[Case analysis and control strategy of imported malaria in Qingcheng District, Qingyuan City from 2011 to 2016].

OBJECTIVE: To understand the characteristics of imported malaria cases in Qingcheng District, Qingyuan City and explore the strategies and priorities in prevention and control, so as to provide the evidence for improving the diagnosis, treatment and management of imported malaria. METHODS: The data of imported malaria as well as the case epidemiological investigations were collected and retrospectively analyzed for the species composition, original countries, population distribution, regional distribution, onset situation, diagnosis, treatment, etc. in Qingcheng District from 2011 to 2016. RESULTS: The number of imported malaria cases was 13 from 2011 to 2016. All the patients were confirmed by laboratory, and of which, 9 patients infected with Plasmodium falciparum, 1 with P. vivax, 1 with P. ovale and 2 with mixed infections (P. vivax and P. falciparum). The yearly incidence of imported malaria presented an uptrend. The infection sources of all the patients were from African countries, and the exported labor workers and travelers for business from malaria endemic areas were the high risk population. The reported time was mainly January, February, November and December (11/13, 84.62%). All the patients were male, and the majority of them (12/13, 2.31%) were 21-60 years old. The median time from onset to seeing a doctor was 2.5 days and the median time from seeing a doctor to being diagnosed was 1.9 day. Six patients (46.15%) were diagnosed as other diseases at the first visit to a doctor, and one patient died of falciparum malaria because of delayed diagnosis. CONCLUSIONS: The incidence of overseas imported malaria presents an uptrend in Qingcheng District. It is necessary to further strengthen the professional training in medical staff to improve the diagnosis and treatment of malaria cases. It is also necessary to strengthen the multisectoral cooperation, establish the surveillance in the high risk population, etc.

Survey of influential factors of female stress urinary incontinence in a county in Chengdu / 上海第二医科大学学报

Objective To investigate the incidence and related risk factors of female stress urinary incontinence(SUI) in a county of Chengdu. Methods The women were interviewed with questionnaires,which were designed to the modified standard of the Advisory Committee of Urinary Incontinence of Asia-pacific Region. Results The total number of the women investigated was 563,while the number of the valid questionnaires was 512,with the efficient rate 98.5%.Of these women,46.1%(236/512) had urinary incontinence,21.9%(112/512) had simplex SUI,4.7%(24/512) had simplex urgent urinary incontinence and 19.5%(100/512) had complex urinary incontinence.The incidence of SUI(simplex SUI plus complex urinary incontinence) was 41.4%(212/512).The incidence of SUI was associated with factors such as age,pregnancies,drinking and education level,and the severity was associated with age,body mass index and education level.Conclusion The incidence of SUI in this county of Chengdu is relatively higher.Heath education is very important for the female health.

Surveillance of pathogens from patients with hospital infection in intensive care unit / 上海第二医科大学学报

Objective To analyze the distribution and antimicrobial resistance of pathogens from patients with hospital infection in intensive care unit(ICU),and to discuss the corresponding strategy of prevention and treatment. Methods Clinical data of 891 patients hospitalized in the ICU of our hospital between Jan 2002 and Dec 2005 were collected.All the specimens were analyzed for pathogen distribution and resistance to antibiotics. Results Of all the isolated 1 155 strains,Gram-negative(G-)bacteria were the most popular pathogen(57.84%),whereas Gram-positive(G+) bacteria and fungi accounted for 21.39% and 20.78%,respectively.Most G-bacteria were less sensitive to imipenem(0-10.16%),and Pseudomonas aeruginosa was least sesitive to amikacin(6.89%) and cefoperazone-sulbactam(33.97%).G+ bacteria were most sensitive to vancomycin.Most fungus were Candida albicans(42.92%) and yeast species(22.90%). Conclusion Epidemiological investigation of pathogens in ICU is of great importance to the rational use of anti-biotics and may help to reduce the emergence of resistant strains.

Misdiagnosis analysis of POEMS syndrome and its early diagnosis / 第二军医大学学报

Objective:To study the causes of misdiagnosis of patients with POEMS syndrome and to discuss the clues for its early diagnosis.Methods:The clinical and laboratory data of 26 inpatients with POEMS syndrome,who were treated in Changhai hospital over the last decade,were retrospectively analyzed.Results:The misdiagnosis rate of our group was 100%. The misdiagnosis was made in(3.31?0.97)hospitals and in(3.31?0.93)clinical departments;the misdiagnosis period was (19.42?10.86)months and it had been misdiagnosed as 18 other diseases.The initial symptoms included polyneuropathy in 21 (80.8%)cases,edema of lower extremity in 22(84.6%)cases,and body weight loss in 8(30.8%)cases.The typical clinical symptoms included polyneuropathy in 26(100%)cases and organomegaly in 24(92.3%).Two cases had newly-identified uterine hypertrophy,one had adrenal gland hypertrophy,and one had gastric wall thickening mimicking advanced gastric cancer.Hypothyroidism,impotence,skin pigmentation and sclerosis occurred in 76.9%(20/26),60%(6/10),92.3%(24/ 26)and 65.4%(17/26)cases,respectively.Monoclonal plasma cell proliferation was documented in 18(81.8%);M proteins were positive in 14(63.6%)cases by serum immunofixation,and only 2(9.1%)cases also positive by serum protein electrophoresis.One patient was positive of M protein by urine immunofixation and one had abnormal infiltration of plasma cells in the gastric wall.Lymph node biopsy were performed in 8 patients and 3 were found to have Castleman disease;the other 5 cases had lymphocyte infiltration,with 3 complicated with plasma cell proliferation.Nerve biopsy in 4 cases all revealed axonal degeneration and one patient complicated with demyelination.Bone marrow biopsy in 5 cases revealed plasmacytosis in 2 cases and myeloma in one.Excessive radioactivity resorption was found in 10 of the 16 cases(62.5%)and abnormal plasma cells were detected in 2 cases by bone aspiration guided by radioisotope bone scan.Conclusion:Misdiagnosis of POEMS syndrome is very common.Polyneuropathy,edema of lower extremity and body weight loss are the common early symptoms of POEMS syndrome. Early diagnosis can be made by having an intimate knowledge of the progression of the disease and by detecting M protein through various approaches.