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Objective:To analyze the etiological and epidemiological characteristics of hand, foot and mouth disease (HFMD) in Xi′an from 2019 to 2021, so as to provide evidence for the prevention and control of HFMD.Methods:Stool specimens and anal swabs were collected from patients with HFMD. Enteroviruses (EVs) including enterovirus 71 (EV71), coxsackievirus A16 (CVA16), CVA6 and CVA10 were detected by RT-PCR. Excel 2007 and SPSS18.0 software were used for data collection and statistical analysis, respectively. The epidemiological data of HFMD cases were analyzed by descriptive epidemiology method. The VP1 gene sequence of the representative strain of each CVA6 genotype was downloaded. Phylogenetic trees were constructed using MEGA X software and the genetic characteristics were analyzed.Results:A total of 1 531 HFMD cases were involved and 1 365 were positive for EVs with a positive rate of 89.16%. The detection rates of EV71, CVA16, CVA6, CVA10 and other EVs were 1.31% (20/1 531), 32.46% (497/1 531), 38.47% (589/1 531), 5.09% (78/1 531) and 11.23% (172/1 531), respectively. There were significant differences in the pathogen composition in HFMD cases of different clinical types (χ 2=46.14, P<0.01) and occupations (χ 2=34.65, P<0.01) as well as in different years (χ 2=462.86, P<0.01). The average age was greater in patients with CVA16 infection than in those with CVA6 or CVA10 infection ( F=6.00, P<0.01). In 2019, the HFMD cases were mainly caused by CVA16, while in 2020 and 2021, the main pathogen was CVA6. Enterovirus-positive cases showed a bimodal distribution with the main peak from May to July and the secondary peak from September to November. CVA16 was the predominant pathogen in spring and summer, and CVA6 was the predominant pathogen in autumn. CVA6 was the dominant pathogen in eight districts and counties of Xi′an; CVA16 was the dominant pathogen in six districts and counties; CVA6 and CVA16 co-circulated in one district. The CVA6 isolates belonged to two evolutionary branches of D3a subtype. Conclusions:CVA6 and CVA16 were the prevalent pathogens of HFMD and CVA6 subtype D3a circulated in Xi′an from 2019 to 2021. The pathogen composition of HFMD cases showed obvious differences in population, time and regional distribution.
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CCAAT enhancer binding protein β (C/EBPβ), as a nuclear transcription factor necessary for the development of liver, airway epithelium, and adipose tissue, plays a vital role in physiological processes related to cell proliferation, apoptosis, and differentiation. However, the up-regulation of C/EBPβ activates signal pathways related to inflammatory response, epithelial-mesenchymal transition, cell proliferation and invasion, immune response, and angiogenesis by regulating a series of downstream genes transcription promotes the development of lung diseases. Therefore, targeting C/EBPβ may be a potential treatment strategy for lung diseases. This paper summarizes the regulatory effects of C/EBPβ and related signaling pathways in lung infection, asthma, chronic obstructive pulmonary disease, lung injury, pulmonary fibrosis, and lung cancer to provide a theoretical basis for the precision medicine of lung diseases.
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@#<b>Objective</b> To investigate the radionuclide radium-226 and natural uranium content in the main agricultural products around a decommissioned uranium tailings pondand to determine the radioactivity level in the food around the tailings pond. <b>Methods</b> From 2017 to 2021, several samples of rice and beans were collected in the surrounding area of the tailings pond for five consecutive years, and the concentrations of radium-226 and natural uranium were measured by a high-purity germanium gamma spectrometer. The annual accumulated effective dose of internal exposure caused by radium-226 ingested through local standard human diet was estimated by the indirect method. <b>Results</b> The detection rate of natural uranium in rice was 96.0%, and the detection rate of radium-226 was 74.0%; the detection rate of natural uranium in beans was 96.7%, and the detection rate of radium-226 was 73.3%. The annual accumulated effective dose caused by radium-226 ingested through diet was about 170.22 μSv/a in surrounding residents. <b>Conclusion</b> The concentrations of radium-226 and natural uranium in the main agricultural products around the tailings pond are within the limit of the national standard. By comparing with the research results in related fields in China, the radiation effects caused by radium-226 ingested through dieton the residents around the tailings pond are acceptable.
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Acute lung injury/acute respiratory distress syndrome (ALI/ARDS) is a life-threatening lung disease characterized by refractory hypoxemia. Metabolomics is an emerging discipline for qualitative and quantitative analysis of small molecular weight metabolites in organisms or cells. Mass attention has been paid to its role in disease diagnosis and treatment. Recently, many metabolites based on metabolomics have been proposed as potential biomarkers for early development and prognosis of ALI/ARDS, and provide insights into new targeted interventions. Based on metabolomics, this article discusses the role of endogenous metabolites in the pathogenesis and biomarkers of ALI/ARDS, and summarizes its application in medical therapy.
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Acute lung injury/acute respiratory distress syndrome (ALI/ARDS) is a common respiratory disease in clinic, and with a pathological manifestation of pulmonary edema, decreased pulmonary compliance as well as pulmonary epithelial/endothelial cells injury. At present, it was suggested that systemic inflammatory response syndrome (SIRS) caused by various causes which play an important role in the occurrence and development of ALI/ARDS. Widely activated neutrophils can migrate to lung tissue and release plenty of proteases in the procedure of SIRS, including neutrophil serine proteases (NSPs), lysozyme, myeloperoxidase and collagenase, which can induce severe lung injury. Meanwhile, NSPs, such as neutrophil elastase (NE), cathepsin G (CG), proteinase 3 (PR3) and neutrophil serine proteinase 4 (NSP4), are important in the pathogenesis of ALI/ARDS. Therefore, Serpins may protect lung tissue by inhibiting NSPs. However, the specific mechanism of Serpins is not totally clear. In this article, we will discuss the mechanism of action of NSPs in the inflammatory response of ALI/ARDS, the structural overview of Serpins, the primary role of Serpins in ALI/ARDS,such as the inhibition of NSPs activity, other roles of Serpins in ALI/ARDS, such as the inhibition of inflammatory factor release, regulation of apoptosis and protection of vascular endothelial cells and pulmonary surfactant-associated glycoprotein D (SP-D), and the clinical application of exogenous Serpins in ALI/ARDS to explore the role of Serpins in the pathogenesis of ALI/ARDS. The aim is to provide new ideas and strategies for the clinical treatment of ALI/ARDS.
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Objective:To investigate the positive rates of 2019-nCoV nucleic acid in different specimens from confirmed COVID-19 cases during hospitalization and after discharge.Methods:Patients with confirmed COVID-19 were enrolled from designated hospitals. Nasal swabs, throat swabs, and specimens of stool, urine and blood were collected during hospitalization. After the patients were discharged, nasal swabs, throat swabs and stool specimens were collected during follow-up. Real-time RT-PCR was used to detect 2019-nCoV nucleic acid.Results:This study involved 25 confirmed COVID-19 cases. During hospitalization, all patients tested positive in both nasal and throat swab 2019-nCoV nucleic acid tests, and nine of them (36.00%) were positive in stool specimen test. Urine and blood specimen test results were all negative. Nasal swabs, throat swabs and stool specimens were collected from each patient 7 d and 14 d after discharge. Two patients (8.00%) tested positive for 2019-nCoV nucleic acid again in nasal and throat swab tests on 7 d, while all stool specimen tests were negative. No 2019-nCoV nucleic acid was detected in nasal swabs, throat swabs or stool samples on 14 d.Conclusions:2019-nCoV nucleic acid was detected in stool samples of confirmed COVID-19 cases during hospitalization. Nasal and throat swab nucleic acid tests turned positive again in some patients after discharge.
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Objective To understand the distribution of novel coronaviruses in the external environment of confirmed COVID-19 cases. Methods Environmental surface swab specimens such as bed rails, doorknob, closestool, hand washing sink, table, locker,ward pager, mobile phone, cup, clothes, were collected from the sentinel hospital of COVID-19, and samples were collected for the nucleic acid detection by RT-PCR. Results A total of 150 environmental samples were collected from 30 confirmed COVID-19 cases, 6 samples were determined to be novel coronaviruses postive (positive rate 4.00%). The total 14 mobile phone showed 3 novel coronaviruses positive.Among the 30 confirmed COVID-19 cases, 6 cases (positive rate 20.00%)were found novel coronaviruses in the external environment. Conclusions Novel coronaviruses exists in external environment of confirmed COVID-19 cases, which indicates the potential risk of COVID-19 infection.
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Objective@#To analyze the epidemiological characteristics and etiologic agent of herpangina in Xi’an in 2016.@*Methods@#Herpangina epidemiological data and random stool samples were collected from two sentinel hospitals. The data were statistically analyzed with Excel and SPSS 18.0 and samples were detected and enteroviruses were genotyped using real-time PCR and RT-snPCR.@*Results@#Totally 421 cases were reported and the male-to-female ratio was 1.54∶1, age ranged from 3 month to 13 years, and 90.50% were under three years of age. Herpangina showed semiannual peaks in April to October, of which the highest was in June (23.75%, 100/421). Lab result showed that 71.05% were EV positive out of 152 samples, and further genotyping indicated 60 were non-typable, and other 48 comprised of eight serotypes of EV including EV-A71, CV-A4, CV-A5, CV-A6(6.48%), CV-A10(23.15%), CV-A12, CV-A16 and CV-B3.@*Conclusions@#Male children under 3 years of age were the main population and herpangina cases were most frequently reported in June in Xi’an in 2016. CV-A6 and CV-A10 were more frequently detected in the typable ones.
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Objective@#To know the genetic characteristics of nucleoprotein(N)of wild type measles virus in Xi’an, 2013-2017.@*Methods@#We used the pharyngeal swab specimens of suspected measles cases which were tested positive for measles virus (MV) nucleic acid by Real-time RT-PCR to isolate MV strains with Vero-SLAM cells, extracted RNA of the strains, amplified the N genes of MV strains and the pharyngeal swab specimens which had lower Ct values by One-Step RT-PCR, and analyzed the result after sequencing.@*Results@#Thirty carboxyl terminal sequences of the N genes of MV endemic strains were obtained and identified as genotype H1a. The nucleotide and amino acid homology among the epidemic strains were 97.3%-100% and 96.7%-100%, among the epidemic strains and S191 were 91.3%-92.2% and 87.3%-90.0%, while among the epidemic strains and C47 were 92.2%-92.7% and 88.0%-90.7%. The nucleotide homology among the epidemic strains and wild strains of same period in Anhui, Gansu, Shandong, Henan, Jilin were higher than that in Shanxi, Sichuan, Hunan and Guangdong. The most different amino acid sites among the epidemic strains and the two vaccine strains which had high level of entropy were 422, 457 and 497, secondly 467, thirdly 500. The mutations at the 467 site only existed in 2017. dN/dS=0.199 and no positive selection site was found.@*Conclusions@#The dominant genotype of the epidemic MV strains in Xi’an was H1a in 2013-2017, the genetic diversity of viruses decreased in 2016-2017. We should strengthen the surveillance of etiology of MV to provide evidence for elimination of measles.
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Objective@#To explore the application effect of noninvasive mechanical ventilation in chronic obstructive pulmonary disease(COPD) patients with respiratory failure.@*Methods@#From April 2016 to October 2017, 150 COPD patients with respiratory failure in Ningbo Geriatric Rehabilitation Hospital were selected, and they were divided into observation group and control group by using the random number table method, with 75 cases in each group.The control group was treated with conventional comprehensive therapy, the observation group was treated with noninvasive mechanical ventilation method on the basis of the control group.The clinical effect of the two groups was compared.@*Results@#In the observation group, the RR, HR and arterial blood PaCO2 were significantly better than those in the control group(t=13.29, 12.48, 13.42, all P<0.05). The PaO2, pH value in the observation group were significantly higher than those in the control group(t=5.91, 2.88, all P<0.05). The total effective rate of the observation group was 97.33%(73/75), which was higher than 73.33%(55/75) of the control group, the difference was statistically significant(χ2=1.81, P<0.05).@*Conclusion@#Application of noninvasive mechanical ventilation in COPD patients with respiratory failure can significantly improve respiratory function, and not only effectively shorten the treatment time, but also improve the treatment effect, and it is worthy of clinical promotion.
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Objective To explore the application effect of noninvasive mechanical ventilation in chronic obstructive pulmonary disease(COPD) patients with respiratory failure.Methods From April 2016 to October 2017, 150 COPD patients with respiratory failure in Ningbo Geriatric Rehabilitation Hospital were selected,and they were divided into observation group and control group by using the random number table method,with 75 cases in each group.The control group was treated with conventional comprehensive therapy,the observation group was treated with noninvasive mechanical ventilation method on the basis of the control group.The clinical effect of the two groups was compared.Results In the observation group,the RR,HR and arterial blood PaCO2 were significantly better than those in the control group(t=13.29,12.48,13.42,all P<0.05).The PaO2 ,pH value in the observation group were significantly higher than those in the control group(t=5.91,2.88,all P<0.05).The total effective rate of the obser-vation group was 97.33% (73/75),which was higher than 73.33% (55/75) of the control group,the difference was statistically significant ( χ2 =1.81,P <0.05). Conclusion Application of noninvasive mechanical ventilation in COPD patients with respiratory failure can significantly improve respiratory function,and not only effectively shorten the treatment time,but also improve the treatment effect,and it is worthy of clinical promotion.
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Neuronal guidance factor Netrin-1 has been known to be involved in nervous system development by controlling neuronal migration through both chemoattractive and chemo-repulsive signaling by binding different receptors. Netrin-1 has been shown to play a positively regulatory role during inflammatory process recently. Since the chemorepulsive receptors were found in leukocytes, it is suggest that Netrin-1 played a protective role in tissue through inhibiting leukocyte trafficking and accumulating during inflammatory process in researches. It is demonstrated that Netrin-1 can limit inflammatory response through the involvement of inflammatory cascades, attenuate hypoxia-inducible tissue injury and suppress apoptosis concurrently. It is indicated that Netrin-1 can be a novel target in future through preventing and inhibiting inflammatory diseases in these researches. This review will focus on recent relevant advances and in-depth study to elucidate its mechanism of anti-inflammation.
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Objective To evaluate the diagnostic value of chest X-ray film of pulmonary emphysema (PE)signs for infantile bronchitis.Methods Clinical data of 60 infants with bronchitis (case group)in a hospital between Janu-ary 2010 and December 2014 were analyzed retrospectively,and compared with data of 30 infants with non-respira-tory diseases (control group).Results Of 60 infants with bronchitis in case group,95.00%(57/60)showed mani-festations of PE on X-ray,and 18.33% (11/60)of whom were with mild PE(apical or intercostal pneumocele), 76.67%(46/60)were with typical PE (diaphragm descent);one case (3.33%)in control group showed intercostal pneumocele,the other 29 cases (96.67%)were normal X-ray findings and without signs of PE.The sensitivity, specificity and accuracy of PE signs on chest X-ray film for diagnosing infantile bronchitis were 95.00%,96.67%, and 95.56% respectively.Conclusion Signs of PE on chest X-ray film have important diagnosis value for infantile bronchitis.
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Objective To analyze the clinical characteristics and drug resistance of gram -negative bacillus in Department of Respiratory Medicine.Methods 100 patients in Department of Respiratory Medicine were selected, analyzed the clinical characteristic and drug resistance of 125 strains of gram -negative bacillus that was separated. Results 125 strains of pathogenic gram negative bacilli were isolated out of 100 patients,among which 34 strains were pneumonia klebsiella bacteria,24 strains were acinetobacter baumannii,18 strains were pseudomonas aeruginosa, 10 strains were enterobacter cloacae,18 strains were escherichia coli and 21 strains were other bacteria.Results The drug resistance rates were 79.4%,76.5%,76.5% and 76.5% respectively in klebsiella pneumoniae to amikacin, cefotaxime,ampicillin and imipenem,was more sensitive to meropenem and cefoperazone,the drug resistance rate was 100.0% in acinetobacter baumannii to ampicillin and cefazolin,and was 91.7% to ceftriaxone,and the resistance rate for other drugs are higher generally.The drug resistance rate was 100.0% in pseudomonas aeruginosa to ampicillin and ceftriaxone,and was 94.4% to cefotaxime and levofloxacin,the drug resistance rate was 90.0% in enterobacter cloacae to ampicillin,and was 60.0% to ceftriaxone,cefazolin and cefoxitin,the drug resistance rate on the other drug was relatively low.Conclusion Klebsiella pneumoniae,acinetobacter baumanni and pseudomonas aeruginosa were the main gram negative bacillis the cause hospitalized patients with drug resistance.
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Adjuvant therapy of breast cancer in the child-bearing period tends to affect ovarian function of patients.Adjuvant chemotherapy has a great damage for ovarian function,and tamoxifen's extent of the damage is not yet clear,but gonadotropin-releasing hormone (GnRH) has a protective effect on ovarian function.In the adjuvant therapy,synthetic weigh the pros and cons,make the best individualized programs,is the future direction of the treatment of breast cancer.
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Objective To investigate the expression and relationship between Phosphatase and tension homolog deleted on chromosome ten (PTEN) and Alpha fetoprotein(AFP) in hepatocellular carcinoma. Methods PTEN and AFP expression was examined by immunohistochemical method. Results PTEN expression was significantly weaker in patients with tumor less than 5.0 cm and patients with CLIP score≥1 (P<0.05). The expression of PTEN and AFP was negatively correlated ( Rs=-0.422, P=0.043), serum AFP and tissue expression of AFP was positively correlated (Rs=0.380, P=0.042), but for individual expression was not consistent. Conclusions PTEN and AFP is respectively negative and positive adjustment factor of PI3K/AKT pathway. Tissue expression of AFP may be more significant, and may become the new targets for the treatment of hepatocellular carcinoma.
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Objective To evaluate the use of three-dimensional reconstruction (3D) to improve the success rate in the first attempt of radiofrequency ablation (RFA) for small hepatocellular carcinoma (HCC).Methods A retrospective study was conducted on 109 patients with small HCC (with single nodule from 3 to 5 cm in diameter) treated with radiofrequency ablation between June 2010 and June 2013.A safe ablation margin was evaluated before and after radiofrequency ablation.The patients were divided into two groups: the 3D-RFA group (49 patients were evaluated by three-dimensional reconstruction before RFA treatment) and the 2D-RFA group (60 patients were not evaluated by three-dimensional reconstruction before RFA treatment).The success rate of the first attempt of radiofrequency ablation, recurrence free survival, overall survival and complications were compared between the two groups.Results The success rate of first ablation reached 95.9％ (47/49) in the 3D-RFA group which was significantly higher than the 48.3％ (29/60) in the 2D-RFA group (P ＜ 0.05).The local tumor progression rate was 8.1％ in the 3D-RFA group versus 23.3％ in the 2D-RFA group (P ＜0.05).The 1-, 2-, 3-year recurrence free survival rates were 85.4％, 63.9％, and 49.8％ respectively in the 3D-RFA group and 72.4％, 43％, and 34.4％ respectively in the 2D-RFA group (P ＜ 0.05).The 1-, 2-, 3-year overall survival rates were 91.4％,78.4％, and 60.9％ respectively in the 3D-RFA group and 83.3％, 58.7％, and 40.9％ respectively in the 2D-RFA group (P ＜0.05).Complications occurred significantly less in the 3D-RFA group (4％, 2/49) than the 2D-RFA group (13.3％, 8/60;P ＜ 0.05).Conclusion Three-dimensional reconstruction improved the success rate of the first attempt of radiofrequency ablation and the prognosis of patients, and with less complications for small hepatocellular carcinoma.
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Purpose To investigate the clinical value of gated myocardial perfusion imaging (GMPI) quantitative analysis technique in evaluating left ventricular remodeling and its effects on left ventricular function in patients with myocardial infarction (MI). Materials and Methods Seventy-six cases of MI patients were retrospectively analyzed, including pure left anterior descending artery (LAD) disease in 21 cases , left circumlfex artery (LCX) or right coronary branch (RCA) disease in 23 patients and multivessel disease in 32 cases. Seventy-four healthy people were additionally selected as control group. GMPI was performed on all subjects. Reconstruction images were automatically analyzed by using cardiac software QGS 2009 to obtain left ventricular remodeling index, including diastolic sphericity index (SIED) and end-systolic sphericity index (SIES). Cardiac function parameters were also obtained, including left ventricular end-diastolic volume (EDV), end-systolic volume (ESV), left ventricular ejection fraction (LVEF), and peak iflling rate (PFR). Differences of the left ventricular remodeling index and cardiac function parameters between the MI group and the control group were compared to analyze the relationship between left ventricular remodeling after myocardial infarction and coronary artery lesions. Results SIED, SIES and EDV, ESV in MI group were signiifcantly higher than those in the normal group (P0.05). Linear regression analysis showed that LVEF and PFR in group of left ventricular remodeling was signiifcantly lower with the increase of SIED (F=43.231 and 15.642, P<0.01). SIED and SIES analysis resulted in high correlation for both intra-observer and inter-observer (r=0.881-0.926, P<0.01). Conclusion Left ventricular remodeling after myocardial infarction can be accurately evaluated by GMPI. Patients with myocardial infarction due to LAD or multi-vessel coronary artery diseases may have left ventricular remodeling easier and more severe. Left ventricular remodeling will seriously affect the myocardial contraction and diastolic function, resulting in the entire left ventricular dysfunction.
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Objective To study the foxml gene and its protective effect on the lung tissue of rats with acute lung injury (ALI) induced by lipopolysaccharide (LPS), and to observe the dexamethason' s (DEX) impacts on foxml gene and the prognosis of ALI. Method Seventy-two healthy mice were randomly(random number) divid-ed into three groups: control group (A group, n = 24), model group (B group, n = 24) and DEX treatment group (C group, n = 24). The observing intervals were respectively set in 24 h, 48 h and 72 hours. At each ob-serving interval, the foxml protein in lung tissue of mice was detected by using immunohistochemistry (IHC), and the expression of foxml gene in lung tissue was detected by using RT-PCR, as well as to observe the pathological changes in lung tissue. Results Comparisons were made between paired groups at 24 h,48 h and 72 h intervals in which the expression of foxml mRNA and the level of foxml protein in lung tissue of mice in C group were signifi-cantly higher than those in B group (P < 0.05), and those in B group were significantly higher than those in A group (P < 0.05). The expression of foxml mRNA and the level of foxml protein in lung tissue of mice in B group at 48 h interval were significantly higher than those both at intervals of 72 h and 24 h (P < 0.05), and the those at 72 interval were significantly higher than those at 24 h interval (P < 0.05). Compared with B group, the pathologi-cal changes in lung tissue of mice in C group were lessened. Conclusions In both model group and dexamethasone treatment group, the expression of foxml mRNA and the level of foxml protein in lung tissue of mice are increased significantly. Dexamethasone lessens the injury of both vascular endothelial cells and alveolar epithelial ceils of lung tissue, and it also significantly increases the expression of foxml mRNA and the level of foxml protein.
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Objective To investigate the relationship of iPTH levels, calcium and phosphorus metabolism with cardiovascular event status in the chronic renal failure (CRF) patients. Methods This article retrospectivly studied the clinical and laboratory data of 87 CRF patients. 66 patients of A group didnt occur cardiovascular events,and 21 cases of B group occurred cardiovascular and cerebrovascular events. This article analyzed iPTH levels,serum calcium, phosphorus, calcium and phosphorus product and therelationship between cardiovascular and cerebrovascular events between the two groups. Results Decreased iPTH,increased serum C reactive protein and increased lipoprotein(a) had relationship with cardiovascular and cerebrovascular events in patients with chronic renal failure,but calcium,phosphorus,calcium and phosphorus product has nothing to do with the cardiovascular and cerebrovascular events. Cardiovascular and cerebrovascular events increased significantly in dialysis patients than in non - dialysis patients. Conclusiou Chronic renal failure patients on dialysis levels of serum iPTH, CRP level, LP(a) level and dialysis could lead to cardiovascular and cerebrovascular events.