[Clinical application value of modified Lee grading system to evaluate the degree of foraminal stenosis in patients with intervertebral foraminal lumbar disc herniation].

Objective: To investigate the clinical application value of the modified Lee grading system (abbreviated as the modified system) in evaluating the degree of intervertebral foraminal stenosis(IFS) in patients with foraminal lumbar disc herniations(FLDH). Methods: MRI data of 83 patients with FLDH-IFS (34 patients in the operation group and 49 patients in the conservative group) in Yantai Affiliated Hospital of Binzhou Medical University and Yantai Yantaishan Hospital from March 2018 to February 2021 were retrospectively collected. There were 43 males and 40 females, ranged from 34 to 82 years old, with an average of (61±10) years. MRI images of selected patients were independently evaluated and recorded by two radiologists in a blind method, using both the Lee grading system (abbreviated as Lee system) and the modified system, respectively and each method was evaluated twice. The difference between the evaluation level of the two systems, and the agreement of observer assessments of the two systems were compared, and the correlation between the evaluation level of the two grading systems and the clinical treatment modalities was analyzed. Results: The percentage of nongrade 3 (grade 0-2) patients with effective conservative treatment according to the two grading systems was 94.6 % (139/147) and 64.2 % (170/265), respectively. The percentage of grade 3 patients requiring surgical treatment according to the two grading systems was 69.2 % (128/185) and 61.2 % (41/67), respectively. There was a statistically significant difference between the evaluation levels of the modified system and the Lee system (Z=-5.16, P=0.001). In the Lee system, the intra-observer observation consistency Kappa values of the two radiologists were 0.735 and 0.542, respectively, which were highly and moderately consistent; and the inter-observer observation consistency Kappa values were 0.426-0.521, which were moderate consistency. In the modified system, the intra-observer consistency Kappa values of the two radiologists were 0.900 and 0.921, respectively, and the consistency was almost completely consistent; and the inter-observer consistency Kappa values were 0.783-0.861, which were highly consistent or almost completely consistent. Lee system and clinical treatment modalities was correlative (rs=0.39,P<0.001), and modified system and clinical treatment modalities was correlative (rs=0.61,P<0.001). Conclusion: According to FLDH-IFS, the modified system can comprehensively and accurately grade, with high reliability and reproducibility. The evaluation level has a more significant correlation with clinical treatment modalities.

[Analysis of volatile organic components of organic solvents used in Bao'an District of Shenzhen].

Objective: To understand the volatile organic components in the organic solvents used by enterprises in Baoan District, Shenzhen. Methods: From January to December 2020, a total of 541 organic solvent samples used by 86 companies were collected for volatile organic component analysis, and the main volatile components and high-risk occupational hazards in organic solvents used in different industries were analyzed. Results: A total of 201 volatile organic components were detected in 541 organic solvents. The top 5 components detected include xylene (29.76%, 116/541), toluene (21.81%, 118/541), methanol (20.70%, 112/541), n-hexane (14.79%, 80/541) and ethylbenzene (14.23%, 77/541). The detection rates of benzene, trichloroethylene, n-hexane, and 1, 2-dichloroethane, which were high-risk occupational hazards, were 2.40% (13/541), 3.70% (20/541), 14.79% (80/541), and 1.66% (9/541), respectively. The volatile components in organic solvents used in different industries was different. Benzene is more frequently detected in organic solvents used in the printing industry, trichloroethylene was more frequently detected in organic solvents used in the electronics industry, and n-hexane was more commonly found in organic solvents used in the electronics industry, printing and other industries, and 1, 2-dichloroethane has been more frequently detected in organic solvents used in the machinery industry. Conclusion: There are many types of organic solvents used by enterprises in Bao'an District, with complex components and differences in different industries.

[Molluscicidal effect of 25% wettable powder of pyriclobenzuron sulphate in hilly schistosomiasis-endemic regions].

OBJECTIVE: To evaluate the molluscicidal effect of 25% wettable powder of pyriclobenzuron sulphate (WPPS) against Oncomelania snails in hilly schistosomiasis-endemic regions and test its toxicity to fish. METHODS: In October 2020, a snail-infested setting which had been cleared was selected in Nanjian County, Yunnan Province and divided into several blocks, and the natural snail mortality was estimated. 25% WPPS was prepared into solutions at concentrations of 1 and 2 g/L, and 25% wettable powder of niclosamide ethanolamine salt (WPNES) was prepared into solutions at a concentration of 2 g/L. The different concentrations of drugs were sprayed evenly, and the same amount of water was used as blank control. Snails were surveyed using the systematic sampling method 1, 3 and 7 days post-treatment, and snail survival was observed. A fish pond was selected in Nanjian County, and 2 kg 25% WPPS was evenly sprayed on the water surface to allow the effective concentration of 20 g/L. Fish mortality was estimated 8, 24, 48 and 72 h post-treatment. RESULTS: One-day treatment with 1 and 2 g/L WPPS and 2 g/L WPNES resulted in 97.99%, 97.99% and 94.11% adjusted snail mortality rates (χ2 = 3.509 and 3.509, both P values > 0.05), and the adjusted snail mortality was all 100% 3 d post-treatment with 1 and 2 g/L WPPS and 2 g/L WPNES, while 7-day treatment with 1 and 2 g/L WPPS and 2 g/L WPNES resulted in 91.75%, 86.57% and 57.76% adjusted snail mortality rates (χ2 = 14.893 and 42.284, both P values < 0.05). Treatment with 2 g/L WPPS for 72 h resulted in a 0.67% cumulative mortality rate of fish. CONCLUSIONS: 25% WPPS is effective for snail control and highly safe for fish, which is feasible for use in hilly schistosomiasis-endemic regions.

Prospective Analysis of Fruit and Vegetable Variety on Health Outcomes in Community-Dwelling Chinese Older Adults.

OBJECTIVES: Evidence on the topic regarding fruit and vegetable (FV) variety and health outcomes among older adults is limited. This study explored the prospective association of fruit variety, vegetable variety and combined FV variety with the risk of sarcopenia, frailty, all-cause and cause-specific mortality in community-dwelling Chinese older adults. DESIGN: Prospective cohort study. SETTING: Community. PARTICIPANTS: Community-dwelling Chinese older adults aged ≥65 years in Hong Kong. MEASUREMENTS: Fruit variety, vegetable variety and combined FV variety at baseline were assessed using a validated food frequency questionnaire and the variety scores were stratified into tertiles. Sarcopenia (Asian Working Group for Sarcopenia 2019), frailty (Cardiovascular Health Study) and all-cause and cause-specific mortality (retrieved from an official database) were assessed at 14-year follow-up. Adjusted binary logistic regression or Cox proportional hazards model were performed to examine the association of fruit variety, vegetable variety and combined FV variety with each health outcome. Data are presented as hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: Baseline dietary data of 3992 participants (median age: 72 years (interquartile range: 68-76), 49.9% women) was available. There were 436 and 371 participants who were newly identified as having sarcopenia and frailty respectively, and 1654 all-cause mortality, 367 cardiovascular diseases (CVD) mortality and 534 cancer mortality over 14-year. Tertiles of fruit variety, vegetable variety and combined FV variety were not associated with sarcopenia, frailty, CVD mortality and cancer mortality. Participants in the highest tertile of fruit variety (HR 0.81, 95% CI 0.70-0.95, p-trend 0.010), vegetable variety (HR 0.77, 95% CI 0.67-0.89, p-trend <0.001) and combined FV variety (HR 0.77, 95% CI 0.67-0.89. p-trend <0.001) showed lower risk of all-cause mortality compared with participants in the lowest tertile. CONCLUSION: Among community-dwelling Chinese older adults, FV variety was not associated with sarcopenia, frailty, CVD mortality and cancer mortality over 14-year. Higher fruit variety, vegetable variety and combined FV variety were associated with a lower risk of all-cause mortality. Promoting a wide FV variety might be recommended to benefit the health and longevity of this population.

[Effects of protein disulfide isomerase on hyperglycemia and hypoxia/reoxygenation injury in H9c2 cardiomyocytes].

Objective: To explore the effect of protein disulfide isomerase (PDI) in diabetic ischemic heart disease. Methods: We established an in vitro model of high glucose and hypoxia/reoxygenation in H9c2 rat myocardial cells. Cultured cells were divided into four groups: Control, high glucose (HG), hypoxia/reoxygenation (H/R) and HG+H/R. Changes in PDI expression mediated by PDI adenovirus(Ad-PDI) infection and siRNA(PDI-siRNA) transfection in myocardial cells were observed by inverted fluorescence microscopy. We also measured lactate dehydrogenase(LDH) activity and malondialdehyde(MDA) and high molecular weight(HMW)-APN concentrations. PDI, APN, cleaved caspase-3, and glucose regulated protein 78 (Grp78) protein expression were detected. Results: PDI expression was significantly decreased in the HG, H/R and HG+H/R groups compared to the Control group; however, LDH activity[(179.7±10.4) U/L、(218.4±18.4) U/L、(328.2±5.3) U/L vs (91.0±11.0) U/L], MDA concentration[(7.0±0.4) µmol/L、(10.0±1.0) µmol/L、(11.7±1.0) µmol/L vs (4.2±1.8) µmol/L], cleaved caspase-3, and Grp78 expression were increased. Interestingly, APN and HMW-APN expression were decreased [(2.01±0.21) µg/L、(1.64±0.27) µg/L、(1.20±0.14) µg/L vs (2.62±0.12) µg/L, all P<0.05]. Over expression of PDI attenuated high glucose and hypoxia/reoxygenation induced apoptosis and oxidative stress in H9c2 cardiomyocytes(all P<0.05), and simultaneously increased APN and HMW-APN expression [(2.86±0.03) µg/L vs (3.03±0.10) µg/L、(2.06±0.05) µg/L vs (2.31±0.06) µg/L、(1.83±0.07) µg/L vs (1.96±0.11) µg/L、(1.20±0.06) µg/L vs (1.39±0.09) µg/L]. PDI-siRNA transfection increased LDH activity, MDA concentration, and cleaved caspase-3 and Grp78 expression, and decreased APN and HMW-APN expression [(0.75±0.09) µg/L vs (0.59±0.09) µg/L、(0.62±0.04) µg/L vs (0.53±0.05) µg/L、(0.55±0.14) µg/L vs (0.51±0.12) µg/L、(0.48±0.12) µg/L vs (0.35±0.08) µg/L] in response to different treatments in cultured H9c2 cardiomyocytes (all P<0.05). Conclusion: PDI may regulate the expression of APN and HMW-APN, and play an important role in the function of diabetic ischemia-reperfusion cardiomyocytes.

[Analysis on the incidence of occupational diseases in Bao'an District of Shenzhen city from 2006 to 2019].

Objective: To analyze the characteristics of occupational diseases in Bao'an District of Shenzhen from 2006 to 2019, so as to provide scientific basis for formulating occupational disease prevention policies and measures. Methods: In September 2020, the information of new occupational disease cases in Bao'an District of Shenzhen from 2006 to 2019 was collected through the national occupational disease and occupational health information monitoring system, and the classification, disease type distribution, population distribution and industry and enterprise scale distribution of new occupational disease cases were analyzed. Results: From 2006 to 2019, a total of 762 new occupational diseases were reported in Bao'an District of Shenzhen, of which the top three were occupational ear, nose, throat and oral diseases (233 cases, accounting for 30.58%) , occupational chemical poisoning diseases (219 cases, accounting for 28.74%) , occupational pneumoconiosis and other respiratory diseases (127 cases, accounting for 16.67%) . The classification composition of occupational diseases was different in different years, and the difference was statistically significant (P<0.05) . New occupational diseases are mainly distributed in the manufacturing industry (394 Eaterprises, caccouling 93.59%) , concentrated in (346 cases, accounting for 47.66%) and medium-sized enterprises (199 cases, accounting for 27.4%) small enterprises. Conclusion: New occupational diseases in Bao'an District of Shenzhen should focus on small and medium-sized manufacturing enterprises, carry out risk assessment of occupational hazards, implement classified and hierarchical supervision of occupational health, and implement occupational health protection.

[Laparoscopic diagnosis of postoperative recurrence of peritoneal metastasis in gastric cancer patients and the clinical efficacy of bidirectional intraperitoneal and systemic chemotherapy].

Objective: To explore the diagnostic value of laparoscopy in the postoperative recurrence of peritoneal metastasis in gastric cancer, and to investigate the efficacy of bidirectional intraperitoneal and systemic (BIPS) chemotherapy for the recurrence. Methods: The descriptive case series study was conducted. Case inclusion criteria: (1) gastric cancer patients without synchronous distant metastasis received D2 radical gastrectomy; (2) postoperative adjuvant chemotherapy was administered; (3) no other distant metastasis except recurrence of peritoneal metastasis; (4) age of 18-75 years; (5) Eastern Cooperative Oncology Group (ECOG) performance-status score≤2; (6) pretreatment evaluation suggested that surgery and chemotherapy could be tolerated. Eight consecutive gastric cancer patients with postoperative recurrence of peritoneal metastasis who met the above criteria at Department of Gastrointestinal Surgery of Ruijin Hospital from September 2015 to September 2016 were enrolled into the study. There were 6 males and 2 females with the median age of 52 (38-68) years. They received laparoscopy or laparotomy first, and then were evaluated with reference to the Sugarbaker peritoneal cancer index (PCI) and the peritoneal metastasis classification of gastric cancer developed by the Japanese Gastric Cancer Research Association. A peritoneal access port was implanted in the subcutaneous space of the lower abdomen and the patients received chemotherapy for 21 days as a course of treatment. All the patients received intraperitoneal 20 mg/m(2) of paclitaxel (PTX) via implanted subcutaneous peritoneal access ports and intravenous 50 mg/m(2) of PTX at day 1 and day 8, meanwhile 80 mg/m(2) of Tigio was orally administered per day for 14 consecutive days, followed by 7 days of interval. Follow-up ended on December 15, 2019. Results: Of these 8 patients with recurrence of peritoneal metastasis after gastric cancer surgery, 1 case underwent laparotomy and loop stoma of terminal ileum because of complete colonic obstruction, and the remaining 7 cases underwent laparoscopy successfully and the recurrence of peritoneal metastasis was clearly diagnosed. Two patients with ovarian metastasis underwent laparoscopic bilateral adnexectomy. The median follow-up time was 17.5 (1.5 to 39.0) months, the median number of BIPS chemotherapy course was 11 (1 to 30), and the median survival time (MST) after BIPS chemotherapy was 17.0 months. The major adverse reaction in BIPS treatment was mainly myelosuppression, of which grade 3/4 leukopenia and neutropenia developed in 1 and 2 cases respectively. No BIPS-related death occurred. The MST of gastric cancer after radical gastrectomy was 40.0 months. Conclusions: Laparoscopy is a safe and feasible method for diagnosing the recurrence of peritoneal metastasis of gastric cancer. BIPS chemotherapy is effective and safe for its treatment and deserves further study.

[Observation and analysis of lens turbidity lesion induced by low intensity 635 nm laser radiation].

Objective: To study the characteristics of the lens turbidity after long-term exposure to low intensity 635nm laser. Methods: Cluster sampling method was adopted to select 812 employees in a laser leveler workshop in a city of Guangdong Province from January 2014 to December 2018. They were divided into the control group, diffuse reflection (DR) group and direct vision (DV) group for retrospective observation and analysis of lens turbidity. The laser irradiation intensity of each group was investigated, the position and shape of lens opacity were analyzed, and the influencing factors were statistically analyzed with the repeated measurement data of dichotomy. Results: The laser irradiance and radiant exposure of DV group were between 0.72×10(-4) and 9.92×10(-4) mW/cm(2) and between 2.61×10(-2) and 1.53 J/cm(2), respectively. The subjects were mainly diagnosed with lens turbidity lesion, especially for the DV group. Most of lesions occurred in the pole and periphery of the anterior cortex. The lesions exhibited multipoint patterns with greyish white color. The turbidity rates in DV group (before work and work for 1, 2, 3 years) were 0%, 1.99% (8/402) , 4.98% (20/402) and 6.72% (27/402) , respectively, in the order of observation points. The statistical analysis of single factor effect showed that the turbidity rate was higher in DV group and higher in the second year in the DV group (P<0.01) . Multi-factor analysis of the laser effect on the lens showed that the main effect between groups, between the observation point were statistically significant (P<0.05) , but no statistical significance in the interaction between group×observation points (P>0.05) . Conclusion: Lens turbidity lesion can be caused by long-term exposure to low intensity 635 nm laser, so the product safety classification should be strictly strengthened. It is necessary to strengthen the protection of laser photochemical damage in the production process.

[Adult femur CT modeling and 3D automatic measurement of anatomical parameters].

Objective: To reconstruct a 3D model from adult femur CT scan data and automate a measurement of femoral anatomical parameters to study the characteristics of Chinese femur anatomical parameters. Methods: Using Mimics17.0, models from the CT data of 148 adult patients were established. The completed model was imported into Geomagic Studio and the anatomical landmarks of the femur were extracted to establish 3D coordinate system and unified coordinate system. Programmed with Matlab, using the nearest point iterative ICP algorithm and the 3D automatic extraction algorithm of anatomical landmarks to provide precision positioning, the femoral anatomical parameters were automatically measured and analyzed. The data were compared by using independent sample t test. Results: In this group, the diameter of the male femoral condyle was (84.1±3.6) mm, and it was (74.8±3.3) mm in the female; the anteroposterior diameter of the male femoral condyle was (66.5±3.7) mm, and it was (61.2±3.5) mm in the female; the diameter of the male ball head was (48.8±2.1) mm and it was (43.4±2.2) mm in the female; the differences between the two genders were all statistically significant (t=16.21, 8.84, 15.20, all P<0.05). The male femoral moment radius was (112.5±24.5) mm, and it was (124.7±19.2) mm in the female (t=3.30, P=0.002). The neck angle in male participants was 124.9°±4.0°, and it was 126.1°±5.5° in the female (t=1.40, P>0.05). As the height growed, most of the anatomical parameters increased accordingly. Conclusions: The 3D automatic measurement of femoral anatomical parameters is more reproducible and accurate than manual measurement. It is necessary to establish and enrich the femoral anatomical database to design and develop internal fixation products that meet the needs of Chinese people.

[Analysis and comparison of the clinical features and prognosis between extra - gastrointestinal stromal tumors and duodenal gastrointestinal stromal tumors].

Objective: To investigate the differences of clinicopathological features, diagnosis, treatment and prognosis between patients with extra-gastrointestinal stromal tumors (EGIST) and duodenal gastrointestinal stromal tumors (DGIST). Methods: A retrospective case - control study was performed. Case inclusion criteria: (1) tumor confirmed by histology and pathology; (2) primary tumor locating in the extra - gastrointestinal tract or duodenum; (3) without other synchronous tumors; (4) complete clinical and pathological data. Clinical data of 20 EGIST patients and 32 DGIST patients from March 2011 to September 2016 at Department of Gastrointestinal Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine were retrospectively collected and analyzed. The observational parameters included clinicopathological characteristics, treatment and prognosis conditions. Continuous data of abnormal distribution were expressed as median (range) and compared using the Mann-Whitney U-test. Survival curves were drawn by the Kaplan-Meier method and compared with the Log-rank test. Results: Of the 20 EGIST patients, 8 were males and 12 were females with age of 61.0 (30.0 to 86.0) years and of the 32 DGIST patients, 12 were males and 20 were females with age of 55.5 (27.0 to 70.0) years. Compared with DGIST patients, EGIST patients were older (U=188.000, P=0.012], had larger tumor size [10.0 (3.0 to 29.0) cm vs. 4.0 (1.5 to 10.0) cm, U=98.500, P<0.001] and higher ratio of high risk classification [85.0% (17/20) vs. 12.5% (4/32), χ(2)=26.870, P<0.001]. Among the 20 EGIST patients, 5 were diagnosed with distal metastasis and received imatinib (400 mg/d), and the other 15 patients underwent radical resection who were included in survival analysis. All the 32 DGIST patients underwent radical resection. The median follow-up of whole group was 43 (14 to 76) months. The 3-year recurrence/metastasis-free survival rate of 15 cases undergoing radical resection in the EGIST group was 85.6%, which was lower than that of the DGIST group (88.6%), and the difference was not statistically significant (P=0.745). There was no significant difference in the 3-year overall survival rate between the EGIST group (92.9%) and the DGIST group (100%) (P=0.271). Conclusions: As compared to DGIST, EGIST mostly occurs in those with older age, larger tumor size and higher risk grade. The prognosis of EGIST patients after radical resection is similar to that of DGIST patients.

[Predictive factors for lymph node metastasis in patients with poorly differentiated early gastric cancer].

Objective: This study aimed to identify clinicopathological factors predictive of lymph node metastasis in patients with the poorly differentiated early gastric cancer (EGC) to assess the feasibility of using endoscopic submucosal dissection (ESD). Methods: The records of patients with poorly differentiated early gastric cancer undergoing gastric radical resection between January 2012 and December 2016 were reviewed in Ruijin hospital. Those with distant metastasis, two or more malignant tumors, remnant gastric cancer, neo adjuvant therapy, previous history of gastric surgery or clear history of perigastric lymphadenectomy, and mixed tumors were excluded. Age, sex, presence of ulcerous lesion, tumor size, tumor location, depth of invasion, type of differentiation, lymphatic vessel invasion, vascular invasion, nerve invasion and HER2 expression were collected. Univariate and multivariate stepwise logistic regression analyses were used to identify the independent risk factors of perigastric lymph node metastasis.According to the Guidelines for the Treatment of Gastric Cancer (2018 edition) of the Chinese Society of Clinical Oncology (CSCO), the expanded indications of ESD for EGC are as follows: (1)no ulcerative lesions, the maximum diameter of lesions >2 cm of differentiated intramucosal cancer; (2)ulcerative lesions, the maximum diameter of lesions ≤3 cm of differentiated intramucosal cancer; (3)no ulcerative lesions, undifferentiated intramucosal carcinoma with diameter ≤2 cm. The relationship between clinicopathological factors and lymph node metastasis was analyzed. Results: A total of 517 patients, aged 21-83 (57.1±11.7), including 307 males and 210 females, were enrolled in the study. Among them, 114 (22.0%) patients had lymph node metastasis. Univariate analysis showed that ulcerative lesion (P=0.042), tumor diameter (P=0.048), depth of invasion (P<0.001), location of tumors (P<0.001), lymphatic vessel invasion (P=0.009), vascular invasion (P<0.001) and nerve invasion (P=0.028) were related to lymph node metastasis after radical resection of poorly differentiated early adenocarcinoma. Age, sex, type of differentiation and HER2 expression were not significantly correlated to lymph node metastasis (P>0.05). Multivariate analysis showed that tumor size (OR=1.61, 95% CI: 1.03-2.52, P=0.037), depth of invasion (OR=2.77, 95% CI:1.66-4.63, P<0.001), lymphatic duct invasion (OR=14.74, 95% CI:1.58-137.36, P=0.018) were independent risk factors for lymph node metastasis in poorly differentiated EGC, and ulcerative lesion was not a risk factor for lymph node metastasis (OR=0.82, 95% CI:0.56-1.18,P=0.285). A total of 119 patients with poorly differentiated EGC fully complied with the relative indications of ESD recommended by the Japanese Statute and the criteria for radical resection after ESD. Among them, 14 (11.8%) still had perigastric lymph node metastasis, while the gender, tumor diameter, location, differentiation and HER2 expression were not associated with lymph node metastasis (P>0.05). Conclusion: For patients with poorly differentiated EGC, the application of ESD should be carefully weighed with precise assessment of tumor diameter, depth of invasion, and lymphatic duct invasion.

[Analysis of herpes zoster incidence and hospitalization in three areas of Beijing in 2015 based on health information system of medical institutions].

Objective: Using data of health information system (HIS) of medical institutions to study the incidence and hospitalization of herpes zoster in three districts of Beijing. Methods: According to the different level of economic development and geographical features in Beijing, 3 districts of Xicheng, Changping and Miyun were chosen and all 110 medical institutions of the first level and above in the 3 districts are included in the survey. All the outpatient and inpatient herpes zoster cases in 2015 were retrospectively reviewed by HIS system. After distinguishing the reduplicated cases, Using the first outpatient case as a molecule and the resident population as denominator to estimate the annual incidence rate, as well as the annual hospitalization rate was estimated based on primary diagnostic hospitalized cases as molecule and the resident population as denominator. Results: A total of 32 313 primary visit outpatient cases were investigated, of which 18 360 cases (56.8%) were women and 20 923 cases (64.8%) were ≥50 years old. The overall estimated incidence of the 3 districts was 8.8‰ with an increase trends with age and reached to the highest in ≥80 years old (30.5/1 000). The incidence of Xicheng, Changping and Miyun districts are respectively 16.2‰, 4.0‰ and 5.7‰. A total of 701 primary visit inpatient cases were identified, of which 366 cases (52.2%) were women and 651 cases (92.9%) were ≥50 years old. The estimated annual hospitalization rate was 19.4/100 000, with the primary and secondary diagnostic hospitalization rate are respectively 5.9/100 000 (212 cases) and 13.5/100 000 (489 cases). The disease types of secondary diagnostic inpatient herpes zoster cases were as follows: cardiovascular disease (19.0%, 93 cases), stroke (14.5%, 71 cases), pneumonia/chronic obstructive pulmonary disease (14.1%, 69 cases), tumor (12.5%, 61 cases) and diabetes (5.7%, 28 cases). Conclusion: Most of the herpes zoster cases in Beijing are over 50 years old, and the incidence of female is slightly higher than male. This disease should become a public health issue of great concern.

[Application of multiplex PCR assay to study early multiple herpesviruses infection during HSCT].

Objective: To investigate herpesvirus infection in early stage of hematopoietic stem cell transplantation (HSCT) by multiplex polymerase chain reaction (PCR), and to explore the association between multiple herpesviruses infection and clinical characteristics in HSCT patients and its impact on post-transplant complications and prognosis. Methods: A total of 734 peripheral blood samples were collected from 90 patients undergoing HSCT in the Department of Hematology, the First Affiliated Hospital of Soochow University between February 2017 and August 2017. The peripheral blood specimens were obtained before and within 90 days after transplantation at different time points. Lab-Aid824 Nucleic Acid Extraction Mini Reagent was used to extract DNA and multiplex PCR assay was used to simultaneously detect 8 kinds of human herpesviruses from genomic DNA. The incidence of various herpesvirus infections, its correlation with clinical features and effects on post-transplant complications and prognosis were analyzed. Results: The median follow-up time was 192 (range: 35-308) days. Among the 90 patients before transplantation, the incidence of herpes virus infection was 35.6% (32/90), including 12.2% (11/90) with one herpes virus infection and 23.3% (21/90) with multiple viruses infection. The incidence of herpes virus infection after transplantation was 77.8% (70/90), including 20.0% (18/90) with one herpes virus infection and 57.8% (52/90) with multiple herpes virus infection. Among the 52 patients with multiple herpes viruses infection, 30 (57.7%) patients were infected by 2 kinds of viruses, 18 (34.6%) patients by 3 kinds of viruses and 4 (7.7%) patients by 4 kinds of viruses. There was a correlation between HHV-6 and HHV-7 herpesvirus infection (OR=13.880, Q=0.026). EBV infection was related to HHV-7 infection (OR=0.093, Q=0.044). The age of patients was correlated with the incidence of HHV-1 infection before transplantation. There were 24 patients in our study experienced clinical symptoms associated with viral infection. The main manifestations were hemorrhagic cystitis (HC), interstitial pneumonia, enteritis, viral encephalitis and fever of unknown origin. EBV infection was related to HLA incompatibility and the inconsistent of the ABO blood group and grade Ⅱ-Ⅳ aGVHD after transplantation. HLA incompatibility and the unrelated donor and grade Ⅱ-Ⅳ aGVHD were related to multiple viruses infection. Conclusion: Multiple herpesviruses were common in patients undergoing HSCT, which were closely related to HLA mismatch, unrelated donor and grade Ⅱ-Ⅳ aGVHD.

[Characteristic analysis of organic fluorosis caused by appliying of touch screen anti-fingerprint nanocoating material].

Objective: To analysis pathogenic conditions and pathogenic characteristics of organic fluorosis caused by applying of anti-fingerprint coating material on touch screen glass of the mobile phone. Methods: To collect clinical data and analyze the causes and pathogenic characteristics of poisoning through surveying occupational health, detecting occupational hazards in the workplace, collecting clinical data and diagnosing of occupational diseases. 6 employees in workshop 1 of packaging were as the organic fluorine exdposed group, and 16 employees in other workshops were as the non-exposed group. Results: Organic fluorine chemicals (perfluoro-1, 3-dimethylcyclohexane, hexadecafluoroheptane, perfluoro-hexane, perfluoromethy lopentane, perfluoro-2-methyl-2-pentene, etc.) can be volatilized by spraying and baking of anti-fingerprint nano-coating material on touch screen. The relative percentage of volatile components in air is 85.65%. Four cases of acute poisoning were caused by organic fluorosis deposited in a dustless air conditioning workshop with poor ventilation.The clinical manifestations of the patients were acute bronchitis, pulmonary edema and/or myocarditis. The average concentration of urine fluorine in the organic fluorine exposed group was 13.7± 4.4 mmol/mol creatinine, which was 4-5 times higher than that of other non-organic fluorine exposed groups. The difference of urine fluorine level between the organic fluorine exposed group and non exposed group was statistically significant (P<0.01) . The main indicators were abnormal for the blood oxygen saturation of finger pulse under suction air, leukocytes, neutrophils, monocytes, hypersensitivec-reactive protein, procalcitonin, l-lactate dehydrogenase, forebrain diuretic natriuretic peptide, hypersensitive troponin T in the four cases. One case was myocardial ischemia, four cases had bilateral lung symmetrically exudative lesions, one case was accompanied by a small amount of pleural pericardial effusion. Conclusion: Acute organofluorine poisoning can caused by the applying of the fingerprint nano-coating material on touch screen of the mobile phone. Attention should be paid to occupational poisoning caused by the applying of the small molecular perfluoroalkanes (olefins) in new industries, new processes and new materials.

[Application of Ischemia Modified Albumin for Acute Ischemic Heart Disease in Forensic Science].

OBJECTIVES: To explore the application value and forensic significance of ischemia modified albumin （IMA） in pericardial fluid to diagnose sudden cardiac death. METHODS: IMA level in pericardial fluid was detected in acute ischemic heart disease group （n=36）, acute myocardial infarction group （n=6）, cardiomyopathy group （n=4） and control group （n=15） by albumin cobalt binding method. The levels of IMA were compared among these groups. The best cut-off IMA value was estimated and the sensitivity and specificity of acute myocardial ischemia group was distinguished from control group by receiver operating characteristics （ROC） curve. RESULTS: The IMA level in acute ischemic heart disease group was significantly higher than that of control group （P<0.05）. Compared with acute myocardial infarction group and cardiomyopathy group, the IMA level in acute ischemic heart disease group had no significant difference （P>0.05）. The cut-off value for the identification of acute myocardial ischemia which obtained by ROC analysis was 40.65 U/mL. And the sensitivity and specificity for distinguishing acute ischemia cardiac disease was 60.0% and 80.5%, respectively. CONCLUSIONS: The IMA value in pericardial fluid can be a reference marker for the diagnosis of acute myocardial ischemia, which also can provide objective basis for the forensic identification of sudden cardiac death.

[Application of IMA and H-FABP in Forensic Diagnosis of Sudden Cardiac Death].

Acute myocardial ischemia is the most common cause of sudden cardiac death. The diagnosis of early myocardial ischemia is a hot point in forensic medicine, which is also an early and important part for a prevention against myocardial infarction. This paper conducts a comprehensive discussion of the structure, function, clinical value and forensic medicine application prospect of ischemia modified albumin （IMA） and heart-type fatty acid binding protein （H-FABP), aiming to determine whether the two proteins can be used as biochemical detection indicators of early myocardial ischemia for the diagnosis of sudden cardiac death in forensic medicine.