Effects of dulaglutide combined with metformin on body metabolism, body fat composition and serum adipokines in obese patients with type 2 diabetes mellitus / 药学实践与服务

Objective To explore the clinical efficacy of dulaglutide combined with metformin in the treatment of obese patients with type 2 diabetes mellitus（T2DM）. Methods A total of 200 obese patients with T2DM who were treated in Shanghai Jiading District Anting Hospital from January 2021 to January 2023 were randomly divided into liraglutide group（n=100）and dulaglutide group（n= 100）. The liraglutide group was treated with liraglutide combined with metformin, and the dulaglutide group was treated with dulaglutide combined with metformin. Both groups were treated for 3 months. The body metabolic indexes [fasting blood glucose（FBG）, 2 h postprandial blood glucose（2 h PBG）, hemoglobin（HbA1 c）, total cholesterol（TC）, triglyceride（TG）], body fat composition [body fat rate, body mass index, subcutaneous fat rate of limbs, visceral fat index] and serum adipokines（adiponectin, neuropeptide Q（NPQ）, asprosin, irisin）levels were compared before treatment and 3 months after treatment. The clinical efficacy and adverse reactions of the two groups were observed. Results After 3 months of treatment, FBG, 2 h PBG, HbAlc, TC, TG, body fat rate, body mass index, subcutaneous fat rate of limbs, visceral fat index and asprosin in the two groups were lower than those before treatment, and those in the dulaglutide group were lower than those in the liraglutide group（P<0.05）. After 3 months of treatment, the levels of serum adiponectin, NPQ and irisin in the two groups were higher than those before treatment, and the increase in the dulaglutide group was greater than that in the liraglutide group（P<0.05）. The effective rate of dulaglutide group（98.00%）was higher than that of liraglutide group（91.00 %）（P<0.05）. There was no significant difference in the incidence of adverse reactions between the two groups（11.00%, 14.00%）（P>0.05）. Conclusion Dulaglutide combined with metformin could improve the metabolic status of obese T2 DM patients, regulate body fat composition and serum adipokines, with significant clinical efficacy and safety.

Effects of different polymers on biomimetic mineralization of small intestine submu-cosal scaffolds / 北京大学学报(医学版)

Objective:To explore the effects of different polymers on in vitro biomimetic mineralization of small intestinal submucosa(SIS)scaffolds,and to evaluate the physicochemical properties and bio-compatibility of the SIS scaffolds.Methods:The SIS scaffolds prepared by freeze-drying method were im-mersed in simulated body fluid(SBF),mineralized liquid containing polyacrylic acid(PAA)and mine-ralized liquid containing PAA and polyaspartic acid(PASP).After two weeks in the mineralized solu-tion,the liquid was changed every other day.SBF@SIS,PAA@SIS,PAA/PASP@SIS scaffolds were ob-tained.The SIS scaffolds were used as control group to evaluate their physicochemical properties and bio-compatibility.We observed the bulk morphology of the scaffolds in each group,analyzed the microscopic morphology by environment scanning electron microscopy and determined the porosity and pore size.We also analyzed the surface elements by energy dispersive X-ray spectroscopy(EDX),analyzed the struc-ture of functional groups by Flourier transformed infrared spectroscopy(FTIR),detected the water ab-sorption rate by using specific gravity method,and evaluated the compression strength by universal me-chanical testing machine.The pro-cell proliferation effect of each group of scaffolds were evaluated by CCK-8 cell proliferation method.Results:Under scanning electron microscopy,the scaffolds of each group showed a three-dimensional porous structure with suitable pore size and porosity,and crystal was observed in all the mineralized scaffolds of each group,in which the crystal deposition of PAA/PASP@SIS scaffolds was more regular.At the same time,the collagen fibers could be seen to thicken.EDX analysis showed that the characteristic peaks of Ca and P were found in the three groups of mineralized scaffolds,and the highest peaks were found in the PAA/PASP@SIS scaffolds.FTIR analysis proved that all the three groups of mineralized scaffolds were able to combine hydroxyapatite with SIS.All the scaf-folds had good hydrophilicity.The compressive strength of the mineralized scaffold in the three groups was higher than that in the control group,and the best compressive strength was found in PAA/PASP@SIS scaffold.The scaffolds of all the groups could effectively adsorb proteins,and PAA/PASP@SIS group had the best adsorption capacity.In the CCK-8 cell proliferation experiment,the PAA/PASP@SIS scaffold showed the best ability to promote cell proliferation with the largest number of living cells observed.Con-clusion:Compared with other mineralized scaffolds,PAA/PASP@SIS scaffolds prepared by mineralized solution containing both PAA and PASP have better physicochemical properties and biocompatibility and have potential applications in bone tissue engineering.

Correlation between changes in homocysteine, uric acid, and lipid metabolism in patients with first-episode schizophrenia and their psychopathological status / 中国基层医药

Objective:To investigate the correlation between the changes in homocysteine, uric acid, and lipid metabolism and the psychopathological status of patients with first-episode schizophrenia.Methods:Between June 2021 and June 2023, a total of 82 patients with first-episode schizophrenia who received treatment at Wenzhou Seventh People's Hospital were included in the study group. Additionally, 82 individuals who underwent physical examination at the same hospital during the same period were included in the control group. The homocysteine levels were measured using the enzyme cycling method, while uric acid levels were determined via the uric acid enzyme method. Lipid metabolism levels were assessed using a fully automated biochemical analyzer. The positive and negative syndrome (PANSS) scale scores, which assess positive, negative, and general psychopathological status in patients with first-episode schizophrenia, were obtained. Serum homocysteine and uric acid levels, as well as lipid metabolism levels, were compared between the two groups. Pearson correlation analysis was used to assess the correlation between general psychopathological status scores and homocysteine, uric acid, and lipid metabolism levels. Multivariate logistic regression analysis was performed to investigate the factors (homocysteine, uric acid, or lipid metabolism levels) that affect first-episode schizophrenia.Results:The patients with first-episode schizophrenia exhibited positive symptom scores of (25.74 ± 5.63) points, negative symptom scores of (23.12 ± 6.76) points, general psychopathological status scores of (37.91 ± 5.87) points, and a total score of (86.77 ± 7.75) points. The serum homocysteine and uric acid levels in the study group were (23.12 ± 3.78) μmol/L and (345.12 ± 27.38) μmol/L, respectively. These values were significantly higher than those in the control group [(8.81 ± 2.19) μmol/L, (218.48 ± 23.51) μmol/L, t = 29.66, -31.78, both P < 0.05]. There were no significant differences in total cholesterol and triacylglycerol levels between the two groups (both P > 0.05). However, serum level of low density lipoprotein cholesterol in the study group was (3.26 ± 1.04) mmol/L, which was significantly higher than that in the control group [(2.34 ± 0.78) mmol/L, t = -6.41, P < 0.05]. Serum level of high density lipoprotein cholesterol in the study group was (1.02 ± 0.13) mmol/L, which was significantly lower than that in the control group [(1.17 ± 0.14) mmol/L, t = 7.11, P < 0.05). Pearson correlation analysis indicated a positive linear correlation between the general psychopathological status score and homocysteine, uric acid, and low density lipoprotein cholesterol levels. Conversely, it exhibited a negative linear correlation with high density lipoprotein cholesterol levels. Multivariate logistic regression analysis further showed that homocysteine, uric acid, and low density lipoprotein cholesterol levels were strongly associated with first-episode schizophrenia. Conclusion:In patients with first-episode schizophrenia, homocysteine, uric acid, and low density lipoprotein cholesterol levels are elevated, while high density lipoprotein cholesterol levels are reduced. There markers are closely related to patients' psychopathological status.

Professor ZHOU Zhongying's Experience in Differentiating and Treating Hepatitis and Liver Cirrhosis from Deficiency and Excess / 中医杂志

This paper summarized Professor ZHOU Zhongying's experience in differentiating and treating hepatitis and liver cirrhosis from deficiency and excess. It is considered that the pathogenesis of hepatitis and liver cirrhosis belongs to deficiency in root and excess in branch， with depletion of liver， spleen and kidney as the root， and constraint and bind of damp-heat and stasis toxin as the branch. Moreover， mutual cause and promotion between deficiency and excess leads to the disease. For general principle of treatment， it is recommended to clear and transform pathogenic excess， supplement deficiency and rectify the healthy qi. In the early stage of hepatitis and cirrhosis， excess pathogen hyperactivity is the main manifestation， which can be treated by clearing and transforming damp-heat and stasis toxin， supplemented by regulating spleen and stomach， with modified Yinchenhao Decoction （茵陈蒿汤） and Biejiajian Pill （鳖甲煎丸）. In the middle and late stages， cases with deficiency-excess complex were more common， which should be treated by clearing damp-heat and stasis toxin， regulating and supplementing liver-spleen-kidney， using medicinals with the function of clearing heat and dispelling damp， dissolving stasis and resolving toxins to treat the branch. Moreover， Liujunzi Decoction （六君子汤）， Yiguan Decoction （一贯煎）plus Erzhi Pill （二至丸） and Buzhong Yiqi Decoction （补中益气汤） modifications are suggested respectively in correspondence to the different kinds of root deficiency including irregular liver and spleen， liver and kidney yin deficiency， and liver-spleen-kidney deficiency.

Resection of superior polar gland flap of the breast combined with dual plane augmentation through Omega nipple root approach / 中华医学美学美容杂志

Objective:To investigate the feasibility of superior polar gland flap resection combined with biplanar augmentation mammoplasty through the root of the nipple to correct pseudoptosis/mild breast ptosis.Methods:From January 2019 to January 2021, 20 patients (40 breasts) with pseudoptosis/mild breast ptosis underwent augmentation mammoplasty with superior polar gland flap through the root of the nipple and microvilli anatomical silica gel prosthesis.Results:No postoperative complications such as hematoma infection, capsular contracture and abnormal sensation of the nipple and areola were found in 20 patients. During the follow-up of 3 to 18 months, the patients' breasts were plump and straight, the appearance was good, and the prolapse was basically corrected. Postoperative satisfaction was achieved in 20 cases (95%), and the satisfaction of incision scar was 100%.Conclusions:The comprehensive surgery restores the normal anatomical suspension system of the breast, achieves a long-term mechanical stable balance among prosthesis, muscle, breast gland and skin, and receives high satisfaction with breast shape after operation.

Application of progressive case teaching method based on core competency in standardized nursing training / 中华医学教育探索杂志

Objective:To explore the application effect of progressive case teaching method based on core competency in standardized nursing training.Methods:A total of 63 nursing students rotated in department of neurosurgery from June 2020 to June 2022 were selected as the research objects and randomized into experimental group ( n=31) and control group ( n=32). The experimental group adopted the progressive case teaching method based on core competency, and the control group adopted the conventional teaching mode. The data was analyzed using SPSS 26.0 to conduct t-test or non-parametric test based on the data normality for comparing the theory results, objective structure clinical examination (OSCE) scores, core competency, self-directed learning ability scores, teaching satisfaction and nursing satisfaction of patients in two wards between the two groups. Results:The theoretical results ( t=4.74, P<0.001) and OSCE scores ( t=3.81, P<0.001) of the experimental group were better than those of the control group. The scores of core competency and autonomous learning ability ( t=4.32, P<0.001) of the experimental group were better than those of the control group. The teaching satisfaction score ( t=2.21, P=0.044) and patient satisfaction score ( t=2.92, P=0.011) of the observation group were better than those of the control group. Conclusion:The progressive case teaching method based on core competency can improve the post competency of nurses, and also improve the teaching satisfaction rate and patient satisfaction rate, which is worthy of being carried out in the subsequent teaching activities.

Moxifloxacin combined with biapenem for severe pneumonia in 65 older adult patients / 中国基层医药

Objective:To investigate the clinical effects of moxifloxacin combined with biapenem on controlling inflammatory responses and improving immune function in older adult patients with severe pneumonia.Methods:120 older adult patients with severe pneumonia, who received treatment in the Second People's Hospital of Lishui from February 2017 to March 2020, were included in this study. They were randomly assigned to receive either biapenem (control group, n = 55) or moxifloxacin combined with biapenem (observation group, n = 65) for 7 days. Inflammatory response control, immune function improvement, and adverse reactions were assessed in each group after treatment. Results:After treatment, levels of interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP) and procalcitonin (PCT) in the observation group were (24.51 ± 4.24) ng/L, (12.51 ± 3.15) mg/L and (4.62 ± 1.05) μg/L, respectively, which were significantly lower than those in the control group [(48.74 ± 4.67) ng/L, (26.80 ± 4.24) mg/L, (8.92 ± 1.10) μg/L, t = 29.77, 21.14, 21.87, all P < 0.001). The proportion of CD 3+ and CD 4+ cells and CD 4+ / CD 8+ ratio in the observation group were (63.27 ± 3.72)%, (39.97 ± 2.18)%, 1.79 ± 0.16, respectively, which were significantly higher than those in the control group [(55.58 ± 2.28)%, (35.18 ± 2.62)%, 1.41 ± 0.15, t = 17.08, 10.93, 13.34, all P < 0.001). Total effective rate was significantly higher in the observation group than in the control group [96.92% (63/65) vs. 83.64% (46/55), χ2 = 6.32, P < 0.05]. There was no significant difference in the incidence of adverse reactions between observation and control groups [10.77% (7/65) vs. 9.09% (5/55), χ2 = 0.09, P > 0.05]. Conclusion:Moxifloxacin combined with biapenem based on routine treatment for severe pneumonia in older adult patients can greatly strengthen anti-inflammatory effects, improve immune function, and enhance clinical efficacy without increasing adverse drug reactions.

Reflection on the Relationship between the Ethical Principles and Rules of Biomedical Science and Technology / 中国医学伦理学

Clarifying the relationship between ethical principles and rules is the key to promote the legitimate governance of scientific and technological ethics. Ethical principles and rules, as the two basic elements of science and technology ethics, are both different and related. The ethical principles are the basis and direction of the formulation of the ethical rules which are the most direct expression of following the ethical principles and an effective means to improve the effect of ethical governance. Among them, ethical standards are the general standard rules with strong universality. Based on the analysis of the relationship between the ethical principles and the ethical guidelines, this paper put forward the expression mode and reasonable application of science and technology ethical principles in the ethical rules, so as to promote the improvement of the national ethics governance system of biomedical science and technology.

Risk factors for preoperative venous thromboembolism in lower extremity in patients with tibial plateau fracture / 中华骨科杂志

Objective:To analyze the risk factors of deep venous thrombosis (DVT) in patients with tibial plateau fracture during preoperative period.Methods:From July 2017 to October 2019, a total of 264 patients undergoing surgeries of tibial plateau fractures were enrolled. Duplex ultrasonography (DUS) during hospitalization was used to screen for DVT of the bilateral lower extremities. Patients were divided into DVT group and non-DVT group according to results of DUS. Data on demographics, comorbidities, injury-related data, fracture type, laboratory biomarkers were collected and compared between groups with and without DVT.Results:The incidence of preoperative DVT was 39.0% (103/264) among 264 patients with traumatic tibial plateau fractures, and distal thrombosis predominated in DVT group. There were 103 cases in DVT group. 55 were males and 48 were females. The average age was 54.00±11.12. According to the Schatzker classification of tibial plateau fractures, 7 cases belonged to type I, 37 to type II, 2 to type III, 11 to type IV, 29 to type V, and 17 to type VI. There were 161 cases in non-DVT group. 89 were males and 72 were females. The average age was 48.57±13.25. According to the Schatzker classification of tibial plateau fractures, 23 cases belonged to type I, 76 to type II, 2 to type III, 10 to type IV, 33 to type V, and 17 to type VI. Univariate analysis showed that age ( t=3.451, P=0.001), the type of tibial plateau fracture ( χ2=8.314, P=0.004), D-dimer ( χ2=18.552, P<0.001), APTT ( t=2.869, P=0.004), ALB ( t=2.292, P=0.023) and Hb ( t=1.983, P=0.048) were statistically different than those in non-DVT group. Multivariate analysis showed age ( OR=1.033, 95% CI: 1.009, 1.058; P=0.007), the type of tibial plateau fracture ( OR=1.829, 95% CI: 1.014, 3.299; P=0.045) and D-dimer ( OR=1.914, 95% CI: 1.057, 3.464; P=0.032) were independent risk factors. Conclusion:The incidence of DVT in patients with tibial plateau fractures during preoperative period is high, and distal thrombosis is the main part of venous thrombosis of lower extremity. The type of tibial plateau fracture, age and the level of D-dimer are independent risk factors of preoperative DVT in patients with tibial plateau fractures.

Graded and pan-neural disease phenotypes of Rett Syndrome linked with dosage of functional MeCP2

Rett syndrome (RTT) is a progressive neurodevelopmental disorder, mainly caused by mutations in MeCP2 and currently with no cure. We report here that neurons from R106W MeCP2 RTT human iPSCs as well as human embryonic stem cells after MeCP2 knockdown exhibit consistent and long-lasting impairment in maturation as indicated by impaired action potentials and passive membrane properties as well as reduced soma size and spine density. Moreover, RTT-inherent defects in neuronal maturation could be pan-neuronal and occurred in neurons with both dorsal and ventral forebrain features. Knockdown of MeCP2 led to more severe neuronal deficits as compared to RTT iPSC-derived neurons, which appeared to retain partial function. Strikingly, consistent deficits in nuclear size, dendritic complexity and circuitry-dependent spontaneous postsynaptic currents could only be observed in MeCP2 knockdown neurons but not RTT iPSC-derived neurons. Both neuron-intrinsic and circuitry-dependent deficits of MeCP2-deficient neurons could be fully or partially rescued by re-expression of wild type or T158M MeCP2, strengthening the dosage dependency of MeCP2 on disease phenotypes and also the partial function of the mutant. Our findings thus reveal stable neuronal maturation deficits and unexpectedly, graded sensitivities of neuron-inherent and neural transmission phenotypes towards the extent of MeCP2 deficiency, which is informative for future therapeutic development.

Metabonomics changes in adolescents with depressive disorder and the effect of sertraline intervention / 中华行为医学与脑科学杂志

Objective:To detect the potential biomarkers in the serum of adolescents with depressive disorder and provide the basis for clinical diagnosis of depression.Methods:A total of 45 adolescents with depression who met the inclusion criteria and 47 healthy controls (HC group) were screened.Patients with depression were treated with sertraline (100 mg/d) for 4 weeks.The patients before sertraline treatment were called DN-MDD group and then were called DT-MDD group after sertraline treatmant.Hamilton Depression Scale (HAMD) was used to evaluate the efficacy of the two groups before and after treatment.The serum was collected for UPLC-MS/MS to determine the changes in profiles of endogenous metabolites.And the software of SPSS 21.0, XCMS and Analyst 3.0 were used to analyze the data.The reliability and feasibility of clinical diagnosis were further analyzed by ROC via GraphPad 8.0.Results:After 4 weeks of sertraline treatment, the patients' HAMD score decreased (before: 19.71±1.72, after: 15.36±1.91) and the effective rate reached 51% ( P<0.01). Multivariate statistical analysis showed that HC group and DN-MDD group and DT-MDD group had significant differences in metabolic profile.Compared with healthy controls, 11 different metabolites were found in the plasma of DN-MDD group including glycerate, adenosine, creatine and so on.After treatment, concentrations of glucose, glutamate, aspartate, sucrose, creatine, pyruvate and adenosine were significant changes in serum of adolescent depression patients.Area under ROC curve of glucose and glutamic acid were >0.9, and the AUC of aspartic acid, sucrose, creatine, pyruvate and adenosine were >0.7, suggesting that these 7 metabolites had different degrees of diagnostic ability. Conclusion:There are different metabolic profiles between adolescents with or without depression, and the antidepressant sertraline is helpful to maintain the level of substance metabolism which can be used as one of the treatment methods for adolescent depression.Our research may support the new strategy for clinical diagnosis and treatment of adolescent depression.

Multivariate logistic regression analysis and imaging characteristics of chronic obstructive pulmonary disease with invasive pulmonary aspergillosis / 中国基层医药

Objective:To explore the multivariate logistic regression analysis and imaging characteristics of chronic obstructive pulmonary disease (COPD) with invasive pulmonary aspergillosis.Methods:From February 2017 to February 2019, 73 patients with COPD complicated with invasive pulmonary aspergillosis admitted to the Hangzhou Dajiangdong Hospital were selected as observation group, and 81 COPD patients without invasive pulmonary aspergillosis admitted to the Hangzhou Dajiangdong Hospital from February 2017 to February 2019 were selected as control group.Multivariate logistic regression analysis was used to analyze the independent risk factors of COPD with invasive pulmonary aspergillosis, and to observe the imaging characteristics of COPD with invasive pulmonary aspergillosis.Results:Univariate analysis showed that there were no statistically significant differences in sex, age, course of disease, combined with underlying diseases and smoking history between the two groups (all P>0.05); there were statistically significant differences in long-term hormone use, hypoproteinemia, long-term antibiotics use and invasive operation between the two groups (χ 2=32.372, 16.593, 36.671, 21.566, all P<0.05). The results of logistic regression analysis showed that long-term use of hormones, hypoproteinemia, antibiotics and invasive manipulation were independent risk factors for COPD complicated with invasive pulmonary aspergillosis ( OR=1.685, 95% CI: 1.208-2.142, OR=2.546, 95% CI: 1.682-3.981, OR=2.984, 95% CI: 1.982-4.653, OR=2.109, 95% CI: 1.462-3.241, all P<0.05). The main clinical manifestations of COPD with invasive pulmonary aspergillosis were cough, sputum, chest pain and dyspnea.The main imaging manifestation of COPD with invasive pulmonary aspergillosis was non-specific infiltration, accounting for 50.68%(37/73). Conclusion:COPD complicated with invasive pulmonary aspergillosis is affected by many factors.The main clinical manifestations are cough, sputum, chest pain and dyspnea, and the main imaging manifestation is non-specific infiltration shadow.

Constructionof the militaryandlocal integration course of"Field and Disaster Nursing"based on Delphi method / 中国实用护理杂志

Objective To construct a"Field and Disaster Nursing"course which is suitable for the military and local higher nursing education, on-the-job and post training education to organic integrate the modern disaster nursing teaching and military field nursing teaching. Methods Based on the methods of qualitative and quantitative research, such as literature research, interviews and observational method, a preliminary plan of curriculum design was established, and an expert consultation table was designed.The Delphi expert consultation method was used to conduct two rounds of consultation with 30 related experts on disaster relief.Quantitative data were obtained and statistical data were analyzed. Results The final screening results of the curriculum content applicability index are 4 first grade, and 23 for the two level.A set of"Field and Disaster Nursing"curriculum had been set up that is suitable for education and training needs of the military and local fusion. Conclusion The construction of this course provides a training thought for exploring disaster nursing education suitable for China's national conditions, and has reference and guiding significance for further implementation of military and civilian integration and multi participatory disaster nursing teaching practice.

Feasibility of CM-Dil labeling bone-marrow mesenchymal stem cells in vitro / 重庆医学

Objective To investigate feasibility of CM-Dil labeling mesenchymal stem cells in vitro.Methods We separate,culture and identify rat bone marrow mesenchymal stem cells,after labeling MSCs with CM-Dil concentration respectively in 1,2,4μg/mL,observe label rate of MSCs after 15 min,24 h,48 h,72 h,5 passage and 8 passage,then detect cell cycle with FCM and cell proliferation capability with CCK8.Results MSC cultured with the whole bone marrow adherent method were strongly positive for CD44,CD29 and negative for CD34,CD45.The label rates of MSC 15 min after labeled with CM-Dil 1,2,4 μg/mL were respectively (31.60±1.25)％,(88.73±1.79)％,(96.89±1.31)％,and there has statistically difference (F=1 757.21,P=0.000);the growth curve of the 4 groups was similar,and the percentages of G1 phase,S phase and G2/M phase between the 4 groups have no statistically difference (P＞0.05).Conclusion CM-Dil in concentration 4 μg/mL has high label rate and low cytotoxicity,therefore could be a efficient and stable method of labeling MSCs.

Effect and nursing of red light irradiation corticosteroid dependent dermatitis / 现代临床护理

Objective To observe the effect of red light facial synthesis combined with comprehensive facial therapy on corticosteroid dependent dermatitis (hormone dependent dermatitis) and summarize the nursing strategies. Methods About 160 patients with hormone dependent dermatitis hospitalized in our hospital from June 2015 to March 2016, were equally divided into control group and study group:the control group was treated with conventional comprehensive therapy, while the study group with 30 min red light irradiation together with the nursing measures in the control group. The total symptom scores of the two groups were evaluated before treatment and 4 weeks after treatment. Results Before treatment, the total symptom scores of the control group were no significant difference between them (P>0.05). After treatment,the treatment effect of the study group was significantly better than that of the control group and the scores of ISS SSRI were lower than those of the control group . Conclusion The red light radiation combined with comprehensive facial therapy is effective in the treatment of corticosteroid dependent dermatitis and related nursing should be done well to promote patients relovery.

Analysis on resistance and epidemic trend of Acinetobacter baumannii in two hospitals of Rushan City / 国际检验医学杂志

Objective To analyze drug resistance and epidemic features of Acinetobacter baumannii in two hospitals of Rushan city .Methods Acinetobacter baumannii strains were collected from Rushan People′s Hospital and Chinese Medicine Hospital of Rushan in 2015 .Antimicrobial susceptibility test was carried out by Kirby-Bauer(K-B) method .Homology analysis were conducted by pulsed-field gel electrophoresis(PFGE) in 50 Acinetobacter baumannii strains .Results There were 158 Acinetobacter baumannii strains were isolated ,108 strains were from Rushan People′s Hospital ,50 strains were from Chinese Medicine Hospital of Rushan . 59 .9% strains was from sputum specimens .The most strains were from Respiratory department (39 .8% ) and ICU (25 .3% ) .All strains were resistant to aztreonam ,ampicillin and cefoxitin ,but sensitive to polymyxin B and tigecycline .50 strains could be divided into five types(A -E) .A typewas the predominant type ,including A1 ,A2 ,A3 three subtypes .Conclusion The resistance of Acine-tobacter baumannii was serious in the two hospitals in Rushan city .It mainly cause respiratory infections ,and could spread among different departments .The most strains were from Respiratory Department and ICU .

Analysis on resistance and epidemic trend of Acinetobacter baumannii in two hospitals of Rushan City / 国际检验医学杂志

Objective To analyze drug resistance and epidemic features of Acinetobacter baumannii in two hospitals of Rushan city .Methods Acinetobacter baumannii strains were collected from Rushan People′s Hospital and Chinese Medicine Hospital of Rushan in 2015 .Antimicrobial susceptibility test was carried out by Kirby-Bauer(K-B) method .Homology analysis were conducted by pulsed-field gel electrophoresis(PFGE) in 50 Acinetobacter baumannii strains .Results There were 158 Acinetobacter baumannii strains were isolated ,108 strains were from Rushan People′s Hospital ,50 strains were from Chinese Medicine Hospital of Rushan . 59 .9% strains was from sputum specimens .The most strains were from Respiratory department (39 .8% ) and ICU (25 .3% ) .All strains were resistant to aztreonam ,ampicillin and cefoxitin ,but sensitive to polymyxin B and tigecycline .50 strains could be divided into five types(A -E) .A typewas the predominant type ,including A1 ,A2 ,A3 three subtypes .Conclusion The resistance of Acine-tobacter baumannii was serious in the two hospitals in Rushan city .It mainly cause respiratory infections ,and could spread among different departments .The most strains were from Respiratory Department and ICU .

Study on the situation of drug use in patients with chronic obstructive pulmonary diseases in the Chinese communities of large cities / 中华流行病学杂志

Objectives To understand the medication being used among patients with chronic obstructive pulmonary diseases (COPD) in Chinese communities of large cities.Methods A cross-sectional survey was carried out in Beijing,Shanghai,Chengdu and Guangzhou with the total number as 678 COPD cases who were continuously recruited.Subjects were face-to-face interviewed using a structured questionnaire and with medical records checked at the same time.All data were double entered into a database under EpiData 3.1,and analyzed by SAS 9.2.Results One quarter of all the subjects did not receive any clinical treatment.The top three drugs for COPD were expectorant (50.74％),phosphodiesterase inhibitors (49.56％),and leukotriene (49.12％).Totally,there were 36 different types combination of drugs used for COPD and the proportions of drugs being used as one,two,and three or more at the same time were 29.5％(200 cases),39.7％(269 cases) and 30.8％(209 cases) respectively.In addition 36.6％ (248 cases) of them used oxygen.There were statistical correlations between drug-use patterns and the severity of COPD.Conclusion The patterns of medication varied over COPD cases in communities from Chinese large cities and appeared differently under the recommendations in the clinical guidelines set for COPD.Guidance and surveillance programs on drugs use for COPD should be improved on patients with COPD in the Chinese communities.

Automated immunoassays of heparin induced thrombocytopenia antibodies is superior to the 4T′s score in HIT diagnostic efficacy / 中华检验医学杂志

Objective To discuss the diagnostic value of HIT-antibodies in suspected HIT patients with heart diseases.Methods A single center study.We collected 242 blood samples of suspected HIT patients whose platelet count decreased after heparin application during July 1 st ,2012 to June 30th ,2016 in Wuhan Asia Heart Hospital and detected the concentration of HIT antibodies , meanwhile the 4T′s score were calculated.Among the study objects , there are 206 patients received cardiac surgery , 28 received cardiac interventional therapy and 8 received drug therapy.And we divided them into HIT group (44, median age 57.5, 23 females ) and non-HIT group ( 198, median age 63.5, 87 females ) according to clinical diagnosis.Quantitative data was analyzed by independent t-test or Mann-Whitney U test.Qualitative data was analyzed by Fisher′s exact test.We drew ROC curve according to the statistical analysis to determine the optimal threshold value of antibodies in diagnosis of HIT andsensitivity , specificity, negative likelihood ratio, positive likelihood ratio of the HIT antibody detection .Therefore, we can assess the value of HIT antibody detection in HIT clinical diagnosis and treatment .Moreover, we used the optimal threshold value of antibodies to testify the suspected HIT patients .Results The HIT antibody concentration of HIT group (44) and non-HIT group ( 198 ) are 3.2 ( 95% CI:1.8 -5.5 ) U/ml and 0.4 ( 95% CI:0.3 -0.4 ) U/ml, respectively.The concentration of HIT group is much higher than the non-HIT group(P<0.000).When the cut-off value of HIT-Ab is set at 0.9 U/ml, sensitivity and specificity are 93.2%and 91.9%, respectively. And negative likelihood ratio and positive likelihood ratio are 0.07 and 11.53, respectively.When the cut-off value of HIT-Ab is set at 0.6 U/ml, sensitivity and specificity are 100.0%and 73.7%.HIT-Ab and 4T′s score of ROC-AUC are 0.971 and 0.745, respectively.The diagnosis value of HIT-Ab in HIT is significantly higher than the 4T′s score ( P<0.000).Conclusions HIT antibody detection is a simple and effective auxiliary diagnostic method in HIT exclusion .And HIT antibody detection is more optimal than the 4T′s score in HIT diagnosis and treatment .

The clinical characteristics of neonatal sepsis caused by different pathogens / 中国新生儿科杂志

Objective To study the characteristics of neonatal sepsis caused by gram positive (G +) bacteria,gram negative (G+) bacteria and fungi.Method Clinical data of 202 neonates with sepsis hospitalized from Jan.2012 to May.2015 were studied.According to the different pathogens,202 neonates were divided into gram positive bacteria group,gram negative bacteria group and fungi group.The general information,clinical manifestation,laboratory examination and treatment outcome of the three groups were analysed with Chi square analysis,LSD,Fisher exact probability tests.Result A total of 202 cases of neonatal sepsis were recruited.The detection rate of gram positive bacteria,gram negative bacteria and fungi was 35.2％ (71 cases),56.4％ (114 cases) and 8.4％ (17 cases),respectively.Comparing with gram negative group and fungi group,gram positive group had older gestational age (36.0 ± 3.8 w,compared with gram negative 33.0 ± 3.9 w,fungi group 31.2 ± 3.2 w,P ＜ 0.05),larger birth weight (2 620 ± 925 g compared with gram negative group 1 999 ± 849 g,fungi group 1 595 ± 666 g,P ＜ 0.05),lower nosocomial infection rate (29.6％ compared with gram negative group 70.2％,fungi group 94.1％,P ＜0.05),lower rate of shock,blood glucose disturbance and thrombocytopenia (P ＜ 0.05).There was no statistics difference between the gram negative group and fungi group.Comparing with the other two groups,fungi group was older [20.0 (11.5,39.5) d compared with gram positive group 7.0 (2.0,17.0) d,and gram negative 10.0 (6.0,18.2) d,P ＜ 0.05].The rate of deep venous catheterization in fungi group was higher than that in gram positive group and gram negative group (88.2％ compared with gram positive group 25.4％,gram negative group 40.4％,P ＜0.05).The treatment course of fungi group was longer than that of the gram positive group and gram negative group [22.0 (12.0,37.5) d compared with the gram positive group 14.0 (10.0,17.0) d,gram negative group 14.0 (11.0,18.0) d,P ＜0.05].The incidence of apnea in the gram negative group was higher than that in gram positive group and fungi group (P ＜ 0.05).The rate of leukocytosis,leukocytopenia and elevated CRP were higher in gram negative and gram positive group (P ＜ 0.05).Conclusion The clinical manifestations and laboratory examinations in neonatal sepsis caused by different pathogens were different,which can help to early identification of different pathogenic infections.However,there is no specific indicators to differentiate neonatal sepsis caused by different pathogens.Early identification of the pathogen needs clinical acumen.