Territorywide Study of Early Coronavirus Disease Outbreak,Hong Kong,China

Initial cases of coronavirus disease in Hong Kong were imported from mainland China. A dramatic increase in case numbers was seen in February 2020. Most case-patients had no recent travel history, suggesting the presence of transmission chains in the local community. We collected demographic, clinical, and epidemiologic data from 50 patients, who accounted for 53.8% of total reported case-patients as of February 28, 2020. We performed whole-genome sequencing to determine phylogenetic relationship and transmission dynamics of severe acute respiratory syndrome coronavirus 2 infections. By using phylogenetic analysis, we attributed the community outbreak to 2 lineages; 1 harbored a common mutation, Orf3a-G251V, and accounted for 88.0% of the cases in our study. The estimated time to the most recent common ancestor of local coronavirus disease outbreak was December 24, 2019, with an evolutionary rate of 3.04 × 10⁻³ substitutions/site/year. The reproduction number was 1.84, indicating ongoing community spread.     

Overview and update on molecular testing in non-small cell lung carcinoma utilizing endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) samples

Lung carcinoma remains one of the most frequent and aggressive human neoplasms. Fortunately, in the last decades, the increasing knowledge of the molecular mechanisms leading to cancer development has allowed the use of targeted therapies with improvement of prognosis in many patients. Clinical management has also changed after the introduction of endobronchialultrasonographic bronchoscopy that allows a conservative staging of lung tumors, avoiding the need of mediastinoscopy for lymph node staging. Lung pathologists and cytopathologists are facing the challenge of giving the more comprehensive prognostic and predictive information with ever smaller tissue or cytological samples. The aim of this review is to summarize the molecular testing for non-small cell lung carcinoma and how pathologists can contribute to the patient's outcome with a conscious management of biological samples.     

恶性肿瘤患者血清与尿液中一氧化氮含量测定

0 引言一氧化氮（Nitric oxide,NO）是一种具有活跃生物化学性质的无机小分子. NO对许多肿瘤细胞和微生物有细胞毒性［1］,为探讨NO与肿瘤的关系,我们检测了119例恶性肿瘤患者血清及尿液中的NO.     

自攻自断螺纹钉在大面积缺损牙保存性修复中的应用

目的：探讨自攻自断螺纹钉在大面积缺损牙保存性修复中的应用。方法：采用自攻自断螺纹钉,选择凡因龋坏或者外伤使牙体组织损失残缺过大,牙髓未露,活力正常的牙进行修复。结果：本组50例经自攻自断螺纹钉进行固位修复,5年后随访42例,除2例因上颌磨牙牙尖折断而不能修复拔除外,其它40例均达到评判标准,总成功率达95％,结论：自攻自断螺纹钉主要用于对严重缺损而牙髓健康的牙进行保存性修复,还可对要做壳冠修复的牙进行牙壁加固,该方法因材料来源方便,临床效果显著,值得推广。     

Glove Permeation Tests Using Novel Microchemical Techniques for 2,4-Dichlorophenoxyacetic Acid (2,4-D) Derivatives

The aim was to assess the permeation of different herbicide emulsion concentrate formulations of 2,4-dichlorophenoxyacetic acid (2,4-D) as 60.8 and 83.5% butoxyethyl ester (BEE) and 46.8% dimethyl amine salt (DMAS) through four types of glove materials (lined unsupported nitrile, unlined unsupported butyl, Silver Shield laminate, and Viton). This entailed the development of new microchemical techniques to allow sensitive capillary gas chromatography/mass spectrometry (GC/MS) of the permeated herbicide. The 2,4-D DMAS was esterified to the methyl ester by boron trifluoride-methanol complex with 99.2 ± 3.7% efficiency using microwave heating to minimize reaction time and to process microsamples. The GC/MS detection limit was 5 ng/ml (ppb) of 2,4-D DMAS in the collection medium. The permeates from the ester formulations were analyzed directly for the ester above the detection limit of 9 ng/ml (ppb) BEE. The permeation investigations utilized the American Society for Testing Materials (ASTM)-type permeation cells with liquid collection media. The results showed that these gloves could provide at least 6 h protection for these formulations. Received: 8 July 1998/Accepted: 13 December 1998     

Safety and immunogenicity of combined diphtheria-tetanus-pertussis (whole cell and acellular)-Haemophilus influenzae-b conjugate vaccines administered to Indonesian children

A randomized double-blind trial was conducted to evaluate the safety and immunogenicity of vaccines comprised of diphtheria (D) and tetanus (T) toxoids combined with either a whole cell (P) or an acellular (aP) pertussis component and Haemophilus influenzae type b polyribosylphosphate (PRP) tetanus toxoid conjugate (PRP-T) in Indonesian infants. Three doses of either DTaP, DTaP-PRP-T, or DTP-PRP-T were administered to 930 infants approximately 2-3 months of age and at 2 month intervals thereafter. A booster dose of either DTP-PRP-T or DTaP-PRP-T was administered at 15-18 months of age. Both local and systemic reactions occurred at a significantly (p < 0.001-0.026) higher rate in the group that received whole cell pertussis vaccine versus groups which were immunized with aP containing vaccines. There was no significant difference (p > 0.05) in the rate of adverse events between groups immunized with DTaP or DTaP PRP T. One month after the third dose of vaccine, 99% of subjects had achieved > or =0.1 IU of anti-D and anti-T antibody per ml of serum. The geometric mean titer (GMT) to D was significantly (p < 0.001) higher in the group immunized with DTaP versus the other two groups whereas the anti-T GMT was significantly (p < 0.006) higher for the group immunized with DTP-PRP-T. Both the anti-pertussis toxin (PT) and anti-filamentous hemagglutinin (FHA) antibody levels were significantly (p < 0.001) higher in recipients of acellular versus whole cell pertussis vaccine. In contrast, the anti-B. pertussis agglutinating antibody response was significantly (p < 0.0001) higher in the group immunized with whole cell pertussis vaccine. The anti-PRP GMTs (microg antibody/ml) at 7 months were 0.096, 3.35 and 6.11 for groups immunized with DTaP, DTaP-PRP-T and DTP-PRP-T, respectively. The GMT for those immunized with DTP-PRP-T was significantly (p < 0.001) higher compared to recipients of DTaP-PRP-T. The percent of children who attained > or =0.15 or > or =1 microg/ml after immunization was 18 and 2% for the DTaP group, 93 and 76% for the DTaP-PRP-T group and 97 and 88% for the DTP-PRP-T group. At the > or =1 microg/ml level the difference between the DTaP-PRP0-T and DTP-PRP-T groups was significant (p < 0.01). Children immunized with either DTaP, DTaP-PRP-T, or DTP-PRP-T were reimmunized with DTaP-PRP-T whereas a portion of children immunized with DTP PRP T where also boosted with this vaccine at 15-18 months of age. There was a vigorous anamnestic response to the D and T components with all children possessing > or =0.1 IU/ml. There was also a substantial increase in anti-PT, anti-FHA and B. pertussis agglutinating antibodies. The poorest anti-PT response was seen among children receiving DTP-PRP-T for both primary and reimmunization while the highest agglutinating antibody response followed receipt of 4 doses of DTP-PRP-T. Greater than 80% of children immunized with either DTP PRP T or DTaP-PRP-T possessed > or =0.15 microg/ml before boosting versus 38% for those vaccinated with DTaP (p < 0.001). Primary immunization with DTP-PRP-T resulted in a significantly (p < 0.05) higher percentage (72%) maintaining > or =1 microg/ml compared to those immunized with DTaP-PRP-T (46%). Prior to reimmunization, the anti-PRP GMT was significantly (p < 0.005) higher for children immunized with 3 doses of DTP-PRP-T versus DTaP-PRP-T. Subsequent to reimmunization, > or =95% of subjects attained > or =1 microg/ml.     

Fatal meningoencephalitis due to Bacillus anthracis

Abstract: We report the first case of fatal anthrax meningoencephalitis in Hong Kong over the past 60 years. A 13 year-old boy presented with right lower quadrant pain, diarrhoea and progressive headache. Lumbar puncture yielded gram positive bacilli initially thought to be Bacillus cereus, a contaminant. He was treated with ampicillin and cefotaxime, but died 3 days after hospitalization. The organism isolated from blood and cerebrospinal fluid was later identified as Bacillus anthracis.     

乳腺癌术后患者241例辨证分型探析

通过对241例乳腺癌术后患者进行辨证分型以分析和探讨乳腺癌术后的辨证分型规律,对乳腺癌术后的中医药治疗起着指导作用.结果表明:241例乳腺癌术后患者,气阴两虚证、气血两虚证、冲任失调证分别为122例(50.62%)、82例(34.02%)、138例(57.26%);乳腺癌术后多证兼夹者112例(46.47%),其中气阴两虚证伴有冲任失调证67例(59.82%);气阴两虚证、冲任失调证、肝气犯胃与病程密切相关(P＜0.01);对乳腺癌术后患者临床上提出以益气养阴、健脾养血、补肾调摄冲任为主要治疗大法,佐以化瘀散结解毒.