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Objective:To investigate the clinical characteristics of family clustering pediatric and adult cases with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant infection in Shanghai City.Methods:A field investigation among the pediatric cases with Omicron variant infection and their household contacts from April 4 to April 30, 2022 in Children′s Hospital of Fudan University was conducted. The informations on case finding, clinical manifestations and SARS-CoV-2 vaccination status were collected. The epidemiological and clinical characteristics were compared between pediatric cases and adult cases. The independent sample t test or chi-square test was used for statistical analysis, and the relative risk ( RR) and 95% confidence interval (95% CI) were used to evaluate the protective effect of vaccination on the infection of Omicron variant. Results:There were 1 274 family members in 297 families including 370 children and 904 adults of whom 1 110(87.13%) were infected with Omicron variant, with 989(89.10%) symptomatic and 121(10.90%) asymptomatic. There were 355 children infected with Omicron variant, of whom 337(94.93%) were symptomatic, and the main manifestations were fever (96.74%(326/337)) and cough (40.36%(136/337)). Only one pediatric case with Rett syndrome developed critically severe pneumonia. A total of 194 pediatric cases had imaging examination, 64(32.99%) showed pulmonary inflammatory lesions. There were 755 adult cases infected with Omicron variant, of whom 652(86.26%) reported symptoms, and the main manifestations were fever (73.16%(477/652)) and cough (49.85%(325/652)). Among symptomatic cases, fever was more common in pediatric cases than in adult cases, while cough was more common in adult cases than in pediatric cases, and the differences were both statistically significant ( χ2=80.87 and 8.04, respectively, both P<0.01). The fever spike was higher in pediatric cases than in adult cases ((39.3±0.7) ℃ vs (38.6±0.6) ℃), and the difference was statistically significant ( t=9.85, P<0.001). The interval from the onset of symptoms to cycle threshold (Ct) value of the nucleic acid of Omicron variant≥35 was longer in pediatric cases than in adult cases ((13.0±3.1) d vs (10.9±3.6) d), and the difference had statistically significance ( t=2.97, P=0.004). Among 160 children aged 3 to 18 years, 54 (33.75%) received two-dose vaccination. Among the 904 adults, 388 (42.92%) received two-dose vaccination and 293 (32.41%) received a booster dose. In the adult cases, the risk of symptomatic infection was reduced by only 8% ( RR=0.92, 95% CI 0.86 to 0.98, P=0.014) following two-dose vaccination, and the risks of fever and cough following booster vaccination were reduced by 42%( RR=0.58, 95% CI 0.49 to 0.67, P=0.001) and 50% ( RR=0.50, 95% CI 0.34 to 0.78, P=0.001), respectively. Conclusions:Secondary attack rate and symptomatic rate of household infection are high in the context of the Omicron variant outbreak in Shanghai. Symptomatic infection is common in children and adults in household setting. Fever is the most common symptom and fever duration is short. Booster vaccination may provide certain protection against common symptoms caused by Omicron variant infection.
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There are still many existing problems in the training of medical undergraduates and microsurgery talents in China, such as lack of scientific research ability and scientific literacy of medical undergraduates, insufficient practical ability, short of scientific research opportunities for medical undergraduates, and inadequate talent reserve in microsurgery. In view of the above shortcomings, Wannan Medical College has established a training course on microneurosurgery technology for medical undergraduates, and made a preliminary exploration to solve the above problems. Through the training, undergraduates not only improve their practical ability, but also stimulate their interest in microsurgery, which will help them adapt to clinical and scientific research work at an early stage. Neurosurgical microscopic technology training with emphasis on extracurricular expansion as main content, plays an important role in the cultivation of undergraduate microscopic skills, the establishment of basic theories of neurosurgery, the improvement of scientific research accomplishment and the expansion of extracurricular vision.
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Strengthening clinical research is an inevitable requirement for expediting the development of the medical and healthcare services, as well as enhancing the capability of the hospitals in China. On the basis of sufficient argumentation of the significance and the internal and external environment of developing clinical research according to structure-conduct-performance analysis model, Henan Cancer Hospital set the aim of transforming from clinical hospital to clinical research hospital. By constructing a high-level phase Ⅰ clinical trials center, establishing the department of clinical research management, promoting the collaborative innovation and cooperation among medical institutions, research institutions, and enterprises, and developing the accessory clinical trial management system, Henan Cancer Hospital has turned abundant patient resources into advantages of clinical research. The quality and quantity of clinical trials have been elevated significantly, which could provide strong impetus for hospital′s discipline construction and high-quality development.
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Objective@#To understand the current situation of tobacco use in primary and secondary school staff members in Beijing in 2019, and its association with adolescent tobacco use and exposure, in order to promote the construction of smoke-free schools.@*Methods@#During April to June in 2019，PPS sampling was used to select primary schools, secondary schools and vocational high school. Each selected school randomly investigates 20 faculty members, totalling 2 737. The monitoring contents mainly include the current tobacco use, knowledge and attitude towards health risk of smoking among the school staff.@*Results@#The faculty did not receive the training of adolescent tobacco control (OR=0.20,95%CI=0.14-0.28) were only 20% likely to teach tobacco hazard knowledge compared to the trained staff, and refusal to use tobacco control instruction manual (OR=0.21,95%CI=0.14-0.32) was negatively associated with teaching tobacco control with students. Staff members having given lectures on tobacco refusal were more inclined to uphold "any people can t smoke anywhere on campus "(98.53%), and the interpretation of the rules tends to be more clear. Staff who has been employed for 20-30 years (OR=3.35,95%CI=2.22-5.05) were the most probably to preach tobacco control among students(P＜0.05).@*Conclusion@#Staff caring about health and participate actively in health training were more willing to spread health knowledge. More attention should be paid to the cultivation of health literacy of school staff, and proactively guide faculty unwilling to instruct students in health hazard of smoking to gradually realize the importance of adolescent tobacco control.
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Objective:To investigate the effect of expanded lymphadenectomy on the survival rate of the patients with hilar cholangiocarcinoma(HC).Methods:The clinical data of 129 patients undergoing radical resection of HC were retrospectively analyzed. According to the range of lymphadenectomy, they were divided into regional group(91 cases) and expanded group(38 cases). The clinical data, survival rate and postoperative complications in two groups were compared and analyzed.Results:The 3-year and 5-year survival rates of metastasis free(M0) patients in the regional group and expanded group were 44.1%, 24.8% and 47.0%, 33.6%, respectively; there were no statistically significant difference in survival rates between the two groups(χ 2=0.662, P=0.416). Compared with patients in the regional group, the average number of harvested lymph nodes in the expanded group was significantly increased and the difference was statistically significant( t=14.678, P=0.000), while the incidence of severe complications and mortality does not increase significantly. Conclusion:Expanded lymphadenectomy did not improve the survival rate of M0 HC patients, which while yielding more lymph nodes does not increase the incidence of postoperative complications and mortality in resectable HC patients.
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Objective:To study the impact of additional resection of an intraoperative proximal bile duct positive margin on the survival rate of patients with hilar cholangiocarcinoma (HCCA).Methods:The clinical data of 214 patients with HCCA treated at the First Affiliated Hospital of Zhengzhou University from January 2000 to January 2017 were analyzed. There were 126 males and 88 females, aged (62.3±17.1) years. These patients were divided into three groups according to the pathological status of bile duct margins and whether the proximal bile duct was further resected. Group A consisted of patients with negative margins without additional resection (161 cases). Group B consisted of patients with negative margins after additional resection (21 cases). Group C consisted of patients with R 1 resections (32 cases). The Kaplan-Meier method was used for survival analysis and log-rank test was used for inter-group comparison. Univariate and multivariate Cox regression analysis were used to analyze prognostic factors. Results:The 3-year and 5-year survival rates of patients in groups A, B, and C were 37.1%, 28.6%, 0 and 18.5%, 10.7%, 0, respectively. The cumulative survival rates of patients in group A and group B were significantly higher than that in group C (all P<0.05). Multivariate Cox regression analysis showed that R 1 proximal bile duct margin ( HR=3.728, 95% CI: 2.531-4.936), margin width >5 mm ( HR=0.534, 95% CI: 0.224-0.857), and T 3-4 staging ( HR=5.655, 95% CI: 3.174-8.203) were independent influencing factors for overall survival of patients with HCCA after attempted radical surgery. Conclusion:The survival rate of patients with HCCA with a positive proximal bile duct margin was significantly improved by further resecting the bile duct to obtain a negative margin. The R 1 proximal bile duct margin was an independent risk factor for prognosis in patients with HCCA after attempted radical resection.
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Objective:To investigate the effect of local antibiotics irrigation on chronic proliferative cholangitis (CPC).Methods:CPC model of rabbits was established. Rabbits were divided into CPC group (without local antibiotics irrigation, n=20) and experimental group (with local antibiotics irrigation, n=20). Only the gallbladder was removed, and 20 rabbits with free bile duct (sham operation) were used as normal control. The inflammatory conditions, proliferation of cholangiocytes, biliary fibrosis and biliary stones formation ability were analyzed. Results:Compared with CPC group, the relative expression of inflammation index lipopolysaccharide and interleukin-6 [(1.21±0.13) vs. (3.24±0.21), (1.52±0.22) vs. (3.10±0.23)], biliary cell proliferation index cyclooxygenase-2 and vascular endothelial growth factor [(2.15±0.12) vs. (4.07±0.22), (2.44±0.14) vs. (3.22±0.21)], fibrosis index transforming growth factor-β and Collagen-I [(2.44±0.28) vs. (4.36±0.44), (1.54±0.13) vs. (2.22±0.18)] and biliary stones formation index β-glucuronidase and Mucin 5AC [(1.74±0.20) vs. (3.42±0.31), (1.47±0.15) vs. (2.81±0.22)] were significantly decreased in experimental group (all P<0.05). Conclusion:Local antibiotics irrigation could inhibit CPC by inhibiting the chronic inflammation of the biliary tract and excessive proliferation of cholangiocytes and biliary fibrosis, and reducing the probability of biliary stone formation.
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Objective To analyze the bone metabolism in hospitalized patients with Graves disease and the changes after 131I therapy.Methods The differences of bone metabolism were analyzed between 315 patients with Graves disease and 300 normal controls in a case-control study.The changes in bone turnover markers and BMD levels before and one year after 131I therapy were observed in 60 patients.Results Compared to normal control,bone turnover markers were markly higher and BMD levels were lower in patients with Graves disease.The level of thyroid hormones were positively related to bone turnover markers,while negatively related to total hip BMD (Z-score).But there was no linear relationship with lumbarand femoral neck BMD (Z-score).After one year of 131I therapy,bone turnover markers were markly lower than that before treatment,while BMD levels were partly higher than that before treatment.Conclusions In Graves disease patients,bone turnover markers were generally increased,while BMD levels decreased compared with normal people.After 131I therapy,along with the improvement of thyrotoxicosis,the high bone turnover rate can be suppressed,and BMD can partly recover.
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Objective To understand the infectious pathogens distribution and drug resistance in the surgical departments of our hospital from 2007 to 2011 to provide the basis for the anti-infective therapy in the surgical patients.Methods TheVitek automatic microbial identification system was used to identify bacteria and fungi.The Kirby-bauer (KB)method was used to study the antibi-otic resistance in the pathogens isolated from the patients in the surgical departments.Results 1218 strains of pathogens were iso-lated,including 669 strains(55%)of Gram-negative bacteria,440 strains(36%)of Gram-positive bacteria and 109 strains (9%)of fungi.The top five of bacteria in turn were Escherichia coli in 182 strains(15%),Pseudomonas aeruginosa in 171 strains (14%), Staphylococcus aureus in 105 strains (9%),Klebsiella pneumoniae in 86 strains (7%)and Enterococcus faecalis in 61 strains(5%). Among 283 strains of Escherichia coli,Klebsiella pneumoniae and proteus mirabilis,the detection rate of ESBLs producing strains was 29.7%.Methicillin-resistant Staphylococcus aureus(MRSA)accounted for 63% of Staphylococcus aureus.The resistance rates of Staphylococcus and Enterococcus to multiple antibacterial drugs were above 50%.Enterobacteriaceae bacteria were more sensi-tive to carbapenems as well as compound antibacterial drugs containing enzyme inhibitor.The lowest resistance rate of Acinetobact-er to cefoperazone/sulbactam was 21.1%.Pseudomonas aeruginosa showed the most sensitive to compound antibacterial drugs con-taining enzyme inhibitor and its lowest resistance rate to cefoperazone/sulbactam was 17.4%.Conclusion The drug resistance phe-nomenon in the pathogens isolated from the surgical patients are relatively serious,this study provides some basis for the preventive antimicrobial drugs use in the perioperative period and the empirical medication in the infection therapy.
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5 patients with chronic prolonged mandibular dislocations(CPMD)were examined by CT scan.The patients were treated by manual reduction under general anaesthesia and muscle relaxants.Traction was performed with ligaturing steel wires on fixation titanium screws intermaxillaryly and wrapping up the skull-jaw bone with elastic bandages for 3 weeks.After 1 month,a maximal mouth opening of o-ver 30 mm was noted and no episode of redislocation occurred in 3 -34 month follow-up.
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Objective To explore the risk factors of Qi deficiency syndrome of type 2 diabetes mellitus and to provide evidence for prevention and cure diabetes mellitus with TCM.Methods On the basisof the epidemiological survey,147 cases of Type 2 diabetes mellitus were collected and divided into Qi deficiency syndrome group and non-Qi deficiency syndrome group.The relationships between risk factors and Qi deficiency syndrome were analyzed by unconditional univariate and multivariate Logistic regression.Results Two hours postprandial blood sugar[2PPBS (β value is-0.764,OR (95％CI) is 0.466 (0.236 ～ 0.919)],apolipoprotein-B [APo-B (β value is-1.005,OR (95％CI)is 0.366 (0.140～0.959)],urine glucose [β value is-1.300,OR(95％CI)is 0.273 (0.127～0.584)] were inverse correlation with Qi deficiency syndrome of type 2 diabetes mellitus.Conclusion Qi deficiency syndrome of type 2 diabetes mellitus was inverse correlation with 2PPBS、APo-B and urine glucose.
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Objective To observe the acute toxicity of local achyranthes aspera, and its injury to major internal organs. Methods Estimated the dose before the experiment, then selected 40 mice and divided them into five groups randomly, namely 4 dose-groups and one control group. The doses used in the dose-groups were 400 g/kg, 300 g/kg, 225 g/kg and 169 g/kg respectively. Observed the symptoms and the death for successive 7 days and calculated LD (50)with statistic methods. Dissected the dead mice and observed the lesion of organs. Results The LD50 of acute toxicity test of achyranthes aspera was 309.21 g/kg, Sx=0.0359 g/kg. 95% of the limit of trust was 309.14～309.28 g/kg. According to the acute toxic standard, it belonged to non-toxicity. The specimen revealed that large dose administration caused coagulation of blood in both liver and spleen. Conclusion Local achyranthes aspera had little toxicity. Large dose administration affected heart function of mice.
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OBJECTIVE:To establish the methods for content determination of lead and cadmium in Achyranthes bidentata from different habitats.METHODS:Graphite furnace atomic absorption spectrometry was applied.RESULTS:There were a good linear relationship between the concentration and absorbance of lead and cadmium.The linear range of lead were 0～80.00 ?g?L-1(r=0.999 6) with recovery of 95%～101%(RSD ranged from 0% to 5.00%,n=10).The linear range of cadmium were 0～7.000 ?g?L-1(r=0.998 2) with recovery of 98%～103%(RSD ranged from 1.00% to 5.00%,n=10).CONCLUSION:The method is simple,accurate,convenient and sensitive and the results are satisfactory.