Objective To study the psychological defence (PD) and coping style (CS) of the patients suffering depressive episode (DE).Methods 104 cases of the experimental group and 104 cases of the control group,which were stratified sampled,had been investigated by applying defensive style questionnaire (DSQ),coping style questionnaire(CSQ).Results The total score of the immature PD of the experimental group(5.19±0.73) was significantly higher (t =2.93,P＜ 0.05) than that of the control group (4.41 ± 0.76).In the immature mechanism,withdrawal,somatization,avoiding,passive aggression were significantly higher,but the complaints and fantasy were significantly lower.The total score of mature PD of the experimental group(4.49±0.61) was significantly lower (t=-6.02,P＜0.01) than that of the control group(6.01±0.85).For the mature mechanism,sublimation and humor were lower and the repression was higher.And for the CS,problem solving,consulting and rationalization scores were significantly lower than those of the control group(t=-4.58,P＜0.01 ; t=-4.49,P＜0.01; t=-4.01,P＜0.01).The self-accusation,retreat scores were significantly higher than those of the control group(t=8.21,P＜0.01; t=5.31,P＜0.01).Conclusion Patients suffering DE are apt to use immature PD and CS.To increase the therapeutic effect,the style of the patients' PD and CS should be highlighted,and it is necessary to take steps to guide the patients to use mature PD and CS.

Objective To identify antimicrobial susceptibilities of community-acquired Staphylococcus aureus infections and the risk factors of severe infections.Methods Clinical data of 184 cases of community-acquired Staphylococcus aureus infections collected from 4 hospitals in Ningbo during May 2008 and May 2013 were reviewed.Microbial sensitivity test and virulence genes ( pvl and tst) detection were performed in clinical isolates, and SCCmec genotyping was performed in methicillin-resistant Staphylococcus aureus ( MRSA) strains.Binary logistic regression analysis was used to identify the risk factors for severe infections.Results Among 184 cases of community-acquired Staphylococcus aureus infections, 39 ( 21.20%) were severe cases. Staphylococcus aureus strains were highly resistant to penicillin, erythromycin and clindamycin, but more than 75% strains were sensitive to oxacillin, aminoglycosides, quinolones, rifampicin and vancomycin.Logistic regression analysis showed that advanced age (OR=1.024, 95%CI:1.005-1.043, P<0.05), malignant tumor (OR=15.288, 95%CI:1.609-145.229, P<0.05) , autoimmune diseases or long-term hormone therapy ( OR=12.102, 95%CI:2.082-70.338, P <0.01 ) were risk factors for severe community-acquired Staphylococcus aureus infections. Conclusions Strains isolated from the patients with community-acquired Staphylococcus aureus infections in Ningbo are usually sensitive to oxacillin, aminoglycosides, quinolones, rifampicin and vancomycin, which may be recommended for clinical use.Elder patients and those with malignant tumor, autoimmune diseases or long-term hormone therapy are more likely to develop severe Staphylococcus aureus infections.

OBJECTIVETo investigate the feasibility of establishing an integrated regional network for ST-segment elevation myocardial infarction (STEMI) care in China and evaluate the implementation effect of this network.

METHODSBased on real-time electrocardiogram transmission technology, we established an integrated regional network for STEMI care (IRN-STEMI) with Xiamen Heart Center as the core center, 120 Emergency Systems, PCI-capable hospitals and other community health units as core elements of this network. Reperfusion treatment data of Xiamen Heart Center including the number of patients receiving primary percutaneous coronary intervention (PCI), the mean first medical contact to balloon (FMC-to-B) time, the mean door to balloon (D-to-B) time, the mean length of hospital stay, the mean medical cost and in-hospital mortality were compared before (n = 165) and at 1 year after the built-up of IRN-STEMI (n = 343).

RESULTSCompared to pre-IRN-STEMI era, primary PCI ratio (84.5% (290/343) vs. 75.5% (185/245)) were significantly increased post establishment of IRN-STEMI within the network (P = 0.06). STEMI patients admitted in Xiamen Heart Center was significantly increased from 165 to 256, the annual mean FMC-to-B time ((110.3 ± 34.0)min vs. (137.9 ± 58.5) min, P < 0.01) and D-to-B ( (76.5 ± 33.0) min vs. (107.3 ± 38.0) min, P < 0.01) , as well as the mean medical cost were significantly decreased ( (51 398 ± 22 100) RMB vs. (56 970 ± 24 593) RMB, P < 0.05), while the mean length of hospital stay ((9.0 ± 4.3)d vs. (9.7 ± 4.8)d, P > 0.05) and in-hospital mortality (3.1% (8/256) vs. 3.0% (5/165) , P > 0.05) remained unchanged before and after the setting of IRN-STEMI in Xiamen Heart Center.

CONCLUSIONEstablishment of an integrated regional network system for STEMI patients in China is feasible. With collaboration of qualified heart center, EMS and PCI-capable and non-PCI capable local hospitals, establishment of IRN-STEMI effectively increased the ratio of primary PCI for STEMI patients, it also significantly shortened the FMC-to-B and D-to-B time, decreased mean medical cost, thus, the regional IRN-STEMI network might be an effective working system for improving the medical care for STEMI patients.

China ; epidemiology ; Community Networks ; Cost Control ; Electrocardiography ; Hospital Mortality ; Hospitalization ; Humans ; Length of Stay ; Myocardial Infarction ; mortality ; therapy ; Percutaneous Coronary Intervention ; Time Factors