[Knowledge, attitude and practice of echinococcosis prevention and control, and their influencing factors among residents living in Seda County, Sichuan Province]

OBJECTIVE

To understand the status of knowledge, attitude and practice on echinococcosis prevention and control and investigate their influencing factors among residents living in Seda County of Sichuan Province, so as to provide a scientific basis for the further implementation of health education interventions in the county.

METHODS

A multi-stage stratified random sampling method was employed on September 2018. Ten townships were randomly sampled, and 2 to 3 administrative villages were randomly sampled from each township. Then, 20 to 40 households were randomly sampled from each village, and 1 to 2 villagers were investigated in each household. The knowledge, attitude and practice on echinococcosis prevention and control were investigated using a household questionnaire survey, and the factors affecting the qualification of echinococcosis prevention and control knowledge were identified using chi-square test and logistic regression analysis.

RESULTS

A total of 760 questionnaires were assigned, and 748 effective questionnaires were recovered, with a recovery rate of 98.42%. The overall qualification rate of echinococcosis prevention and control knowledge was 56.42% (422/748) in residents living in Seda County, and the awareness of the question "How to get echinococcosis?" was only 48.40%. The proportion of subjects with a positive attitude towards echinococcosis prevention and control was 64.71% to 94.79%, and the rate of corrected echinococcosis prevention and control behaviors was 10.40% to 82.45%. Univariate analysis showed that factors affecting the qualification rate of echinococcosis prevention and control knowledge included gender, occupation, education level, frequency of echinococcosis screening and frequency of health education (all P < 0.05), and binary logistic regression analysis showed that women, herdsmen as the primary occupation, an education level of primary school and below, absence of echinococcosis screening and absence of health education were factors responsible for the unqualified awareness of echinococcosis prevention and control knowledge (all P < 0.05).

CONCLUSIONS

There is a low awareness rate of echinococcosis prevention and control knowledge and a low proportion of corrected echinococcosis prevention and control behaviors in residents living in Seda County, Sichuan Province. Multiple forms of health education activities pertaining to echinococcosis prevention and control are needed with adaptation to local circumstance, and implementation of appropriate behavioral interventions is recommended.

[Nutritional support therapy during treatment of chronic critical illness]

Chronic critical illness (CCI) refers to a group of critically ill patients who survive the acute phase of intensive care, but with persistent organ dysfunction, thus entering a chronic period of continuous dependence on life support system, and still need to stay in intensive care unit (ICU) for a long time. Persistent inflammatory response-immunosuppression-catabolic syndrome (PICS) is the main pathophysiological feature of CCI. Three factors interact to form a vicious circle, leading to poor prognosis. Nutritional support therapy is a key link in the comprehensive treatment of CCI. Enteral nutrition (EN) should be started as soon as possible if conditions permit. If EN can not be implemented, temporary or transitional parenteral nutrition (PN) should be used, and EN should be added gradually in time. At the same time, the amount of PN should be gradually reduced. When EN meets more than 60% of patients' energy and protein requirements, PN can be considered to be discontinued. The main strategies and functions of CCI nutritional support therapy are as follows: strengthening high protein supply to correct negative nitrogen balance and inhibit catabolism, selecting branched chain amino acids (BCAA) to promote anabolism, using immunomodulators (arginine, ω3 polyunsaturated fatty acids) to improve immune suppression and inflammatory response, supplementing micronutrients (vitamins and trace elements) to counteract the decrease in intake and the increase in consumption, and adding probiotics to maintain the intestinal microecological balance, and so on. Reasonable nutritional support therapy not only improve malnutrition of CCI patients, but also help to reduce complications, thus speeding up rehabilitation, improving prognosis, shortening ICU hospitalization time, and even reducing mortality.

[Oncological safety and prognosis factors analysis of immediate breast reconstruction after nipple-areola-complex sparing mastectomy]

Objective: To explore the oncological safety of immediate breast reconstruction after nipple-areola complex(NAC) sparing mastectomy(NSM+ IBR) in patients with early stage breast cancer, and to analyze the prognostic factors of NSM+ IBR. Methods: From January 2004 to December 2015, the clinical data of 118 cases of stage Ⅰ-ⅡA breast cancer who had undergone NSM+ IBR in Tianjin Tumor Hospital were collected, comparing with 75 cases of Ⅰ-ⅡA breast cancer patients who had undergone immediate breast reconstruction after modified radical mastectomy (MRM+ IBR) at the same period. In addition to the prognosis of these two groups, the prognostic factors were also retrospectively analyzed. Results: The median follow-up were 53 months in the NSM+ IBR group and 51 months in the MRM+ IBR group, respectively. In the NSM+ IBR group, local recurrence, distant metastasis, death and NAC necrosis occurred in 4, 6, 9 and 4 cases during 3 years after operation, respectively. The local recurrence rate (LRR) was 3.4%, 3-year disease-free survival (DFS) rate was 91.5%, and the overall survival (OS) rate was 92.4%. In the MRM+ IBR group, local recurrence, distant metastasis, and death occurred in 1, 4, and 3 cases during 3 years after operation, respectively. The LRR was 1.3%, 3-year DFS was 93.3%, whereas the OS rate was 96.0%. No statistical difference was noted between the two groups (all P>0.05). That HER-2 positive and molecular type correlated with the 3-year DFS (P<0.05) independently and molecular type correlated with OS (P<0.05) independently in the NSM+ IBR group. Conclusions: NSM does not impair patients' prognosis and could ensure oncological safety of patients with early stage breast cancer. IBR could improve female patients' figure and ensure the quality of life. HER-2 status and molecular type are the independent prognostic factors of the 3-year DFS. Molecular type is the independent prognosis factor of OS.

[Postoperative complications and survival analysis of 1 118 cases of open splenectomy and azygoportal disconnection in the treatment of portal hypertension]

Objective: To analyze the recent postoperative and long-term postoperative complications of open-splenectomy and disconnection in patients with portal hypertension. Methods: There were 1 118 cases with portal hypertension who underwent open splenectomy and azygoportal disconnection from April 2010 to September 2015 at Department of Surgery, People's Liberation Army 302 Hospital. Retrospective case investigation and telephone follow-up were conducted in October 2016. All patients had history of upper gastrointestinal bleeding before operation. Short-term complications after surgery were recorded including secondary laparotomy of postoperative abdominal hemostasis, severe infection, intake disorders, liver insufficiency, postoperative portal vein thrombosis and perioperative mortality. Long-term data including postoperative upper gastrointestinal rebleeding, postoperative survival rate and incidence of postoperative malignancy were recorded, too. GraphPad Prism 5 software for data survival analysis and charting. Results: Postoperative short-term complications in 1 118 patients included secondary laparotomy of postoperative abdominal hemostasis(1.8%, 21/1 118), severe infection(2.9%, 32/1 118), intake disorders(1.0%, 11/1 118), liver dysfunction (1.6%, 18/1 118), postoperative portal vein thrombosis(47.1%, 526/1 118)and perioperative mortality(0.5%, 5/1 118). After phone call following-up, 942 patients' long-term data were completed including 1, 3, 5 years postoperative upper gastrointestinal rebleeding rate(4.4%, 12.1%, 17.2%), 1, 3, 5-year postoperative survival rate(97.0%, 93.5%, 90.3%); the incidence of postoperative malignant tumors in 1, 3 and 5 years were 1.7%, 4.4% and 6.2%. Conclusions: Reasonable choosing of surgical indications and timing, proper performing the surgery process, effective conducting perioperative management of portal hypertension are directly related to the patient's short-term prognosis after portal hypertension. Surgical intervention can reduce the rates of patients with upper gastrointestinal rebleeding, improve survival, and do not increase the incidence of malignant tumors.

[The effect of axillary lymph node status on the prognosis of patients with local-regional recurrence after breast-conserving surgery]

Objective: To investigate the effect of axillary lymph node status in evaluating the prognosis of patients with local recurrence after breast-conserving surgery. Methods: The clinical data of 72 patients with local-regional recurrence who had undergone breast-conserving therapy in Tianjin Cancer Hospital from February 2001 to December 2009 were collected and retrospectively analyzed. These patients were divided into axillary lymph node positive group (23 cases) and negative group (49 cases), according to their axillary lymph node status. Results: Among 72 patients, 21 cases were local recurrence, 35 cases were regional recurrence, and 16 cases were local-regional recurrence. In the axillary lymph node positive group, 7 cases were local recurrence, 10 cases were regional recurrence, 6 cases were local-regional recurrence. In the axillary lymph node negative group, 14 cases were local recurrence, 25 cases were regional recurrence, 10 cases were local-regional recurrence. There was no significant difference between these two groups (P=0.807). Moreover, no significant differences of the age, recurrent site, estrogen receptor (ER) and/or progesterone receptor (PR) status, human epidermal growth factor receptor 2 (HER-2) status, disease-free period, local and systemic therapeutic effect, non-distant metastasis survival between these two groups were observed (P>0.05). However, the overall survival of axillary lymph node positive group after recurrence was significantly lower than that of negative group (P=0.014). Cox multivariate analysis showed that recurrent site is an independent prognostic factor of disease-free survival of patients with regional recurrence after breast-conserving surgery (OR=2.050, P=0.002). The axillary lymph node status and recurrent site were independent prognostic factors of overall survival of these patients (OR=3.469, P=0.003; OR=3.676, P<0.001). Conclusions: Axillary lymph node status is an independent factor of overall survival of patients with regional recurrence after breast-conserving surgery, but it is marginally related with their non-distant metastasis survival.

[The Role of Supraclavicular lymph node dissection in Breast Cancer Patients with Synchronous Ipsilateral Supraclavicular Lymph Node Metastasis]

Objective: In this study, we evaluated the effect of supraclavicular lymph node dissection in breast cancer patients who presented with ipsilateral supraclavicular lymph node metastasis (ISLM) without distant metastasis. Methods: A total of 90 patients with synchronous ISLM without distant metastasis between 2000 and 2009 were retrospectively analyzed. Patients were retrospectively divided into two groups, namely supraclavicular lymph node dissection group(34 patients) and non-dissection group(56 patients), according to whether they underwentsupraclavicular lymph node dissection or not.The Kaplan-Meier method was applied to analyze the locoregional relapse free survival (LRFS) and overall survival(OS). Results: Median follow-upwas 85 months(range, 6 to 11 months). Local recurrence in 32 cases, 47 cases of distant metastasis, of which 25 patients were accompanied by both locoregional relapse and distant metastasis. Of the 32 patients with locoregional relapse, 11 patients were in the lymph node dissection group and 21 patients in the control group. Of the 47 patients with distant metastases, 17 were treated with lymph node dissection, 30 in the control group. Thirty-two patients died in the whole group and 16 patients underwentlymph node dissection and 16 patients didn't. There was no significant difference between the rate of 5-year LRFS and 5-year OS (P=0.359, P=0.246). For patients of ER negative, the 5-year loco-regional relapse free survival rates were 63.7% and 43.3% in supraclavicular lymph node dissection group and control group, respectively. The 5-year overall survival rates were 52.1% and 52.3%, respectively, and there were no statistically significant differences (P=0.118, P=0.951). For patients of PR negative, the 5-yearloco-regional relapse free rates were 59.8% and 46.2%, respectively, and the 5-year overall survival rates were 50.6% and 43.2%, respectively, and there was no significant difference between the two groups (P=0.317, P=0.973). The 5-year recurrence-free survival rates of human epidermal growth factor receptor 2 (HER2)-positive patients were 61.2% and 48.0%(P=0.634), respectively, and the 5-year overall survival rates were 37.2% and 65.4%(P=0.032). Forty-seven patients suffered distant metastases and the 5-year metastases free survival rates were 37.3% and 38.5% in supraclavicular lymph node dissection group and control group, respectively. Conclusion: Supraclavicular lymph node dissection maybe an effective approach to improve the loco-regional control for the patients with ISLM, especially for ER negative and PR negative subtypes, but it might has adverseeffects for the patients with negative HER2 status.

[Comparative study on the clinical characteristics of HBV infection patients with different pathologic inflammation grade]

OBJECTIVE

The aim of this study was to compare the biochemical and virological characteristics among patients infected with hepatitis B virus (HBV) according to pathologic inflammation grade.

METHODS

428 patients with chronic HBV infection accept liver biopsy, liver function test, HBeAg detection and HBV DNA levels detection. They were studied and subdivided into four groups according to pathologic inflammation grade. The biochemical and virological characteristics were studied. Univariate analysis was performed with the SPSS 16.0.

RESULTS

In different inflammation grading group, mean age and sex composition were no difference. Serum levels of ALT was highest in group G3 and lowet in group G0-1, there was statistically significant among groups (P = 0.005); AST and TBil were all highest in group G4 and lowest in group G0-1, statistically significant also found among groups (P = 0.000 & 0.004). Serum levels of ALB and PTA were all highest in group G0-1 and lowest in group G4, had statistically significant among groups (P = 0.000 & 0.000). There was no difference of HBV DNA level and percentage of HBeAg (+) among four groups (P = 0.565 & 0.065).

CONCLUSIONS

The serum AST, TBil, ALB and PTA were different and can partly reflect the inflammation degree of liver damage in patients with HBV infection. ALT and PTA can reflect the inflammation degree of G0-1, G2 and G3; AST, TBil, ALB and PTA reflect the G3 and G4. HBV DNA level and HBeAg status can not indicate the inflammation degree in HBV infection patients.

Diversity of nitrogenase (nifH) genes pool in soybean field soil after continuous and rotational cropping

Diazotrophs diversity in soybean is a topic requiring thorough investigation since the previous researches have focused on only rice, forest, grass, water, etc. In this research, iron-only nitrogenase nifH gene was as genetic marker. PCR-RFLP was used to investigate the difference of diazotrophs community diversity in the soil from the continuous cropping (CC) (the 5-yr tilling of soybean) and the rotational cropping (RC) (soybean-corn) soils in the northeast of China. A total of 36 isolates were genetically characterized. Most of the isolates closely related to Azospirillum and Azotobacter. Eighty-six unique nifH gene sequences were obtained by cloning of the respective PCR products in two soil samples. It was found that the diversity of nifH genes in CC changed obviously compared with RC. Phylogenetic analysis indicated that most of the clones clustered together in a high homogeneity with some sequence retrieved from environmental representatives. The sequence diversity of nifH genes was high and the members of the Alphaproteobacteria were predominant in both samples. The experimental study also revealed the two non-proteobacterial diazotrophs, firmicutes and euryarchaeota. Through this study, it can be assumed that different tillage perhaps affected the nifH gene-containing population diversity.

[Determination of phthalic diesters in water by solid phase microextraction-capillary gas chromatography]

The solid phase microextraction (SPME) has the advantages of high efficiency, high sensitivity, simple operation and solvent free operation for analyzing environmental samples. An optical fiber coated with mixed stationary phase of polysiloxane and polymeric fullerene (in ratio of 4:1) was used to extract 5 phthalic diesters by HS-SPME-GC. The operating conditions of SPME such as the extraction temperature, ionic strength of solution, adsorption time and desorption time have been studied. It was compared with commercial polymer coating PDMS fiber through headspace SPME combined with GC. The results indicated that OV-1/PSO-C60 was better than PDMS in extracting high boiling point and semi-volatile phthalic diesters. For phthalic diesters, the detection limits were in the range of 0.331 ng/L-12.5 micrograms/L, and relative standard deviations were below 12% except for dinonyl phthalate.

Quantitative pharmaco-EEG of sustained release valproate in epileptics

The quantitative background EEG effects and serum concentration of the sustained-release form of VPA (SR-VPA) were studied after single-dose administration in 10 previously untreated epileptic patients with generalized tonic-clonic seizures. The result showed an increase of power of alpha 2 band on the occipital areas, a decrease of power of beta band (diffuse and preponderant on posterior scalp areas) with the increase of serum concentration. Both effects were found to reach their maxima and minima respectively when the peak values of serum concentration were reached. A positive correlation between alpha 2 power on the occipital areas and serum concentration was observed, and a negative correlation of serum concentration and beta power were detected on the posterior scalp areas.

Quantitative pharmaco-EEG of carbamazepine in volunteers and epileptics

In order to measure the effect of carbamazepine (CBZ) on quantitative EEG (qEEG), one dose of CBZ (300 mg) was administered to 10 epileptics and 10 healthy adult volunteers. EEG samples were recorded before and at regular intervals within 24 hours following administration. The EEG activity was processed by power spectral analysis and the drug serum concentration was assessed concomitantly. The results showed that with the increase of serum concentration of CBZ, the percentage of power progressively increased in the theta band while it decreased in the alpha 2 band. The percentage of theta and alpha 2 power was found to reach maximum and minimum levels, respectively, when the peak values of serum concentration of CBZ were attained. The effects on qEEG in anterior scalp areas were more evident than in posterior scalp areas.

[Chemical studies of Epimedium acuminatum Franch]

Three flavonol glycosides isolated from the aerial parts of Epimedium acuminatum were identified as baohuoside II, epimedoside A and icariin on the basis of spectral data (UV, IR, MS, and 1HNMR) and chemical properties. Baohuoside II was isolated from the species for the first time.