Concentrations, seasonal trends, sources, health risk and subchronic toxicity to the respiratory and immune system of PAHs in PM2.5 in Xi'an.

PM2.5-bound polycyclic aromatic hydrocarbons (PAHs) have been proved to be hazardous to health. Previous studies have focused on the distribution and sources of PAHs, whereas there is little knowledge of the damage to organs. Here we sought to investigate the pollution level and seasonal variation characteristics of PAHs in PM2.5 in Xi'an and assess the health risk, to establish a PAHs exposure model, and investigate the toxicological effects of PAHs on the respiratory and immune functions. A sub-chronic exposure model of PAHs was established by inhalation. The pathological changes of lung tissues were observed with a light microscope. Inflammatory reactions in alveolar lavage fluid were determined using the corresponding kit. The levels of interleukin-6 (IL-6) and interleukin-8 (IL-8) were detected with enzyme linked immunosorbent assay (ELISA) kit; the proliferation of lymphocytes in spleen was detected with methyl tetrazolium (MTT); DNA immune damage was determined with DNA gel electrophoresis. The results showed that (1) the total concentration of 16 PAHs ranged from 41.1 to 387 ng/m3, with a mean value of 170 ng/m3, and the concentration of PAHs in PM2.5 was higher in winter than in other seasons. (2) The sources of PAHs in the atmosphere of Xi'an urban area were mainly coal combustion, and the equivalent carcinogenic concentration of PAHs in PM2.5 was 3.9 ng/m3. (3) Foreign body granuloma formation and inflammatory cell damage were observed in the lungs of rats infected with toxin; the levels of reactive oxygen species (ROS) and mobile device assistant (MDA) increased while nitric oxide synthase (NOS) decreased with the increase of dose; the expression levels of IL-6 and IL-8 elevated with the increase of toxin dose, showing an obvious dose-effect relationship; the level of PAHs damage to cells showed a dose-effect relationship. Sub-chronic exposure to PAHs could cause sustained inflammatory injury to the organism. Measures should be taken to counter the problems of PAHs in PM2.5 in Xi'an and relevant health promotion strategies should be developed.

[Identification of Carthamus tinctorius NAC gene family and analysis of drought stress response].

The NAC(NAM/ATAF/CUC) transcription factors are members of the largest transcriptional gene family in plants and play an essential role in the response of plants to drought stress. To identify the number and function of the NAC gene family in Carthamus tinctorius, the present study adopted bioinformatics methods to identify NAC gene family members based on the whole genome data of C. tinctorius, and analyzed their physicochemical properties, chromosomal location, phylogenetic relationship, gene structure, conserved domain, and conserved motif. Meanwhile, the real-time fluorescence-based quantitative RT-PCR(qRT-PCR) was used to analyze the transcription level of four NAC genes under drought stress in different time. The results showed that C. tinctorius contained 87 NAC genes unevenly distributed on 11 chromosomes, while no NAC gene was found on chromosome 12. The encoded proteins were 103-974 amino acids and the number of CDS ranged from 3 to 9. According to the phylogenetic relationships, 87 NAC genes were clustered into17 subfamilies. The analysis of conserved domains and motifs revealed that most of the genes contained five conserved subdomains, A-E and motif2 was the most conserved among NAC genes. The expression pattern analysis showed that the transcription levels of four NAC genes related to drought resistance were all up-regulated after drought stress treatment for different time, suggesting that these four NAC genes may be related to drought resistance of C. tinctorius. This study is expected to provide a theoretical basis for further functional analysis of NAC transcription factors in C. tinctorius and references for the cultivation of drought-tolerant C. tinctorius varieties.

Protective Effects of Tyrosol against LPS-Induced Acute Lung Injury via Inhibiting NF-κB and AP-1 Activation and Activating the HO-1/Nrf2 Pathways.

Tyrosol (Tyr) is a natural antioxidant that displays anti-oxidant and anti-inflammatory properties. The present study aimed to investigate the effect and mechanism of Tyr on lipopolysaccharide (LPS)-induced acute lung injury (ALI). In a mouse model, we found that pretreatment with Tyr significantly improved survival rate, attenuated lung permeability, ameliorated histopathological alterations, reduced expression of the inflammatory mediators and improved expression of the antioxidant enzyme. Further study revealed that Tyr markedly inhibited nuclear factor-κB (NF-κB) and activator protein-1 (AP-1) activation at both in vivo and in vitro levels. To investigate the underlying mechanism, we examined the impact of Tyr on the heme oxygenase (HO)-1/nuclear factor erythroid-2 related factor 2 (Nrf2) pathway in vivo and in vitro. The results showed that Tyr significantly improved the expression of HO-1 and the activation of Nrf2. This study offers novel evidence to support the efficacy of Tyr against ALI, which helps to clarify the underlying causes of the therapeutic effects behind Tyr.

Biological Control of Meloidogyne incognita by Spore-forming Plant Growth-promoting Rhizobacteria on Cotton.

In the past decade, increased attention has been placed on biological control of plant-parasitic nematodes using various fungi and bacteria. The objectives of this study were to evaluate the potential of 662 plant growth-promoting rhizobacteria (PGPR) strains for mortality to Meloidogyne incognita J2 in vitro and for nematode management in greenhouse, microplot, and field trials. Results indicated that the mortality of M. incognita J2 by the PGPR strains ranged from 0 to 100% with an average of 39%. Among the PGPR strains examined, 212 of 662 strains (or 33%) caused significantly greater mortality percent of M. incognita J2 than the untreated control. Bacillus was the major genus initiating a greater mortality percentage when compared with the other genera. In subsequent trials, B. velezensis strain Bve2 reduced M. incognita eggs per gram of cotton root in the greenhouse trials at 45 days after planting (DAP) similarly to the commercial standards Abamectin and Clothianidin plus B. firmus I-1582. Bacillus mojavensis strain Bmo3, B. velezensis strain Bve2, B. subtilis subsp. subtilis strain Bsssu3, and the Mixture 2 (Abamectin + Bve2 + B. altitudinis strain Bal13) suppressed M. incognita eggs per gram of root in the microplot at 45 DAP. Bacillus velezensis strains Bve2 and Bve12 also increased seed-cotton yield in the microplot and field trials. Overall, results indicate that B. velezensis strains Bve2 and Bve12, B. mojavensis strain Bmo3, and Mixture 2 have potential to reduce M. incognita population density and to enhance growth of cotton when applied as in-furrow sprays at planting.

Comparison of Tripterygium wilfordii Hook F with methotrexate in the treatment of active rheumatoid arthritis (TRIFRA): a randomised, controlled clinical trial.

OBJECTIVES: To compare the efficacy and safety of Tripterygium wilfordii Hook F (TwHF) with methotrexate (MTX) in the treatment of active rheumatoid arthritis (RA). METHODS: Design: a multicentre, open-label, randomised controlled trial. All patients were assessed by trained investigators who were unaware of the therapeutic regimen. INTERVENTION: 207 patients with active RA were randomly allocated (1:1:1) to treatment with MTX 12.5 mg once a week, or TwHF 20 mg three times a day, or the two in combination. At week 12, if reduction of the 28-joint count Disease Activity Score (DAS28) was <30% in the monotherapy groups, the patient was switched to MTX+TwHF. The primary efficacy point was the proportion of patients achieving an American College of Rheumatology (ACR) 50 response at week 24. RESULTS: 174/207 (84.1%) patients completed 24 weeks of the trial. In an intention-to-treat analysis, the proportion of patients reaching the ACR50 response criteria was 46.4% (32/69), 55.1% (38/69) and 76.8% (53/69), respectively, in the MTX, TwHF and MTX+TwHF groups (TwHF vs MTX monotherapy, p=0.014; MTX+TwHF vs MTX monotherapy, p<0.001). Similar statistically significant patterns at week 24 were found for ACR20, ACR70, clinical Disease Activity Index good responses, EULAR good response, remission rate and low disease activity rate. Significant improvement in the Health Assessment Questionnaire and 36-item Short-Form Health Survey questionnaire scores from baseline to week 24 was seen in each treatment arm (p<0.05), though no significant difference was found among the treatment arms (p>0.05). The result of per-protocol analysis agreed with that seen in the intention-to-treat analysis. Seven, three and five women in the TwHF, MTX and combination groups, respectively, developed irregular menstruation (TwHF vs MTX monotherapy, p=0.216). CONCLUSIONS: TwHF monotherapy was not inferior to, and MTX+TwHF was better than, MTX monotherapy in controlling disease activity in patients with active RA. TRIAL REGISTRATION NUMBER: NCT01613079.

Complete chloroplast genome sequence of Chrysosplenium nudicaule (Saxifragaceae).

Chrysosplenium nudicaule Bunge, Tibetan name 'Yajima,' growing in the highlands of China is a perennial herb belonging to the genus Chrysosplenium Saxifragaceae. As a traditional Chinese medicine, it has been used to treat digestive diseases for hundreds of years. The complete chloroplast genome of Chrysosplenium nudicaule is 152,775 bp in length and comprises two inverted repeats (IR, 25,962 bp), a large single-copy region (LSC, 83,533 bp), and a small single-copy region (SSC, 17,318 bp). It harbors 112 genes, including 78 protein-coding genes, four ribosomal RNA genes, and 30 transfer RNA genes. In addition, the rpl32 gene was deleted. The GC content of the whole chloroplast genome is 37.54%. This chloroplast genome resource will be useful for study on the evolution and genetic diversity of C. nudicaule in the future.

Injectable thermosensitive hydrogel-based drug delivery system for local cancer therapy.

Injectable thermosensitive hydrogel has been regarded as attractive drug delivery system, which displays a sol-gel phase transition upon injection in response to temperature. Recently, thermosensitive hydrogel has become a matter of importance in cancer therapy, providing high local drug concentration, sustained release characteristics, minimal invasiveness, and low systemic toxicities. Here, we review the extensive application of thermosensitive hydrogel in local cancer therapy, including chemotherapy, photothermal therapy, photodynamic therapy, gene therapy, chemo-photothermal combined therapy, and chemo-/immuno- combined therapy.

Evaluating the Efficacy of Massage Intervention for the Treatment of Poststroke Constipation: A Meta-Analysis.

BACKGROUND: It is essential to determine a safe and effective method for treating constipation after stroke. Massage has been widely used in recent years. However, meta-analysis data on the efficacy of massage for the treatment of constipation experienced after stroke are almost nonexistent. OBJECTIVE: This review aimed to examine the effectiveness of using massage therapy to treat constipation in patients who suffered a stroke event. METHODS: This systematic review adhered to the reporting guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Electronic databases, including Cochrane Library, PubMed, EMBASE, Web of Science, China Biology Medicine, Wan Fang Data, VIP Database for Chinese Technical Periodicals, and National Knowledge Infrastructure, were searched for relevant studies on the efficacy of massage for the treatment of poststroke constipation. Rev-Man 5.3 software was used to analyze the study data. RESULTS: A total of 11 randomized controlled trials with 1045 patients were included. A statistically significant difference in the total effective rates was found between the massage and control groups (OR = 4.96; 95% confidence interval (CI): 2.81, 8.76; P < 0.001). Compared with the control groups, the massage group had markedly reduced incidences of constipation (OR = 0.34; 95% CI: 0.25, 0.47; P < 0.001) and of four symptoms of discomfort (P < 0.001). The frequency of defecation on day two and day three in the massage group was significantly higher than that in the control group (P < 0.001). CONCLUSION: Our results strongly suggest that massage can effectively reduce the incidence and severity of constipation after stroke. However, large, multicenter, long-term, and high-quality randomized controlled trials need to be conducted to establish a definitive conclusion.

Correlation between self-perceived burden and self-management behavior in elderly stroke survivors: A longitudinal observational study.

The aim of this study was to assess the levels of self-perceived burden (SPB) and self-management behavior in elderly stroke survivors during the first 3 months after acute stroke, and to explore the correlation between them.A total of 203 consecutive hospitalized elderly patients diagnosed with stroke were recruited. Self-perceived Burden Scale and Stroke Self-management Scale in 1 month (T1) and 3 months (T2) post-stroke were assessed and compared.The score of SPB in elderly stroke survivors was 28.96 ±â€Š5.50 and 27.25 ±â€Š6.17 at T1 and T2, respectively. Stroke self-management scale scored 165.93 ±â€Š9.82 at T1 and 167.29 ±â€Š10.60 at T2. In the first 3 months post-stroke, the physical burden was dominant (T1 14.73 ±â€Š3.07, T2 14.40 ±â€Š3.13), and the behavior of stroke symptoms and signs monitoring (T1 27.58 ±â€Š6.56, T2 28.64 ±â€Š6.43) and rehabilitation exercise management (T1 21.40 ±â€Š3.28, T2 20.74 ±â€Š3.15) was the worst. SPB was negatively correlated with self-management behavior (T1 r = -.202, T2 r = -.511).Elderly stroke survivors experienced a medium level of SPB and self-management behavior in the first 3 months post-stroke. There is a positive relationship between reduced SPB and improved self-management behavior. Addressing the characteristics and correlations as well as development of targeted interventions for SPB decreasing is beneficial to improving self-management behavior for elderly survivors.

Surveillance for Creutzfeldt-Jakob disease in China from 2006 to 2007.

BACKGROUND: Human transmissible spongiform encephalopathies (HTSE), or Creutzfeldt-Jakob disease (CJD), is a group of rare and fatal diseases in central nervous system. Since outbreak of bovine spongiform encephalopathy (BSE) and variant CJD, a worldwide CJD surveillance network has been established under the proposition of WHO. In China, a national CJD surveillance system has started since 2002. The data of CJD surveillance from 2006 to 2007 was analyzed. METHODS: Total 12 provinces are included in CJD surveillance system. The surveillance unit in each province consists of one or two sentinel hospitals and the provincial CDC. All suspected CJD cases reported from CJD surveillance were diagnosed and subtyped based on the diagnostic criteria for CJD issued by WHO. RESULTS: Total 192 suspected CJD cases were reported and 5 genetic CJD, 51 probable and 30 possible sporadic CJD (sCJD) cases were diagnosed. The collected sCJD cases distribute sporadically without geographical clustering and seasonal relativity and the highest incidences in both probable and possible sCJD cases appeared in the group of 60-69 year. The most common three foremost symptoms were progressive dementia, cerebellum and mental-related symptoms. The probable sCJD patients owning both typical EEG alteration and CSF protein 14-3-3 positive have more characteristic clinical syndromes than the ones having only one positive. The polymorphisms of codon 129 of all tested reported cases shows typical patterns of Han Chinese as previous reports, that M129M are predominant whereas M129V are seldom. CONCLUSION: Chinese CJD patients possessed similar epidemiological and clinical characteristics as worldwide.

Biological control of Heterodera glycines by spore-forming plant growth-promoting rhizobacteria (PGPR) on soybean.

Heterodera glycines, the soybean cyst nematode, is the most economically important plant-parasitic nematode on soybean production in the U.S. The objectives of this study were to evaluate the potential of plant growth-promoting rhizobacteria (PGPR) strains for mortality of H. glycines J2 in vitro and for reducing nematode population density on soybean in greenhouse, microplot, and field trials. The major group causing mortality to H. glycines in vitro was the genus Bacillus that consisted of 92.6% of the total 663 PGPR strains evaluated. The subsequent greenhouse, microplot, and field trials indicated that B. velezensis strain Bve2 consistently reduced H. glycines cyst population density at 60 DAP. Bacillus mojavensis strain Bmo3 suppressed H. glycines cyst and total H. glycines population density under greenhouse conditions. Bacillus safensis strain Bsa27 and Mixture 1 (Bve2 + Bal13) reduced H. glycines cyst population density at 60 DAP in the field trials. Bacillus subtilis subsp. subtilis strains Bsssu2 and Bsssu3, and B. velezensis strain Bve12 increased early soybean growth including plant height and plant biomass in the greenhouse trials. Bacillus altitudinis strain Bal13 increased early plant growth on soybean in the greenhouse and microplot trials. Mixture 2 (Abamectin + Bve2 + Bal13) increased early plant growth in the microplot trials at 60 DAP, and also enhanced soybean yield at harvest in the field trials. These results demonstrated that individual PGPR strains and mixtures can reduce H. glycines population density in the greenhouse, microplot, and field conditions, and increased yield of soybean.

[Report of three death cases of imported falciparum malaria in Wenzhou City].

The three death cases of falciparum malaria in Wenzhou City were all imported from Africa. One patient died on 10 January 2007 because of severe clinical symptoms after hospitalization. The second case was initially misdiagnosed as influenza in primary health and medical institution. The patient's condition quickly worsened and died of Plasmodium falciparum infection on 5 March 2011. The third patient belonged to "non-identity" person, and there were no detailed information and epidemiological history on admission, which resulted in the delayed diagnosis, disease exacerbation and death. In conclusion, the health education should be provided to the people who return from Africa and also to medical workers in order to reduce the mortality of falciparum malaria.

Contribution and underlying mechanisms of CXCR4 overexpression in patients with systemic lupus erythematosus.

Aberrant expression of CXCR4 has been indicated to play a role in the pathogenesis of systemic lupus erythematosus (SLE), but the mechanism of CXCR4 dysregulation in SLE is unclear. This study is aimed to explore the clinical significance and possible mechanisms of abnormal CXCR4 expression on B cells from patients with untreated SLE. Expression of CXCR4 on peripheral B cells was determined by flow cytometry and western blotting. Freshly isolated B cells were cultured with exogenous interleukin 21(IL-21) in the presence or absence of CD40 ligand (CD40L) plus anti-IgM antibody (aIgM), and changes in CXCR4 expression were detected. Involvement of phosphatidylinositol 3 kinase (PI3K)/Akt and Janus kinase/Signal transducer and activator of transcription (JAK/STAT) signaling pathways was assessed by adding blocking agents Ly294002 and AG490. Since CD63 is reported to mediate endosomal recruitment of CXCR4 and BCL6 is capable of silencing CD63 gene transcription, we also measured BCL6 and CD63 gene transcription with real-time PCR. It was shown that CXCR4 expression on B cells was significantly upregulated in SLE patients, especially in those with lupus nephritis, and was positively correlated with SLE Disease Activity Index scores and negatively with the serum complement 3 levels (P<0.05). Downregulation of CXCR4 by IL-21 was intact. In contrast, a similar effect of aIgM plus CD40L in downregulating CXCR4 expression was defective in SLE patients but was restored by co-stimulation with IL-21 in vitro. Both Ly294002 and AG490 promoted downregulation of surface CXCR4 expression on B cells from SLE patients (P=0.078 and P=0.064). Furthermore, B cells from SLE patients exhibited diminished CD63 mRNA and enhanced BCL6 mRNA expression (both P<0.05). To sum up, CXCR4 was overexpressed on SLE B cells, positively correlating with disease activity and kidney involvement. Overactivation of the PI3K/Akt and JAK/STAT pathways as well as defective CD63 synthesis may contribute to CXCR4 dysregulation in SLE.

Optimization of In Vitro Techniques for Distinguishing between Live and Dead Second Stage Juveniles of Heterodera glycines and Meloidogyne incognita.

Heterodera glycines (Soybean Cyst nematode, or SCN) and Meloidogyne incognita (Root-Knot nematode, or RKN) are two damaging plant-parasitic nematodes on important field crops. Developing a quick method to distinguish between live and dead SCN and RKN second stage juveniles (J2) is vital for high throughput screening of pesticides or biological compounds against SCN and RKN. The in vitro assays were conducted in 96-well plates to determine the optimum chemical stimulus to distinguish between live and dead SCN and RKN J2. Sodium carbonate (Na2CO3), sodium bicarbonate (NaHCO3), and sodium hydroxide (NaOH) were evaluated for the nematode response to see if these compounds can help distinguish between viable from the dead J2. Results indicated that live SCN J2 responded equally (P ≤ 0.05) to 1 µl Na2CO3 and 10 µl NaHCO3 in 100 µl of water at pH = 10. Live SCN J2 responded by twisting their bodies in a curling shape and increasing rate of movements within 2 minutes of exposure. The twisting activity continued for up to 30 minutes. Live RKN J2 responded by increasing activity with the application of 1 µl NaOH in 100 µl of water at pH = 10 also in the 2 minutes to 30 minutes time frame. Furthermore, in growth chamber tests to confirm the infectivity of live SCN. The live SCN as determined by exposure to 1 µl of Na2CO3 indicated 60.5% of the SCN J2 were alive and of those, 29.5% were infective and entered the soybean roots. The 1 µl of NaOH stimulus revealed that 75.2% RKN J2 were alive and of those, 14.9% were infective and entered soybean roots. These results confirmed that 1 µl of Na2CO3 added to 100 µl suspension of SCN J2 and 1 µl of NaOH added to 100 µl suspension of RKN J2 are the effective stimuli for rapidly distinguishing between live and dead SCN and RKN J2 in vitro. SCN and RKN J2 responded differently to different compounds.

[Epidemiological analysis of malaria situation in Wenzhou City in 2015].

OBJECTIVE: To analyze the characteristics of malaria prevalence in Wenzhou City, so as to provide the evidence for improving the comprehensive control of malaria. METHODS: The epidemiological data of malaria cases in Wenzhou City in 2015 were collected and analyzed with the descriptive epidemiological methods. RESULTS: Totally 24 imported malaria cases were reported in Wenzhou City in 2015 with the incidence of 0.26 per 100 000 and no case was dead. Plasmodium vivax, P. falciparum, and P. ovale were identified in 1 (4.17%), 20 (83.33%), and 3 (12.50%) cases, respectively. The cases reported in Rui'an, Cangnan and Lucheng counties/districts accounted for 70.83% (17/24) of the total cases in Wenzhou City. The cases were mostly concentrated in male young adults and 23 cases (95.83%) were imported from Africa. CONCLUSIONS: Malaria epidemic situation in Wenzhou City is relatively stable and no local malaria cases were reported in 2015. However, the control work of imported malaria should be strengthened.

Defective PTEN regulation contributes to B cell hyperresponsiveness in systemic lupus erythematosus.

PTEN regulates normal signaling through the B cell receptor (BCR). In systemic lupus erythematosus (SLE), enhanced BCR signaling contributes to increased B cell activity, but the role of PTEN in human SLE has remained unclear. We performed fluorescence-activated cell sorting analysis in B cells from SLE patients and found that all SLE B cell subsets, except for memory B cells, showed decreased expression of PTEN compared with B cells from healthy controls. Moreover, the level of PTEN expression was inversely correlated with disease activity. We then explored the mechanisms governing PTEN regulation in SLE B cells. Notably, in normal but not SLE B cells, interleukin-21 (IL-21) induced PTEN expression and suppressed Akt phosphorylation induced by anti-immunoglobulin M and CD40L stimulation. However, this deficit was not primarily at the signaling or the transcriptional level, because IL-21-induced STAT3 (signal transducer and activator of transcription 3) phosphorylation was intact and IL-21 up-regulated PTEN mRNA in SLE B cells. Therefore, we examined the expression of candidate microRNAs (miRs) that could regulate PTEN: SLE B cells were found to express increased levels of miR-7, miR-21, and miR-22. These miRs down-regulated the expression of PTEN, and IL-21 stimulation increased the expression of miR-7 and miR-22 in both normal and SLE B cells. Indeed, a miR-7 antagomir corrected PTEN-related abnormalities in SLE B cells in a manner dependent on PTEN. Therefore, defective miR-7 regulation of PTEN contributes to B cell hyperresponsiveness in SLE and could be a new target of therapeutic intervention.

The application of percutaneous lysis of epidural adhesions in patients with failed back surgery syndrome.

PURPOSE: To investigate the efficacy and the feasibility of application of percutaneous lysis of epidural adhesions in failed back surgery syndrome (FBSS) using a stiff type guide wire and 4F vascular catheter. METHODS: Ninety two patients with FBSS were randomly divided into two groups, the control group (treated by injection dexamethasone only) and percutaneous lysis of epidural adhesions group. Visual analog scale scores (VAS) and therapeutic evaluation were observed in the preoperative, seven days postoperative, one month and six months postoperative. RESULTS: VAS scores for pain were significantly reduced in both groups at seven days. The VAS scores were in controlled group at one month, six months was significantly higher than that in epidural lysis group. However, there was no statistical difference in VAS scores of one month and six months when respectively compared to that of before operation in controlled group. Patients on epidural lysis reported clinical effectiveness rate was 50%. Patients on control was 5.26%, there was a statistical difference between two groups. CONCLUSION: Percutaneous lysis of epidural adhesions by using a stiff type guide wire and 4F vascular catheter is an effective method in the treatment of FBSS and it has a value in clinical application.

[Risk factors for influenza A (H1N1)-associated pneumonia on hospitalized people less than 18 years old in China, 2009-2010].

OBJECTIVE: To describe the epidemiological and clinical features of hospitalized people less than 18 years old with influenza A (H1N1)-associated pneumonia and associated risk factors. METHODS: Through Chinese Reporting System of Influenza A (H1N1), children aged under 18 years who were hospitalized with laboratory confirmed influenza A (H1N1), case report forms and related information on pneumonia were collected between 1 September 2009 and 4 July 2010. Epidemiological and clinical characteristics including demographics, underlying chronic diseases, treatment, complications and clinical outcome etc. were described. Hospitalized children with pneumonia were compared with those without the above mentioned features, through the univariate and multivariate analysis. RESULTS: There were 4240 influenza A (H1N1)-associated hospitalized children with case report forms identified. Of the 4107 influenza A (H1N1)-associated hospitalized children with related information on pneumonia shown in the case report forms, 2289 (55.7%) of them had pneumonia. Hospitalized children with influenza A (H1N1)-associated pneumonia had a younger median age (4.9 year old), when compared with those without pneumonia (13.1 year old, P<0.0001). When compared with the hospitalized children without pneumonia, those hospitalized children with pneumonia were more likely to require intensive care unit care, using mechanical ventilation equipment to develop ARDS, respiratory failure or leading to death. Data from multivariate analysis showed that children aged<6 months (OR=7.08, 95%CI: 4.15-12.06) between 6 and 23 months (aOR=8.26, 95%CI: 6.10-11.20) or between 2 to 4 year old (aOR=9.53, 95%CI: 7.39-12.29) were more likely to develop pneumonia than children aged 5 to 17. Factors as having asthma (OR=12.19, 95%CI: 5.18-28.72), cardiovascular disease (OR=5.19, 95%CI: 1.94-13.90), chronic renal diseases (OR=2.14, 95%CI: 1.02-4.53), chronic hepatic diseases (OR=5.26, 95%CI: 1.40-19.81) and allergy (OR=2.54, 95%CI: 1.64-3.93) were significantly associated with influenza A (H1N1)-associated pneumonia. Risk of complication with pneumonia had an increase when oseltamivir treatment was initiated>2 days after the onset of illness. CONCLUSION: Pneumonia was a common complication among children hospitalized with influenza A (H1N1). Hospitalized children with influenza A (H1N1)-associated pneumonia were more likely to develop either severe clinical courses or outcomes than those without pneumonia.

[Epidemiological characteristics on the clustering nature of pandemic (H1N1) 2009 in China].

OBJECTIVE: To study the epidemiological characteristics on the clustering nature of pandemic (H1N1) 2009 in China. METHODS: Time and place distribution of pandemic (H1N1) 2009 on the nature of clustering through data from Public Health Emergency Management Information System were described. RESULTS: As of August 10, 2010, 2773 pandemic (H1N1) 2009 clusters, a total of 77 363 cases (including 20 deaths) were reported in the mainland of China. The most reported number of clusters was from schools and kindergartens with the total number of 2498 (accounted for 90.08% of the total number). Middle schools appeared the have the most clusters (1223, accounting for 48.96%). The number of clusters reported in the southern provinces (cities) accounted for 77.03% of the total, and was more than that in the northern provinces (cities). Two reported peaks in the southern provinces (cities) were in June and November, 2009, respectively. There was only one reported peak in the northern provinces in September, 2009. CONCLUSION: Time and place distribution characteristics on the clusters of pandemic (H1N1) 2009 were similar to the seasonal influenza, but the beginning of winter peak was much earlier and intensity of reporting was much higher on the clusters of pandemic (H1N1) 2009 than that of seasonal influenza.

The application of percutaneous lysis of epidural adhesions in patients with failed back surgery syndrome / A aplicação da lise percutânea de aderências epidurais em pacientes com síndrome pós-laminectomia

PURPOSE: To investigate the efficacy and the feasibility of application of percutaneous lysis of epidural adhesions in failed back surgery syndrome (FBSS) using a stiff type guide wire and 4F vascular catheter. METHODS: Ninety two patients with FBSS were randomly divided into two groups, the control group (treated by injection dexamethasone only) and percutaneous lysis of epidural adhesions group. Visual analog scale scores (VAS) and therapeutic evaluation were observed in the preoperative, seven days postoperative, one month and six months postoperative. RESULTS: VAS scores for pain were significantly reduced in both groups at seven days. The VAS scores were in controlled group at one month, six months was significantly higher than that in epidural lysis group. However, there was no statistical difference in VAS scores of one month and six months when respectively compared to that of before operation in controlled group. Patients on epidural lysis reported clinical effectiveness rate was 50%. Patients on control was 5.26%, there was a statistical difference between two groups. CONCLUSION: Percutaneous lysis of epidural adhesions by using a stiff type guide wire and 4F vascular catheter is an effective method in the treatment of FBSS and it has a value in clinical application.

OBJETIVO: Investigar a eficácia e a exequibilidade da aplicação da lise percutânea de aderências epidurais na síndrome pós-laminectomia usando um fio-guia tipo Stiff e um cateter vascular 4F. MÉTODOS: Noventa e dois pacientes com síndrome pós-laminectomia foram randomizados em dois grupos: grupo controle (tratado somente com injeção de dexametazona) e grupo lise percutânea de aderências epidurais. Escores de escala visual analógica (VAS) e avaliação terapêutica foram observadas no pré-operatório, no sétimo dia de pós-operatório, um mês e seis meses de pós-operatório. RESULTADOS: Escores VAS para dor foram significantemente reduzidos em ambos os grupos aos sete dias. Os escores VAS foram mais altos no grupo controle comparado ao da lise epidural nos tempos de um mês e seis meses. Entretanto, não há diferença estatística nos escores VAS de um mês e seis meses quando comparados, respectivamente, àqueles de antes da operação do grupo controle. Pacientes com a lise epidural relataram taxa de eficiência de 50%. Nos pacientes do grupo controle foi 5,26%, havendo diferença estatística entre os dois grupos. CONCLUSÃO: A lise percutânea de aderências epidemias usando um fio-guia tipo Stiff e um cateter vascular 4F mostrou-se um método efetivo no tratamento de FBSS e tem valor na aplicação clínica.