Nocardiosis demonstrates a temporal categorization that includes acute, subacute, and chronic stages alongside distinct typical localizations such as pulmonary, cutaneous, and disseminated forms. Disseminated nocardiosis, commonly caused by Nocardia asteroides, N. brasiliensis, and N. farcinica, continues to result in substantial morbidity and mortality. Herein, we report a life-threatening disseminated nocardiosis caused by Nocardia otitidiscaviarum in a patient with minimal change disease. This study emphasizes the difficulty in the diagnosis and treatment of unknown infections in clinical settings and highlights the important role played by laboratories in solving infectious diseases caused by rare pathogens.

暂无摘要。

OBJECTIVE: We aimed to establish appropriate review criteria for blood cell analysis in a specialized women\'s and children\'s hospital. Also, the CellaVision DI-60, was developed as one of the automated digital cell morphology analyzer, we evaluated if it was shown to be most effective under the certain review criteria.
METHODS: A total of 2890 blood samples were detected to optimize the previously established review criteria for women and children with the Sysmex XE-2100. A total of 623 samples were used to validate the criteria.
RESULTS: The microscopic-review rate based on the initial review criteria was 51.0%. After optimization, it was reduced to 17.3% and the false-negative rate was 3.85%. There was > 80% consistency between manual review results and CellaVision DI-60 preclassification when samples triggered the platelet- or red cell-related rules. The sensitivity for abnormalities (immature granulocytes, nucleated red blood cells) of reclassification was 90% to 100% and the false-negative rate was < 5%. However, direct microscopic review was required when the \"Blasts/AbnLympho?\" and \"Atypical Lympho?\" flags were triggered.
CONCLUSIONS: Specialized review criteria are needed for women and children. An automated morphology identification system might help to improve the review criteria.

In order to elucidate the aging performance and aging mechanism of a rubber waterstop in low-temperature environments, the rubber waterstops were placed in the freezing test chamber to accelerate aging, and then we tested its tensile strength, elongation, tear strength, compression permanent deformation and hardness at different times. Additionally, the damaged specimens were tested by scanning electron microscope, Fourier transform infrared spectroscopy and energy dispersive spectrometry. The results showed that with the growth of aging time, the mechanical properties of the rubber waterstop are reduced. At the same time, many protrusions appeared on the surface of the rubber waterstop, the C element gradually decreased, and the O element gradually increased. During the period of 72-90 days, the content of the C element in the low-temperature air environment significantly decreased compared with that in low-temperature water, while the content of O element increased significantly.

Enterocytozoon bieneusi can cause severe diarrhea in children and adults. However, in China, there are scant studies on E. bieneusi in diarrheal children and adults, with the exception of prevalence and genotyping data in a small number of cities including Hubei, Shanghai, and Heilongjiang. In this study, 196 fecal samples (n = 132 in Chongqing, n = 44 in Shandong, n = 20 in Hubei) were collected, including 91 from children and 105 from adults. Through microscopic examination, 19 positive samples (11 from children and 8 from adults) were detected. Using PCR examination, the internal transcriptional spacer (ITS) region was utilized by nested PCR to detect and characterize E. bieneusi. Twenty positive samples were detected, including 14 from children (≤11 years of age) and 6 from adults. According to the sequence analysis of ITS data, one known zoonotic (D) and seven novel (CQH5-11) genotypes were identified. This is the first molecular epidemiological study of E. bieneusi in diarrheal patients in different regions of China. Therefore, this study can provide useful information for the molecular epidemiology and control of E. bieneusi infection in humans in the future.

OBJECTIVE: To analyze the diagnosis of imported malaria cases in Henan Province from 2015 to 2019, so as to provide the evidence for malaria surveillance during the post-elimination stage.
METHODS: The data pertaining to malaria cases in Henan Province from 2015 to 2019 were extracted via the web-based Chinese Information System for Infectious Diseases Control and Prevention and the Parasitic Diseases Information Reporting Management System (PDIRMS) of Chinese Center for Disease Control and Prevention, and the diagnostic methods, diagnostic institutions and diagnostic time of imported malaria cases were analyzed.
RESULTS: A total of 952 imported malaria cases were reported in Henan Province during the period from 2015 through 2019, and all cases were laboratory-confirmed. The positive rate of malaria rapid diagnostic tests (RDTs) was 98.61% (779/790), which was significantly greater than that (94.22%, 897/952) of microscopic examinations (χ2 = 22.773, P < 0.05). The proportion of imported malaria cases diagnosed in medical institutions increased from 65.22% (120/184) in 2015 to 81.50% (185/227) in 2019. Among the 238 imported malaria cases diagnosed in centers for disease control and prevention (CDC), 71.01% (169/238) were diagnosed in county-level CDC, and among the 704 cases diagnosed in medical institutions, only 8.38% (59/704) were diagnosed at county-level medical institutions. The median time from onset to definitive diagnosis of malaria was 3 days, and the median duration between onset and initial diagnosis of malaria was 1 day. The duration between initial diagnosis and definitive diagnosis of malaria varied significantly among years (χ2 = 24.956, P < 0.05), and the interquartile range from initial diagnosis to definitive diagnosis reduced from 4 days in 2016 to 2 days in 2019. In addition, the median time from initial diagnosis to definitive diagnosis was significantly longer in severe falciparum malaria cases than in non-severe falciparum malaria cases (2 days vs. 1 day; Z = 7.557, P < 0.05).
CONCLUSIONS: Medical institutions play a more and more important role in the identification and surveillance of malaria cases; however, the diagnostic capability of malaria remains low in county-level medical institutions. The diagnostic awareness and capability of county-level medical institutions requires to be improved, in order to play their roles as sentinel hospitals in the malaria surveillance during the post-elimination stage.
［摘要］ 目的 分析2015-2019年河南省输入性疟疾病例诊断情况, 为开展消除疟疾后监测工作提供依据。方法 通过中国疾病预防控制中心传染病监测信息系统和寄生虫病防治信息管理系统, 收集2015-2019年河南省疟疾病例信息, 对其诊断方式、诊断机构、诊断时间进行统计分析。结果 2015-2019年河南省共报告输入性疟疾病例952例, 所有病例均为实验室确诊病例。疟疾快速诊断试纸条 (RDT) 阳性检出率为98.61% (779/790), 高于镜检检出率 (94.22%, 897/952), 差异有统计学意义 (χ2 = 22.773, P＜0.05)。输入性疟疾病例在医疗机构诊断的比例由2015年的65.22% (120/184) 升至2019年的81.50% (185/227)。238例在疾病预防控制 (疾控) 机构诊断的输入性疟疾病例中, 71.01% (169/238) 在县级疾控机构诊断; 704例在医疗机构诊断的输入性疟疾病例中, 仅8.38% (59/704) 在县级医疗机构诊断。输入性疟疾病例从发病到确诊中位时间为3 d, 其中从发病到初诊中位时间为1 d, 各年从初诊到确诊时间差异有统计学意义 (χ2 =24.956, P ＜ 0.05), 其四分位数间距由2016年的4 d缩短为2019年的2 d。输入性重症恶性疟病例从初诊到确诊中位时间 (2 d) 长于非重症病例 (1 d), 差异有统计学意义 (Z = 7.557, P ＜ 0.05)。结论 医疗机构在河南省输入性疟疾病例发现和监测中的作用越来越重要, 但县级医疗机构诊断水平仍较低; 应提高其诊断意识和能力, 从而在消除疟疾后监测工作中发挥哨点医院作用。.

BACKGROUND: Malaria remains a serious public health problem globally. As the elimination of indigenous malaria continues in China, imported malaria has gradually become a major health hazard. Well-timed and accurate diagnoses could support the timely implementation of therapeutic schedules, reveal the prevalence of imported malaria and avoid transmission of the disease.
METHODS: Blood samples were collected in Wuhan, China, from August 2011 to December 2018. All patients accepted microscopy and rapid diagnosis test (RDT) examinations. Subsequently, each of the positive or suspected positive cases was tested for four human-infectious Plasmodium species by using 18S rRNA-based nested PCR and Taqman probe-based real-time PCR. The results of the microscopy and the two molecular diagnostic methods were analysed. Importation origins were traced by country, and the prevalence of Plasmodium species was analysed by year.
RESULTS: A total of 296 blood samples, including 288 that were microscopy and RDT positive, 7 RDT and Plasmodium falciparum positive, and 1 suspected case, were collected and reanalysed. After application of the two molecular methods and sequencing, 291 cases including 245 P. falciparum, 15 Plasmodium vivax, 20 Plasmodium ovale, 6 Plasmodium malariae and 5 mixed infections (3 P. falciparum + P. ovale, 2 P. vivax + P. ovale) were confirmed. These patients had returned from Africa (95.53%) and Asia (4.47%). Although the prevalence displayed a small-scale fluctuation, the overall trend of the imported cases increased yearly.
CONCLUSIONS: These results emphasize the necessity of combined utilization of the four tools for malaria diagnosis in clinic and in field surveys of potential risk regions worldwide including Wuhan.

OBJECTIVE: To understand the laboratory technicians\' abilities in blood slide making and reading in 10 prefectures of Yunnan Province which have passed the provincial malaria elimination evaluation, so as to provide the evidence for improving the malaria elimination surveillance and parasite examination.
METHODS: Thirty negative blood slides were randomly sampled to evaluate coating, dyeing and clean quality and reading results, and 4 laboratory technicians were sampled to evaluate their reading abilities from each prefecture level and its 2 subordinate counties (districts) respectively, and then the results were analyzed.
RESULTS: A total of 869 negative blood samples were evaluated. The coincidence rate was 100%. The proportions of good coating, dyeing and clean quality were 96.09%, 91.71% and 96.89%, respectively. Totally 576 blood slides were used to evaluate the reading ability. The number of correct reading was 505, and the correct rate was 87.67%. Among them, the Plasmodium vivax correct reading rate was 87.76%, the P. falciparum correct reading rate was 87.50%, and the correct reading rate of mixed infections was 47.62%. The laboratory technicians\' ability to the mixed infections was significantly lower than the ability to the others (χ2 = 37.169, P < 0.05), however, in the laboratory technicians\' abilities, there was no significant difference among the center (s) for disease control and prevention, general hospitals and township hospitals (χ2 = 2.782, P > 0.05), and the prefecture, county and township levels (χ2 = 0.358, P > 0.05) .
CONCLUSIONS: The 10 prefectures have passed the provincial evaluation in blood slide making and microscopic examination skill indicators requested, but the medical and public health institutions at all levels still should further improve their laboratory technicians\' abilities in blood slide making and microscopic examination skills.
［摘要］ 目的了解通过省级消除疟疾考核评估的云南省10个州 (市) 检验人员血片制作水平和镜检能力, 为消除疟疾 监测和疟原虫检测提供依据。 方法 在云南省通过省级消除疟疾考核评估的10个州 (市), 每个州 (市) 随机抽取30张阴 性血片进行血片涂制质量、染色质量、清洁度和结果判定复核; 随机抽取每州 (市) 及所辖2个县 (区) 医院和疾病预防控 制中心4名检验人员进行疟原虫显微镜检查技能考核, 并对考核结果进行统计分析。 结果 共复检阴性血片869张, 复 检符合率为100%, 其中血片涂制质量、染色质量和清洁度好和中等级血片分别占96.09%、91.71%和96.89%; 镜检技能考 核共镜检读片576张, 正确率为87.67%, 其中间日疟原虫、恶性疟原虫和混合感染血片镜检读片正确率分别为87.76%、87.50%和47.62%, 镜检人员对不同疟原虫虫种的检测能力差异有统计学意义 (χ2 = 37.169, P < 0.05), 来自疾病预防控制 中心、医院和卫生院的镜检人员对疟原虫的检测能力差异无统计学意义 (χ2 = 2.782, P > 0.05), 来自州 (市) 级、县 (区) 级 和乡 (镇) 级机构的检验人员疟原虫镜检能力差异无统计学意义 (χ2 = 0.358, P > 0.05) 。 结论 云南省10个州 (市) 疟原 虫血片制作和镜检技能考核已达到省级消除疟疾考核评估中的指标要求, 但还需进一步提高各级医疗卫生机构检验人 员的疟原虫血片制作和镜检技能。.

OBJECTIVE: To understand the quality of production of blood slides and laboratory personnel\'s ability to microscopically examine Plasmodium at Jiangsu Province clinic inspection stations at all levels, so as to provide the evidence for the construction of malaria diagnostic laboratories and the evaluation of malaria elimination effect.
METHODS: After the reexamination of the negative blood slides of the examination stations of the malaria center in each county (district), the negative blood slides of the outpatient inspection station in the district and all the positive blood slides of the direct report of the network from 2011 to 2017, the staining and cleanliness of the blood smears, microscopic examination results and the coincidence rate of positive blood species were comprehensively analyzed.
RESULTS: A total of 19 109 checked blood samples were examined. The qualified rates of blood preparation, dyeing and cleanliness were 87.5%, 89.3% and 87.6%, respectively. The quality of reexamined blood slides in different years showed statistically significant difference (all P < 0.05), by using chi-square trend test, and there was a trend of increasing year by year. There was a significant difference in the quality of the reexamined blood slides among the different cities with districts (P < 0.05). In addition, there were 1 860 blood samples from 2012 to 2017, and the total coincidence rate was 87.4% and the coincidence rate of positive blood smear examinations was 98.9%. The species coincidence rates of Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae, Plasmodium ovale and mixed infection were 95.4%, 33.3%, 56.0%, 76.5% and 9.1%, respectively (P < 0.05). The total coincidence rates of blood smear reexaminations in different years were 85.0%, 90.1%, 86.0%, 85.3%, 90.0% and 87.6% from 2012 to 2017, respectively, and the difference was not statistically significant (P > 0.05).
CONCLUSIONS: The quality of blood slides at the primary clinic inspection stations in Jiangsu Province conforms to the standard established by the provincial malaria reference laboratory; however, the ability of Plasmodium species identification is insufficient and needs to be improved.
[摘要] 目的 了解消除疟疾阶段江苏省发热病人疟原虫血涂片制作质量和实验室人员疟原虫镜检能力, 为各级疟疾 诊断实验室建设和消除疟疾效果评价提供科学依据。方法 对2011–2017年江苏省全部网报疟疾病例血涂片和随机抽 取的县级疟疾中心镜检站已复核阴性血片, 以及辖区内门诊镜检站已检阴性血片进行镜检复核, 从血片制作、染色、清洁 度、镜检结果及虫种符合情况进行综合分析。结果 2011–2017年共抽检复核已检血片19 109张, 血片制作、染色、清洁 度合格率分别为87.5%、89.3%、87.6%, 不同年份血片质量差异有统计学意义 (P 均< 0.05), 并有逐年增高的趋势。不同 设区市血片质量差异有统计学意义 (P < 0.05)。复核2012–2017年网报疟疾病例血片1 860张, 总符合率为87.4%, 阳性 符合率为98.9%。恶性疟、间日疟、三日疟、卵形疟、混合感染虫种符合率分别为95.4%、33.3%、56.0%、76.5%、9.1%, 差异 有统计学意义 (P < 0.05)。2012–2017年不同年份网报疟疾病例血片复核总符合率分别为85.0%、90.1%、86.0%、85.3%、 90.0%、87.6%, 差异无统计学意义 (P > 0.05)。结论 江苏省基层门诊镜检站的血片质量达到省疟疾诊断参比实验室制 定的判定标准, 血片诊断符合率较高, 但虫种鉴别能力有待进一步提高。.

Objective To investigate the capabilities of Plasmodium microscopic examinations of professional staff in medical institutions in Wuxi City, so as to provide evidences for improving malaria control and elimination work in the future. Methods The data of questionnaires for laboratorial staff in charge of Plasmodium microscopic examinations were collected and analyzed in the medical institutions in Wuxi City in 2016, and the influencing factors related to the capabilities of Plasmodium microscopic examinations were analyzed by the method of logistic regression. Results Totally 54 laboratorial workers in 54 medical institutions in Wuxi City were investigated, 16 of them were male, and 38 were female, and the ratio of male to female was 0.42:1. Among the 54 laboratorial workers, 12 persons (22.22%) had the experience of detecting Plasmodium in the work. The multivariable analysis showed the ability to detect Plasmodium was associated with male laboratorial workers (adjusted OR = 0.11, 95%CI:0.02-0.53), laboratorial workers with intermediate or higher professional titles (adjusted OR = 5.31, 95%CI: 1.04-27.19) and laboratorial workers from county and township medical institutions (adjusted OR = 0.04, 95%CI:0.01-0.98). Conclusions All of the medical institutions in Wuxi City have the capability of microscopic examinations of Plasmodium. However, the ability of laboratorial staff in primary hospitals still should be improved.
［摘要］ 目的 对无锡市各级医疗机构疟原虫镜检能力建设情况进行分析, 为今后疟疾防治工作提供科学依据。方法 收集2016年无锡市各级医疗机构镜检员问卷调查数据, 建立数据库, 并采用Logistic回归对镜检员疟原虫检测能力的影响因素进行分析。结果 共调查全市54家医疗机构54名镜检员, 男性16人, 女性38人, 男女性别比0.42:1; 有12 名镜检员曾在工作中检出疟原虫, 占被调查者的22.22%。多因素分析结果表明:女性镜检员在工作中检测出疟原虫的能力比男性镜检员弱 (调整OR = 0.11, 95%CI:0.02～0.53), 中级及以上职称镜检员在工作中检测出疟原虫的能力高于初级职称镜检员 (调整OR = 5.31, 95%CI:1.04～27.19), 县乡级医疗机构镜检员在工作中检测出疟原虫的能力比其他机构的镜检员弱 (调整OR = 0.04, 95%CI:0.01～0.98)。结论 无锡市各级镜检站均具备一定的疟疾诊治能力, 需进一步加强基层医疗机构的镜检能力建设。 ［关键词］疟疾; 医疗机构; 疟原虫; 镜检; 能力建设.