江苏省镇江市2009-2018年15岁以下少年儿童法定报告传染病流行特征

目的 了解2009-2018年镇江市15岁以下少年儿童法定传染病的流行趋势,为开展防控工作提供依据。方法 从中国疾病预防控制信息系统中收集2009-2018年镇江市15岁以下少年儿童法定传染病疫情资料进行分析。结果 2009-2018年镇江市累计报告15岁以下少年儿童法定传染病病例22种65135例,年报告发病率134.51/万～263.23/万之间,发病率呈现上升波动趋势（〖XC小五号.EPS;P〗趋势=1932.389,P<0.001）;死亡病例12例,年均死亡率0.03/万;累计病例中男童发病数为38156例（58.58%）,年均发病率204.86/万;女童发病数为26979例（41.42%）,年均发病率159.81/万,不同性别间发病率差异有统计学意义（〖XC小五号.EPS;P〗=997.605,P<0.001）。无甲类传染病报告;乙类传染病累计报告病例16种2587例,年均发病率为7.29/万,发病呈下降趋势（〖XC小五号.EPS;P〗趋势=78.566,P<0.001）;丙类传染病累计报告病例6种62548例,年均发病率176.16/万,发病呈上升趋势（〖XC小五号.EPS;P〗趋势=2177.178,P<0.001）。肠道传染病、呼吸道传染病、血源及性传播传染病、自然疫源及虫媒传染病、其它传播途径传染病分别占累计发病总数的86.95%（56636例）、12.65%（8240例）、0.25%（166例）、0.03%（17例）、0.12%（76例）。发病率前2位的传染病为手足口病和流行性腮腺炎,分别占发病总数的78.43%（51088例）和8.42%（5485例）。结论 少年儿童是传染病发病的重点高危人群,应重点加强手足口病、流行性腮腺炎传染病的监测,采取针对性措施控制少年儿童传染病的发生。     

Replication error-positive samples found in pheochromocytomas

Adenomatous polyposis coli, (APC) and E-cadherin (CDH1) tumor suppressor genes were investigated in human pheochromocytoma. Both genes are components of adherens junctions, but are also involved in wnt signalling in which one of the target molecules is c-myc protein. MATERIALS AND METHODS: Fifteen sporadic pheochromocytomas were tested for gene instability by PCR/loss of heterozygosity. Detection of c-myc protein was performed using immunohistochemistry. RESULTS: One sample with allelic imbalance of the APC gene and one with allelic imbalance of the CDH1 gene were found. Interestingly, another type of genomic instability was detected--replication error-positive samples (RER+). Four out of 13 heterozygous samples were RER-positive (30.8%). The instability is the result of impaired cellular mismatch repair. Immunohistochemistry showed increased levels of c-myc in comparison to normal adrenal tissue. CONCLUSION: Our results suggest that microsatellite genetic instabilities of the E-cadherin gene have a role in pheochromocytoma development and progression. Detected instability indicates that mismatch repair may be targeted in pheochromocytoma. Increased expression of c-myc protein as well as allelic imbalances of APC and CDH 1 genes suggest that the wnt signalling pathway may have a role in this malignancy.     

Conformational transition in poly[4-(1,1,3,3-tetramethylbutyl)phenyl methacrylate] and poly(4-tert-butylphenyl methacrylate) in dilute solutions

Temperature dependence of viscosity data and refractive index increment was investigated on two polymers: poly[4-(1,1,3,3-tetramethylbutyl)phenyl methacrylate] ( 1a ) and poly(4-tert-butylphenyl methacrylate) ( 1b ) in dilute solution. A discontinuity in intrinsic viscosity was observed over a narrow temperature range. From this behaviour it was possible to visualize sharp changes of unperturbed dimensions (K_θ) and thermodynamic parameters (B). This phenomenon can be accounted for by assuming conformational changes of the chain in the chosen solvent in a specific temperature range. These changes can be also observed by discontinuities in refractive index increments dn/dc. In the case of 1b the conformational change disappears on addition of a polar solvent (CHCl₃).     

Cancer incidences in the digestive tube: is cobalamin a small intestine cytoprotector?

Malignancies are common in the digestive tube, although with unequal distribution among segments. The aim of this paper was to compare available interpretations of the low cancer incidence in the small bowel and high in the large bowel. Supposed mechanisms include relatively small bacterial population, large secretion of liquid and rapid transit in the small bowel. Small bowel mucosa is the main absorptive part of the digestive tube with absorption rates for various nutrients so high that they can even be considered as clearances from the intestinal content. Consequently, these nutrients are not present in the large bowel. An alternative explanation is that an absorbable protective substance from the intraluminal content, might protect the mucosa from malignant transformations. It can be speculated that if there are any cytoprotective substances in the digested food their effect would be expressed mostly in the absorptive small intestine, leaving the large bowel mucosa unprotected. Vitamin B12 might be a possible candidate for this role. Cobalamin molecules are initially bound to haptocorrin (Hc) in the stomach, but in the small intestine B12 is transferred to intrinsic factor (IF) after the action of pancreatic trypsin on Hc. Cobalamin-IF complexes are absorbed in the terminal ileum leaving only a small fraction of B12 to enter the large bowel. We have tried to summarize available data regarding cancer incidences in digestive tube, segmental length and transit times of tube content. Cancer density is calculated as incidence per length and transit speed as length per transit time. Cancer incidences for seven intestinal segments were considered low if they were below one case per 100 000 inhabitants annually, while the low cancer density meant less than six cases per 100 000 inhabitants per metre. For instance, transverse colon was considered as a high cancer incidence place (2.15 cases), with low cancer density (4.3 cases/m). Transit speed more than 0.3 metre/hour was associated with low cancer incidences (accuracy 0.85) and low cancer density segments (accuracy 1.00). Cobalamin availability showed similar distribution, available in low incidence segments and unavailable in high incidence segments. Experimental studies are needed to quantify B12 availability in the large bowel and to determine whether small amounts of B12-IF or, perhaps, B12-haptocorrin complexes are absorbed by the small bowel mucosa. Without that, no cytoprotective effects of B12 in the digestive tube can be expected.     

心理一致感在脑卒中患者主要照顾者照顾负担与抑郁间的中介效应研究

目的 探讨心理一致感在主要照顾者照顾负担与抑郁间的中介作用,为提高主要照顾者身心健康提供理论参考。方法 用便利抽样方法抽取某三甲医院神经内科的脑卒中患者主要照顾者,使用一般情况调查表、照顾负担量表、心理一致感量表和流调中心抑郁量表进行调查。采用SPSS 21.0与AMOS 22.0对数据进行统计分析。结果 回收有效问卷436份,有效回收率为96.88%。主要照顾者照顾负担得分为36.50±7.49分、心理一致感得分为63.15±8.46分、抑郁得分为14.03±6.77分。心理一致感与照顾负担、抑郁得分均呈负相关(r=-0.642、-0.592,P<0.01);照顾负担与抑郁得分呈正相关(r=0.625,P<0.01)。Bootstrap 法进一步验证了心理一致感的中介效应,中介效应占总效应的16.6%。结论 心理一致感是脑卒中患者主要照顾者照顾负担与抑郁间的中介变量。     

贵州省2014-2018年人感染H7N9禽流感病例流行病学调查分析

目的 了解贵州省Ｈ７Ｎ９禽流感病例的特征,为进一步防控提供参考。方法 收集贵州省2014-2018年人感染Ｈ７Ｎ９禽流感临床及流行病学疫情资料,用描述性流行病学方法分析其流行特征。结果 2014-2018年贵州省共确诊21例人感染H7N9人禽流感病例,死亡11例,病死率52.3%。以男性、中老年、农民为主,61.9%的病例发生在黔东南和黔南地区,2017年病例数占总病例数的80.9%,未发现聚集性疫情和二代病例。病例发现以不明原因肺炎监测发现为主,从暴露到发病、发病到首诊、发病到确诊、发病到抗病毒药物使用及发病到死亡的时间中位数分别为5天、3天、7天、7天和14天;有无基础性疾病的病死率差异无统计学意义（〖XC小五号.EPS;P〗=0.38,P=0.54）,后期病例病死率低于前期（〖XC小五号.EPS;P〗=4.24,P=0.04）。19例本地病例均有明确的活禽或活禽市场相关环境接触史,其中94.7%的活禽市场或活禽相关场所均检出H7核酸阳性,平均阳性率为32.3%(1.34%～82%),全面长期关闭活禽市场后疫情得到有效控制。 结论 接触活禽或活禽市场环境是感染的主要因素;加强活禽市场外环境监测,规范化管理及长期关闭活禽市场,可有效预警和控制疫情;加强基层医疗机构救治水平可有效降低病死率。     

Does breast biopsy marker cost and availability influence utilisation in radiology practice?

Introduction

Breast Screen Australia and Breast Screen Aotearoa guidelines recommend breast biopsy marker (BBM) use in indicated patients. This study aims to evaluate whether BBM cost and availability impacts BBM utilisation.

Methods

An online survey was disseminated to radiologists who identified ‘breast imaging’ as their area of practice in the Royal Australian and New Zealand College of Radiologists (RANZCR) customer relationship management system. Survey questions addressed participant demographics and factors relating to BBM use.

Results

Most (92%, 245/266) participants report that BBMs are routinely available at their place of practice. Those employed in private practice were more likely to report that BBMs are not routinely available. 22% (58/266) of radiologists report that BBM cost influences choice of biopsy type (core biopsy vs fine needle aspirate), this finding was more frequent in those employed in private practice. 47% of respondents report that the cost of BBMs is passed on to the patient, with all these respondents employed in a private or mixed private/public setting. Half the respondents (133/266) reported that their decision to use BBMs would be influenced by the availability of insurance coverage to cover BBM costs.

Conclusions

Results suggest that BBM cost and availability influences both choice of biopsy type (core biopsy vs FNA) and choice to use a BBM. Radiologists working in private practice or mixed private/public practice report that BBMs are less likely to be available for use, and that BBM cost is more likely passed to the patient; possibly disadvantaging patients who present to private radiology providers with imaging findings or conditions that would indicate BBM insertion under current national guidelines.     

Merkel cell carcinoma arising in the ear canal

A case of rare tumor, Merkel cell carcinoma, located in the ear canal of a 25-year-old woman is presented. A polypoid tumor mass was extirpated, and tympanoplasty was done at the first operation, whereas at the second operation, all the bones of the ear canal were removed. Epitympanum and cavum were filled with tumor, and the tumor mass was removed in toto. The histopathology and immunohistochemical staining characteristics of tumor confirmed the presence of Merkel cell tumor. Postoperatively, radiation therapy to the tumor bed was completed. There was no clinical or radiographic evidence of recurrence or metastasis of Merkel cell tumor for 3 years.     

Acute doxorubicin pulmotoxicity in rats with malignant neoplasm is effectively treated with fullerenol C60(OH)24 through inhibition of oxidative stress

The aim of this study was to investigate the possible protective role of fullerenol (FLR, C₆₀(OH)₂₄ on doxorubicin (DOX)-induced lung toxicity using biochemical and histopathological approaches. Rats (Sprague-Dawley outbred) were randomly divided into five groups. The healthy control group received no medication (saline only). The other four groups had chemically induced breast cancer (1-methyl-1-nitrosourea; 50 mg/kg, ip). The second group was the cancer control group (saline only). The other three groups were DOX (8 mg/kg, ip), FLR/DOX (100 mg/kg, ip, 30 min before DOX; 8 mg/kg, ip), and FLR (100 mg/kg, ip), respectively. The levels of malondialdehyde (MDA) and oxidized glutathione (GSSG) in the lung tissue were higher in the group treated with DOX alone than in the control groups. The activities of catalase (CAT), glutathione reductase (GR), superoxide dismutase (SOD), and lactate dehydrogenase (LDH) were found to be increased in the lung tissue of the animals in the DOX group over all the other groups, while GSH-Px significantly decreased in activity compared with the control and FLR groups. There was no significant difference in MDA and GSSG levels and enzyme activities in either control (healthy; cancer) or FLR (FLR/DOX; FLR) groups. The acute change found in the DOX group was subpleural edema. In contrast, the groups treated with FLR appeared to be virtually histopathologically normal.In conclusion, this study clearly indicates that DOX treatment markedly impairs pulmonary function and that pre-treatment with FLR might prevent this toxicity in rats through inhibition of oxidative stress.