Objective In order to prevent the infection of Acinetobacter baumannii and use antibiotics rationally,the clinical infection and drug resistant data of multi-drug resistance Acinetobacter baumannii (MRAB)detected in intensive care unit (ICU)of Beijing Friendship Hospital from 2011 to 2013were analyzed.Methods This study is a retrospective study.One hundred and eighty five strains of MRAB were collected from the patients in ICU from January 2011 to December 2013.Identificationand antibiotic susceptibility of strains were determined with Vitek-2 Compact automatic bacteria identification system.The annual infection rate of MRAB was counted.PCR was used to detect the resistance genes.The clinical features of the patients with MRAB were analyzed.The average age,acute physiology and chronic health evaluation (APACHE) Ⅱ score,duration in ICU and mortality ratio of the MRAB patients were compared with the patients without MRAB.Rank-sum test was used to analyze the average age,APACHE Ⅱ score and duration in ICU.Chi-squared test was used to analyze the mortality ratio and annual infection rate.Results The average age [(67 ± 17)vs (59-± 19) years old,Z =-5.365,P =0],APACHE Ⅱ score [(25.68±7.93) vs (17.62±8.39),Z=-14.821,P=0],duration in ICU [(27 ±29) vs (5 ±8) d,Z =-4.342,P =0] and mortality ratio [10.82％ (53/185) vs 28.65％ (147/1 359),x2 =45.92,P =0] of the patients infected by MRAB were significantly higher than those without the infection.The MRAB was found mostly in sputum and bronchial precipitates (83.78％,155/185).Though detection rate reduced yearly and there was a significant reduction in 2013 compared with 2011 [11.07％ (69/469) vs 8.37％ (52/621),x2 =8.755,P =0.003],the drug resistant rate was in high level and did not show any change in the 3 years.OXA-23 and OXA-51 were detected in all MRAB.Conclusions The main drug resistant mechanism of MRAB in ICU is related to OXA-23.More active methods of coutrol and prevention of MRAB should be used in elderly aud severely pneumonic patients.Intensive disinfection and isolation measures can decrease MRAB detection rate.Combined antibiotics should be used in patients with MRAB infection.

Objective : To investigate the effect of exposure to low concentrations of benzene on miR-155 and miR-223 expression in peripheral blood lymphocytes among workers with benzene exposure. Methods : A hundred male employees at a risk of exposure to benzene (the exposed group) were randomly sampled from two small metal products manufacturing enterprises and one medium-sized chemical raw material and chemical products manufacturing enterprise in Ningbo City, Zhejiang Province, and 60 age-matched male employees without benzene exposure were randomly selected as the unexposed group. Age, body mass index ( BMI ), smoking status, alcohol consumption, disease history, medication history and routine blood testing results of subjects were collected using a questionnaire survey. The 8-hour time weighted average concentration ( CTWA ) of benzene was measured in the workplace using thermal desorption gas chromatography, and the urine 8-hydroxy-2' deoxyguanosine ( 8-OHdG ) levels were determined using high-performance liquid-chromatography tandem mass spectrometry (HPLC-MS/MS). The miR-155 and miR-223 expression was quantified in peripheral blood lymphocytes using quantitative fluorescent reverse transcription-polymerase chain reaction assay, and the factors affecting miR-155 and miR-223 expression were identified using multivariable logistic regression analysis. Results : The subjects in the exposed group had a mean age of ( 31.17±7.30 ) years, and were exposed to low concentrations of benzene ( CTWA, 0.05 to 0.30 mg/m3 ) , while the subjects in the unexposed group had a mean age of ( 32.52±6.15 ) years. There were no significant differences between the exposed and unexposed groups in terms of age, BMI, proportion of smokers or proportion of alcohol consumers ( P>0.05 ). There was no significant difference in the median relative miR-155 expression between the exposed and unexposed groups ( 0.953 vs. 1.293, P>0.05 ), and lower median relative miR-223 expression was quantified in the exposed group than in the unexposed group ( 0.540 vs. 1.433, P<0.05 ). Multivariable logistic regression analysis revealed that down-regulation of miR-223 expression correlated with exposure to benzene ( OR=2.719, 95%CI: 1.308-5.651 ). Conclusion Down-regulation of miR-223 expression may be associated with exposure to low concentrations of benzene.

Objective:To compare the indicators of non-communicable diseases (NCD) and predict the achieving time of United Nations (UN) Sustainable Development Goals (SDG) in 125 countries participating in the Belt and Road (B&R) initiative and China.Methods:Using the open access data of Global Burden of Disease study, we first got the premature mortality rates of four main chronic diseases (cardiovascular disease, cancer, diabetes and chronic respiratory diseases) and suicide mortality rate in the 126 countries from1990 to 2017. We transformed the value of each indicator into a scale of 0-100 in percentile for each country and applied geometric mean to calculate total NCD score for comparison among 126 countries. We then examined the association of NCD scores with socio-demographic index (SDI) values. Finally, we used annualized rates of change during 1990-2015 to predict achieving time of the UN goal by 2030 for each indicator of chronic diseases premature mortality rate and suicide mortality rates in each B&R country.Results:The integral median of total NCD score in the 126 countries in 2017 was 82.7. The score of China was 87.6, ranking 33 rd. The top three countries were Kuwait (98.1), Peru (97.5) and Italy (96.0). The last three countries were Papua New Guinea (28.9), Vanuatu (54.7) and Ukraine (58.0). The total NCD score showed positive correlation with SDI values ( r=0.33) mainly due to chronic disease indicator ( r=0.45). Fifteen countries will achieve the SDG goal of chronic disease premature mortality in or before 2030, but China will achieve it in 2038. Fifteen countries are expected to achieve the goal of suicide mortality, and China will acheive the goal ahead of schedule in 2024. Conclusions:The NCD rates varied widely among the countries along B&R. It is a challenge to achieve the SDG goal of chronic disease premature mortality rate by 2030 for China. In order to achieve the SDG goals by 2030, we should strengthen multilateral cooperation and complement each other’s advantages, and reduce NCD mortality of people and improve people’s health in countries along B&R.

Objective: To report an investigation of a family cluster of coronavirus disease 2019 ( COVID-19 ) in Ningbo, so as to provide reference for the prevention and control measures. Methods: According to the COVID-19 Prevention and Control Program ( fourth version ) , an epidemiological investigation was conducted to collect the demographic information, clinical features and exposure history, to find the close contacts, and to figure out the source and route of infection. Results: Twelve confirmed cases and one asymptomatic case were reported. The attack rate was 16.05%. Among them, five were males and eight were females; the age ranged from 11 to 85 years old, with a median of 39 years old; most had mild symptoms. The incubation period was 2-13 days, with a median of 6.5 days. The first case ( Case 1 ) developed the symptoms on January 22, and had close contact with Zhang, an asymptomatic case, on January 20. Zhang was related to a cluster in the Buddhist assembly on January 19. Case 1, who caused the spread of the epidemic among family members, participated in several family visits and dinners from January 22 to 27 with other 24 families, resulting in six secondary cases and six third-generation cases. There were 54 close contacts except the family members, no infection was found. Conclusion This family cluster may result from the close contact with an asymptomatic case, and then spread within families through having dinners and living together.

Objective:To study the epidemic situation of Marmota himalayana plague and Yersinias infection in Yugur Autonomous County of Sunan (Sunan County) of Gansu Province, and to provide new ideas for prevention and control of plague. Methods:From 2014 to 2018, liver and spleen, cecum, throat swabs and blood samples of Marmota himalayana were collected on the spot in Sunan County, where Yersinia strains were isolated and identified, and plague F1 antigen and antibody were detected. Results:A total of 634 liver and spleen samples, 427 cecum samples and 426 throat swabs samples were collected from Marmota himalayana, and 23 strains of Yersinia pestis, 2 strains of Yersinia marcescens, and 1 strain of Yersinia flexneri were detected, with the detection rates of 3.63% (23/634), 0.47% (2/427) and 0.23% (1/426), respectively. The detection rate of Yersinia pestis in different years was statistically significantly different (χ 2 = 13.19, P = 0.010). A total of 1 822 serum samples of Marmota himalayana were detected, and 5 F1 antibody positive samples were detected, with a positive rate of 0.27%, the difference of positive rate between different years was statistically significant (χ 2 = 25.22, P < 0.001); 282 liver and spleen tissue homogenates of Marmota himalayana were detected, 22 F1 antigen positive samples were detected, the positive rate was 7.80%, and there was no statistically significant difference between different years (χ 2 = 7.85, P = 0.097). The 23 strains of Yersinia pestis detected were distributed in Mati Tibetan Township (12 strains), Dahe Township (6 strains) and Qifeng Tibetan Township (5 strains); 1 strain of Yersinia flexneri and 2 strains of Yersinia marcescens were both located in Dahe Township. Conclusion:There is an epidemic of plague among animals in Sunan County from 2014 to 2018, and the areas where Yersinia pestis and non pathogenic Yersinia are detected overlapped.

Objective To evaluate the feasibility of dual microcatheter "cross-regional" embolization technique in treating intracranial irregular aneurysms. Methods The clinical data of 19 patients with intracranial irregular aneurysms, who were treated with "cross-regional" embolization technique at authors' hospital during the period from May 2016 to May 2017, were retrospectively analyzed. The embolization strategy formulation, selection of embolization materials, surgical process and embolization effect were summarized. Results Successful treatment of intracranial irregular aneurysm was accomplished in all the 19 patients. In one patient, during the embolization process of the neck of aneurysm the steel coil was over-protruded into the parent artery, and stent implantation had to be carried out to rescue the therapy, and finally successful treatment was achieved. The technical success rate of "cross-regional" embolization was 95％. Complete embolization was obtained in 15 patients and subtotal embolization in 3 patients. Conclusion For the treatment of some specified intracranial irregular aneurysms, dual microcatheter "cross - regional" embolization technique is technically simple, and it is a safe and effective treatment option. (J Intervent Radiol, 2018, 27: 199-202)

Objective:To explore the levels and clinical significance of serum and sputum surfactant protein D (SP-D)in pa-tients with chronic obstructive pulmonary disease (AECOPD).Methods:Thirty-four patients with AECOPD (Group A),37 patients with stable COPD (Group B),30 healthy people with smoking history (Group C),and 30 helthy people without smok-ing history (Group D)were enrolled.SP-D levels in the serum and sputum of the four groups were detected and compared. Moreover,the correlation between serum SP-D level and sputum SP-D level in patients with AECOPD was analyzed.Results:The serum SP-D levels in Group A,Group B,Group C and Group D were (165.09±16.72)ng/mL,(126.48± 15.64)ng/mL, (72.85±8.62)ng/mL and(54.70±7.29)ng/mL,respectively.The sputum SP-D levels in Group A,Group B,Group C and Group D were (109.03 ± 18.95)ng/mL,(133.28± 16.36)ng/mL,(260.04±47.91)ng/mL and(665.89± 117.49)ng/mL. There were significant differences in the levels of serum and sputum SP-D among the four groups(P <0.05).Serum SP-D level and sputum SP-D level in patients with AECOPD were negatively correlated (r=-0.698,P <0.05).Conclusions:The detec-tion of SP-D levels in serum and sputum contributes to the clinical assessment of AECOPD.There is a negative correlation be-tween serum SP-D level and sputum SP-D level in AECOPD patients.

Objective To investigate correlation between QT interval(QT),corrected QT interval(QTc) and metabolic syndrome(MS). Methods Residents who participated in our survey concerning atherosclerosis and related diseases conducted in Shenyang were included. They accomplished questionnaire,physical examination, laboratory tests and electrocardiography test. We divided them into MS group and non-metabolic syndrome (NMS)group according to International Diabetes Federation(IDF)diagnostic criteria for MS. QT interval was measured from the standard 12-lead electrocardiogram. QTc was calculated by using Bazett and Fridericia equations. We analyze correlation of QT ,QTc and MS. Results A total of 739 residents who were 35~64 years old were included. Individuals with MS had longer QTcB and QTcF than NMS group[(415.8 ± 31.9)ms vs.(410.1 ± 32.1)ms, (407.2± 29.1)ms vs.(402.6 ± 28.8)ms,P<0.05]. The more the number of abnormal MS parameters they had, the longer the QT,QTcB and QTcF they had. Regression analysis showed that QT was associated with serum potassium,smoking,blood glucose,and LDL,and QTcB and QTcF were associated with hypertension,waist circumference and blood potassium. Conclusions MS is associated with corrected QTc. Careful ECG monitoring among persons with MS for early detection of a long corrected QT interval may prevent severe and often fatal arrhythmias or sudden death.

Objective:To investigate the levels of serum surface active protein D (SP-D) and clara cell protein (CCl6) in workers exposed to black silica dust, and analyze its influencing factors.Methods:From July to September 2021, 174 workers in 37 positions exposed to silica dust in 5 ferrous metal foundry were investigated by cross-sectional research method. The exposure concentration of silica dust workers was obtained through occupational health field investigation and detection, and the general situation of the study subjects was obtained through questionnaire survey and peripheral blood was collected. Double antigen sandwich enzyme-linked immunosorbent assay (ELISA) was used to detect the concentrations of SP-D and CC16 in serum of workers. The mean values were compared by one-way ANOVA, and the influencing factors of SP-D and CC16 concentrations in serum were analyzed by ordered multiple logistic regression.Results:The time-weighted average concentration (C-TWA) of 174 workers exposed to silica dust (respirable dust) ranged from 0.09 mg/m 3~3.58 mg/m 3, and the C-TWA overstandard rate of dust exposed workers was 32.18% (56/174) , with differences among workers in different positions (χ 2=28.85, P<0.001) . The highest concentration of silica dust was (0.82±0.11) mg/m 3. Using C-TWA<50% OEL occupational exposure limit (OEL) as reference, serum SP-D concentration in workers with ≥50% OEL was increased ( OR=4.95, 95% CI: 1.86~13.17, P=0.001) , while CC16 concentration was decreased ( OR=0.15, 95% CI: 0.05~0.40, P<0.001) ; Serum CC16 concentration decreased in workers exposed to silica dust C-TWA≥OEL ( OR=0.46, 95% CI: 0.28~0.98, P=0.043) . Compared with those with low occupational health literacy, the serum SP-D concentration of workers with high occupational health literacy decreased ( OR=0.48, 95% CI: 0.25~0.92, P=0.027) and CC16 concentration increased ( OR=2.09, 95% CI: 1.10-3.97, P=0.024) . Conclusion:When no abnormality was found in the physical examination of workers, the serum SP-D and CC16 concentration levels changed, and the change was related to the concentration of workers exposed to silica dust.

Objective:To investigate the levels of serum surface active protein D (SP-D) and clara cell protein (CCl6) in workers exposed to black silica dust, and analyze its influencing factors.Methods:From July to September 2021, 174 workers in 37 positions exposed to silica dust in 5 ferrous metal foundry were investigated by cross-sectional research method. The exposure concentration of silica dust workers was obtained through occupational health field investigation and detection, and the general situation of the study subjects was obtained through questionnaire survey and peripheral blood was collected. Double antigen sandwich enzyme-linked immunosorbent assay (ELISA) was used to detect the concentrations of SP-D and CC16 in serum of workers. The mean values were compared by one-way ANOVA, and the influencing factors of SP-D and CC16 concentrations in serum were analyzed by ordered multiple logistic regression.Results:The time-weighted average concentration (C-TWA) of 174 workers exposed to silica dust (respirable dust) ranged from 0.09 mg/m 3~3.58 mg/m 3, and the C-TWA overstandard rate of dust exposed workers was 32.18% (56/174) , with differences among workers in different positions (χ 2=28.85, P<0.001) . The highest concentration of silica dust was (0.82±0.11) mg/m 3. Using C-TWA<50% OEL occupational exposure limit (OEL) as reference, serum SP-D concentration in workers with ≥50% OEL was increased ( OR=4.95, 95% CI: 1.86~13.17, P=0.001) , while CC16 concentration was decreased ( OR=0.15, 95% CI: 0.05~0.40, P<0.001) ; Serum CC16 concentration decreased in workers exposed to silica dust C-TWA≥OEL ( OR=0.46, 95% CI: 0.28~0.98, P=0.043) . Compared with those with low occupational health literacy, the serum SP-D concentration of workers with high occupational health literacy decreased ( OR=0.48, 95% CI: 0.25~0.92, P=0.027) and CC16 concentration increased ( OR=2.09, 95% CI: 1.10-3.97, P=0.024) . Conclusion:When no abnormality was found in the physical examination of workers, the serum SP-D and CC16 concentration levels changed, and the change was related to the concentration of workers exposed to silica dust.