender,medication,surgical therapy,age,tumor sizes were statistically significant (all P ＜ 0.05).Multivariate analysis revealed that G grade (P =0.001),tumor sizes (P =0.012) and TNM stage (P =0.008) were the independent factors affecting the prognosis.Conclusion Patients with rectal neuroendocrine neoplasms have no specific clinical characteristics.G grade,tumor sizes and TNM stage were the independent factors affecting the prognosis.

Clinicopathological features and prognosis of patients with gastric neuroendocrine carcinoma from multiple centers in southern China / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To analyze the clinicopathological features and prognostic factors of gastric neuroendocrine carcinoma(NEC) based on a multicenter database from five medical centers in Southern China.</p><p><b>METHODS</b>Clinical and pathological data of 1 183 gastroenteropancreatic neuroendocrine neoplasms patients between January 2006 and December 2015 from five centers were retrospectively analyzed. A total of 156 gastric NEC cases(13.2%) with complete follow-up information were screened and included in the study, wherein 73 cases from Sun Yat-sen University Cancer Center, 27 cases from Nanfang Hospital of Southern Medical University, 26 cases from The First Affiliated Hospital of Sun Yat-sen University, 15 cases from Guangdong General Hospital and 15 cases from Sun Yat-sen Memorial Hospital of Sun Yat-sen University. The overall survival rate was calculated by using Kaplan-Meier method. The prognostic factor was analyzed using the Cox proportional hazards model.</p><p><b>RESULTS</b>In 156 NEC patients, the ratio of male to female was 3.9 vs 1.0, the median age was 61 years old, and the maximal tumor diameter was (4.5±2.3) cm. There were 12 case(7.7%) with functional tumors. At the initial diagnosis, there were 111 patients (71.2%) with regional lymph node metastases and 58 patients (37.2%) with distant metastases. One hundred and twenty-three patients (78.8%) underwent surgical treatment and 94 patients (60.3%) received systematic treatment. There were 31 patients(19.9%) in localized disease stage, 67 patients (42.9%) in regional disease stage and 58 patients(37.2%) in distant disease stage. The 5-year overall survival rate was 44.7%. Cox regression model showed that surgical treatment (HR=0.512, 95%CI:0.287 to 0.912, P=0.023) and clinical stage(HR=1.488, 95%CI:1.067 to 2.076, P=0.019) were independent prognostic factors. The 5-year overall survival rate of patients with and without surgical treatment were 54.6% and 10.9%(P=0.000). Meanwhile, the 5-year overall survival for localized, regional and distant disease stages were 66.1%, 56.1% and 21.1% respectively(P=0.000).</p><p><b>CONCLUSIONS</b>Gastric neuroendocrine carcinoma is a group of rare tumors with strong invasiveness, high malignancy and poor prognosis. The gastric NEC patients can benefit from surgical treatment.</p>

Clinicopathological characteristics and prognosis analysis of colorectal neuroendocrine neoplasms based on the data from domestic six medical centers / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathological characteristics and their relationship with prognosis of colorectal neuroendocrine neoplasms (NEN).</p><p><b>METHODS</b>Medical records of 329 patients with colorectal NEN between June 2001 and July 2016 from 6 large scale centers in China were reviewed to investigate the clinicopathological characteristics and their relationship with prognosis of colorectal NEN.</p><p><b>RESULTS</b>(1) Colonic NEN: A total of 41 patients with colonic NEN were enrolled from The First Affiliated Hospital of Sun Yat-sen University(n=11), Sun Yat-sen University Cancer Center (n=15), Guangdong General Hospital (n=10), Sun Yet-san Memorial Hospital of Sun Yat-sen University (n=3) and Fudan University Shanghai Cancer Center (n=2). 41 cases, including 20 males and 21 females with a mean age of (58.7±4.7) years. Twenty-three colonic NEN originated in hindgut (23/41, 56.1%), and 20 patients were stage IIII( (20/41, 48.8%). Nine cases (22.0%) were neuroendocrine tumor(NET), 25(61.0%) were neuroendocrine carcinoma (NEC) and 7(17.1%) were mixed adenoendocrine carcinoma (MANEC). Six cases (14.6%) were G1 grade, 3(7.3%) were G2 grade and 32(78.1%) were G3 grade. Ulcerative or cauliflower-like tumors were the most common appearance under endoscopy (both 9/41, 22.0%). Thirty-three patients (80.5%) underwent surgery. During follow-up, 19 cases died and the 3-year survival rate was 46.1%. Multivariate analysis revealed that stage IIII( was an independent risk factor of poor prognosis (HR=3.871, 95%CI:1.342 to 11.167, P=0.012) in colonic NEN patients. (2) Rectal NEN: A total of 288 patients with rectal NEN were enrolled from The First Affiliated Hospital of Sun Yat-sen University(n=130), Nanfang Hospital of Southern Medical University (n=115) and Fudan University Shanghai Cancer Center (n=43). Two hundred and eighty-eight cases, including 181 males and 107 females with a mean age of (47.7±1.5) years. One hundred and ninety-seven patients were stage I((197/288, 68.4%). Of 288 rectal NEN cases, 267(92.7%) were NET, 20(7.0%) were NEC and 1(0.3%) was MANEC; 214(74.3%) were G1 grade, 53(18.4%) were G2 grade and 21(7.3%) were G3 grade. Submucosal tumor was the most common appearance under endoscopy(164/288, 56.9%). Most of the rectal NET G1/G2 tumors were submucosal(146/214, 68.2%;18/53,34.0% respectively) while most of G3 tumors were cauliflower-like (14/21,66.7%). A total of 175 patients (60.8%) underwent endoscopic therapy, while 96 patients(33.3%) underwent surgery. During follow-up, 12 cases died and 3-year survival rate was 94.0%. Multivariate analysis revealed that poor differentiation as NEC or MANEC(HR=8.919, 95% CI:1.911 to 41.637, P=0.005) and stage III( to IIII((HR=10.304, 95%CI:1.772 to 59.916, P=0.009) were independent risk factors of poor prognosis in rectal NEN patients.</p><p><b>CONCLUSIONS</b>The clinicopathological manifestations of rectal NEN and colonic NEN are quite different. Rectal NEN are more common with better differentiation and has better prognosis than colonic NEN.</p>

Clinical value of serum uric acid in patients with acute ST-elevation myocardial infarction / 中华急诊医学杂志

Objective To assess the clinical value of serum uric acid levels in patients with acute ST-elevation myocardial infarction(STEMI).Methods A total of 502 consecutive patients with STEMI were enrolled from January 2005 to December 2010 for retrospective study.The level of serum lipid,echocardiographic data and in-hospital major adverse cardiovascular events(MACE)in patients with hyperuricemia(n =119)were compared with those in patients without hyperuricemia(n =383).The relationship between the level of serum uric acid and the degree of diseased coronary artery was analyzed.All data were analyzed with SPSS version 17.0 software to make t test and x2 test and Pearson correlation analysis.Results Serum uric acid level was positively correlated with serum triglyceride level.Compared with non-hyperuricemia patients,hyperlipidemia was more commonly found among hyperuricemia patients (43.7％ vs.33.7％,P =0.047),and serum triglyceride level was significantly higher in hyperuricemia patients[(2.11 ± 1.24)mmol/L vs.(1.78 ± 1.38)mmol/L,P =0.014].But a significant association between serum uric acid level and one or more diseased vessels was not observed(P ≥ 0.05).Leftventricular end-diastolic diameter(LVEDd)was found to be larger in hyperuricemia patients than non-hyperuricemia patients[(53.52 ±6.19)mm vs.(52.18 ±4.89)mm,P =0.041].Higher incidence in left systolic dysfunction and diastolic dysfunction was discovered in hyperuricemia patients(36.4％ vs.15.1％,P ＜0.01; 68.2％ vs.55.8％,P =0.023).Also,hyp-eruricemia patients had more in-hospital MACE(P ＜ 0.05).Conclusions Serum uric acid level is positively correlated with serum triglyceride level,but not with the severity of coronary artery disease.Hyperuricemia patients after STEMI tended to have higher incidence in left systolic dysfunction and diastolic dysfunction,and have more in-hospital MACE.

Assessment of left atrial appendage function by real-time three-dimensional transesophageal echocardiography / 中华超声影像学杂志

Objective To evaluate the feasibility and accuracy of real-time three-dimensional transesophageal echocardiography(TEE) in assessment of left atrial appendage(LAA) function. Methods Forty-two atrial fibrillation patients underwent real-time three-dimensional TEE. LAA ejection fraction based on two-dimensional area measurements(EFA-2D), three-dimensional area measurements(EFA-3D) and three-dimensional volume measurements(EFv-3D) were calculated and related to LAA peak empty velocity (PEV). The variability within observer and interobserver were tested. Results EFA-2D was significantly higher than EFA-3D[(62.84 ± 17.27)% vs (45.39 ± 16.58)%, P = 0.000] and EFv-3D [( 62.84 ±17.27) % vs (48.35 ± 19.37) %, P = 0.001 ], whereas EFA-3D and EFv-3D had no significant difference ( P = 0.158). In a simple linear correlation,the degree of association between EFv-3D and PEV was higher as between EFA-3D and PEV ( r = 0.662 vs 0.604,both P ＜0.05). No significant correlation was observed between EFA-2D and PEV ( r = 0.529, P = 0.130). Variabilities within observer and interobserver were no significant differences by the three methods( P ＞0.05). Conclusions LAA ejection fraction calculation by real-time three-dimensional TEE is feasible and more accurate than by 2D TEE.

Analysis of succumbed reasons of emergent percutaneous coronary intervention in treatment of acute myocardioal infarction / 中华急诊医学杂志

Objective To analyze the succumbed reasons of emergent pereutaneous coronary intervention(EPCI)in treatment of acute myocardial infarction(AMI)during operation and in-hospital period.Method During March 1999 to June 2005,623 AMI patients received EPCI,and 27 patients died.The succumbed reasons and clinical characteristics of the succumbed patients were analyzed.Result Among the 27 succumbed patients,with age 51 to 91(69?18)years old, 16 had three-vessel lesions.10 had two-vessel lesions and l had single vessel lesion.Ten patients were accompanied with old myocardial infarction,9 with diabetes meUitus,19 with hypertensions,4 with impaired renal functions,and 6 with old cerebral infarction.Nine patients died of eardingenic shocks,6 died of no-reflows,2 died of heart ruptures,2 thrombosis, 2 acute left heart failure,2 acute renal failure,2 intracranial hemorrhage,l shock due to hemorrhage of puncture position, and l acute perieardiae tamponade.Conclusion The succumbed reasons of EPCI in treatment of acute myocardial infarction were various.Cardiac shock and no-reflow were primary reasons.Old age,multi-vessel lesion,diabetes mellitus, and old myocardial infarction may serve as predicting factors.

Effects of hyperuricemia on vascular endothelial function / 中国实用内科杂志

Objective To investigate the effects of hyperuricemia on vascular endothelial function.Methods With high-resolution ultrasound,flow-and nitroglycerin induced dilation,the vasodilation of brachial artery was measured in 30 hyperuricemia male patients and 30 healthy male subjects(control group).Both serum NO and plasma endothelin-1(ET-1) levels were determined at the same time.Results In patients with hyperuricemia,flow-induced vasodilation was much reduced compared with that in the control subjects(P0.05).Plasma NO level in the hyperuricemia group was lower than that in the control group (P