Objective To study in patients with stable chronic obstructive pulmonary disease treatment, the use of Tiotropium Bromide Powder for Inhalation treatment combined with psychological intervention effect.Methods In 40 cases of patients with stable chronic obstructive pulmonary disease treatment using tiotropium bromide powder for inhalation, and classified as the control group, the other 40 patients in the control group based on the use of psychological intervention combined with treatment the treatment, and classified as the observation group, two groups of patients were in our hospital from January 2016 to January 2017.Results There was no significant difference in anxiety and depression of patients in the two groups before intervention, after the intervention group patients in the observation group improved significantly better;two groups of patients before intervention PaCO2, there was no significant difference in PaO2 index, after group intervention of patients in the observation group improved significantly better;compared two groups of patients with the treatment efficiency, the obvious observation group were higher, there were significant differences (P<0.05).Conclusion Tiotropium Bromide Powder for Inhalation combined psychological intervention treatment of patients with stable chronic pulmonary disease blocking was observed, which can improve the patient's condition, and improve the treatment effect, the patient's mental state adjustment also has a positive effect, it is worthy of reference.

Objective To improve the quality of antibiotics prescriptions in outpatient and emergency departments, to reduce the irrational use of antimicrobial drugs and to improve the quality of pharmacy service through system of rational drug administration.MethodsAnalyzing and evaluating the data of irrational administration of antimicrobial drugs between 2014 and 2015.The data was collected by the system of rational drug administration.ResultsFrom 2014 to 2015, the qualified rate of antibiotics prescriptions increased from 95.40% to 98.71%.Different types of irrational use of antimicrobial agents significantly reduced.ConclusionThe application of system of rational drug administration can improve the qualified rate of antibiotics prescriptions in outpatient and emergency departments and can promote pharmacy service.

Objective To observe the effect of Zusanli acupoint injection of Astragalus Membranaceus Injection on patients with tumor leukopenia after radiotherapy and chemotherapy and its influence on cellular immune function.Methods According to clinical case of random table,60 cases of malignant tumor patients in Hubei province Xiangyang city hospital from March 2010 to August 2011 were randomly divided into two groups of 30 patients in each group.The treatment group was treated with Zusanli acupoint injection of Astragalus Injection therapy,while the control group was taken Leucogen,vitaminB4,batyl alcohol orally.Venous blood and peripheral white blood cell were taken in both groups before and after treatment.Direct immunofluorescence staining and flow cytometry were used for the detection of peripheral blood T lymphocyte total number and its subsets.Results ① clinical efficacy:Total effectiveness was 77.5％in the treatment group,and 52.5％ the control group,the difference was statistically significant between the two groups (x2=8.027,P＜0.05).Comparison of the white blood cell count and T lymphocyte subsets of peripheral blood:the white blood cell count was (3.56～4.21) × 109/L in the treatment group,and (2.89～3.39) × 109/in the control group,there was significant difference between two groups (t=2.435,P＜0.05); there was significant elevation of CD3 +,CD4+,CD4+/CD8 + [(62± 1.63) ％,(43 ± 0.80) ％,(1.48 ± 0.23) in the treatment group after the treatment comparing with (48± 1.25)％,(31 ± 0.74)％,(0.93± 0.12) before the treatment (P＜0.05 or 0.01),while there was no such changes in the control group.Conclusion Zusanli acupoint injection of Astragalus Injection may modulate the cellular immune function of patients with cancer.It is effective in the treatment of leukopenia after radiotherapy and chemotherapy.

Objective To study epidemiology, clinical findings, diagnosis and treatment of sepsis caused by Vibrio vulnificus. Method Patientss with Vibrio vulnificus sepsis were collected from 1995 to 2008. The medical records including epidemiological and clinical data were analyzed. Results The male-to-female ratio of 34cases was 4.7:1 and 76. 5% of these patients suffered from chronic liver disease. Most patients occurred from April to October with signs of abrupt fever, characteristic cutaneous lesions, hypotension and progressive multiple organ disfunction syndrome (MODS). The mortality was over 47.1% . The criteria proposed for early diagnosis of Vibrio vulnificus sepsis were abrupt onset with fever during the period from April to November, characteristic cutaneous lesions, such as the most commonly occurred haemorrhagic bullae on the extremities or even extensive necrosis of skin and muscular tissue, progressive hypotension or shock accompanied by MODS, pre-existing liver disease or chronic abuse of alcohol, and consumption of raw seafood or exposure to seawater within 12 week. Early administration of the third-generation cephalosporins with the quinolones in full dosage, aggressive wound debridement,appropriate dermoplasty and supportive care contribute to a better outcome. Conclusions Vibrio vulnificus sepsis progresses rapidly with high mortality. Early diagnosis, rapid treatment with prompt antibiotics and aggressive surgery treatment are very important to improve the outcome.

Objective To examine the clinical features of sporadic patients with H7N9 avian influenzain Taizhou city of Zhejiang province and to characterize its viral genes.Methods Fifteen patients with H7N9 influenza infection confirmed by Zhejiang Provincial Centre for Disease Control and Prevention during January 201 4 and January 201 5 were included in the study.The basic diseases,poultry exposure history,clinical manifestation,laboratory examination,imaging features,treatment and outcome and viral gene sequencing were analyzed retrospectively.Results The first clinical symptoms were fever and cough in all patients,acuterespiratory distress syndrome(ARDS)occurred in 1 3 patients,the average time from onset to antiviral therapy was (7 ±2)d.Among 1 5 patients,9 survived and 6 died,including 2 died of multiple organ failure (MOF).The phylogenetic tree showed that there was highly homologous in hemagglutinin (HA)and neuraminidase(NA)genes between human H7N9 virus strains and poultry reference strains.The result of genetic sequencing indicated that human H7N9 virus strains had mutations at 226 (Q226L)sites in HA protein.Conclusions ARDS is likely to occur in patients with H7N9 viral infection,and early antiviral treatment usually leads to a good prognosis.With the occurrence of adaptive mutation in avian influenza virus H7N9,spread from poultry to the human beings may take place.

The difficulty in the participant recruitment is the common question in acupuncture clinical trial study. The existing recruitment of clinical trial is most applicable for the clinical trial of medicines. Because the intervention of acupuncture clinical trial is different from that of medicines, characterized as the specialties in "theory, principle, acupoints, technique", it is very necessary to develop the strategy on the participant recruitment in acupuncture clinical trial. The free community medical consultation is one of the important means of recruitment. In the paper, by taking the participant recruitment of acupuncture clinical trial on chronic stable angina pectoris as the example, the discussion is given on the strategy on the recruitment of free community medical consultation in the aspects of feasible investigation of recruitment approach, recruitment plan, participant screening, etc. The revisiting after the free community medical consultation is the important approach to the improvement of successful recruitment. This strategy on the recruitment of free community medical consultation is highly practical and improves the successful rate and compliance of the participant recruitment. Hence, this strategy deserves to be promoted.
Acupuncture Therapy ; Clinical Trials as Topic ; standards ; Humans ; Personnel Selection ; standards ; Research Design ; standards

ObjectiveTounderstandthetrendsandepidemiologicalcharacteristicsofsexuallytransmitteddiseases(STDs)inChinaandprovidescientificbasisformakingcontrolstrategies.MethodsDuringtheperiodof1991～2001,thecase-reportingdataof8kindsofnotifiableandmonitoringSTDs,collectedfrom31provinces,autonomousregionsandmunicipalities,wereanalyzedwithepidemiologicalmethods.Results①Epidemictrends:Duringthisperiod,theincidenceof8kindsofSTDssteadilyincreasedfrom175528(15.48per100000population)in1991to859040(68.91per100000population)in2000.Theaverageannualgrowthofincidencewas19.30%,witharangeof2.59%～36.88%.However,thereportedcasesin2001were795612withadecreaseof7.38%comparedwiththosein2000,anditwasthefirstdecreasesinceSTDcaseswerereportedfrom1987.②Geographicaldistribution:Thehigh-incidenceareasweretheZhujiangRiverDelta,YangtzeRiverDelta,MinjiangRiverValley,NortheasternChina,andBeijing,Tianjin,andChongqingManicipalities,withtheincidencerateofover70～100casesper100000populationafter1997,andtherewereveryhighratesofincidenceover1000casesper100000populationinsomeareas.Thelow-incidenceareaswerenorthChina,partsofCentralChina,NorthwesternChinaandSouthwesternChina,withtheincidenceratesoflowerthan30～50per100000population.③Populationdistri-bution:Themaletofemaleratiodecreasedfrom1.60∶1～1.69∶1intheearly1990sto1.35∶1～1.40∶1inthelate1990s.STDincidencerateswerehighestinthe20～39agegroup,andthereportedSTDcasesofthisagegroupaccountedforover80%oftotalcases.ConclusionSexuallytransmitteddiseasesinChinahavebecomeaseriouspublichealthproblemandtheeffectiveinterventionprogrammesagainstSTDsmustbeimplementedacrossthecountry.

Objective To evaluate predictive factors affecting the short-term efficacy of PD-1 inhibitors in non-small cell lung cancer (NSCLC) and to construct a prediction model. Methods From October 2019 to November 2021, 221 patients with advanced NSCLC who met the inclusion criteria and were treated with PD-1 inhibitors were prospectively enrolled. Patients who were enrolled before May 1st, 2021 were included inthe modeling group (n=149), whereas those who enrolled thereafter were included in the validation group (n=72). The general clinical data of patients, information of the four TCM diagnoses were collected, and TCM syndrome elements were identified. R software version 4.0.4 was used in constructing a nomogram clinical prediction model of objective response rate. The predictive ability and discrimination of the model were evaluated and externally validated by using a validation group. Results After two to four cycles of PD-1 inhibitor therapy in 221 patients, the overall objective response rate was 44.80%. Multivariate logistic regression analysis of the modeling group showed that the TPS score (OR=0.261, P=0.001), number of treatment lines (OR=3.749, P=0.002), treatment mode (OR=2.796, P=0.019), qi deficiency disease syndrome elements (OR=2.296, P=0.043), and syndrome elements of yin deficiency disease (OR=3.228, P=0.005) were the independent predictors of the short-term efficacy of PD-1 inhibitors. Based on the above five independent predictors, a nomogram prediction model for the short-term efficacy of PD-1 inhibitors was constructed. The AUC values of the modeling and validation groups were 0.8317 and 0.7535, respectively. The calibration curves of the two groups showed good agreement between the predicted and true values. The mean absolute errors were 0.053 and 0.039, indicating that the model has good predictive performance. Conclusion The nomogram model constructed on the basis of the syndrome elements of Qi-deficiency disease and Yin-deficiency syndrome of TCM, as well as TPS score, number of treatment lines and treatment mode, is a stable and effective tool for predicting the short-term efficacy of PD-1 inhibitors in advanced non-small cell lung cancer.

Objective To construct a nomogram prediction model for the treatment effect of anlotinib with the participation of traditional Chinese medicine syndrome elements on the patients with extensive-stage small cell lung cancer (ES-SCLC) who previously received multiple lines of chemotherapy. Methods The clinical data of 127 patients with ES-SCLC who received at least two cycles of anlotinib treatment were retrospectively studied. Kaplan-Meier method was used to analyze the relationship between each factor and the overall survival time. Cox regression analysis was applied to screen the independent influencing factors of the prognosis of patients with ES-SCLC. R language was employed to build a nomogram prediction model, C-index was used to evaluate the model, and calibration curve was adopted to verify the accuracy of the model. Results Age, PS score, brain metastases, qi deficiency syndrome, yin deficiency syndrome, and blood stasis syndrome were related risk factors for ES-SCLC treated with anlotinib. PS score, brain metastasis, and blood stasis syndrome were independent prognostic factors. On the basis of these three independent influencing factors, a nomogram model was established to predict the prognosis of patients with ES-SCLC treated with anlotinib. The predicted risk was close to the actual risk, showing a high degree of coincidence. Conclusion The nomogram model established with PS score, blood stasis syndrome elements, and brain metastasis as independent factors can predict the prognosis of patients with ES-SCLC receiving second- and third-line treatment of anlotinib.

Objective: To investigate the impact of COVID-19 infection and health related behaviors on the health related quality of life of children and adolescents aged 8-15 years in Nanjing, so as to provide a theoretical basis for improving HRQoL in children and adolescents. Methods: From December 2022 to January 2023, a total of 2 398 students aged 8-15 years from the third grade of primary school to junior middle school in Nanjing were selected by multistage random cluster sampling. The 3 level EuroQol 5 dimension Questionnaire Youth Vension (EQ-5D-Y-3L) was completed by the respondents on their own, and the parents assisted in completing the rest of the questionnaire. Results: The EuroQol-index(EQ-index) and Visual Analogue Scale (VAS) scores of being infected individuals were lower than those of uninfected and previously infected ( P <0.05). The proportion of being infected individuals reporting difficulty on "Pain/Discomfort" was higher than that of uninfected and previously infected individuals, and the proportion of reporting difficulty on "Mobility" was also higher than that of uninfected individuals ( P <0.05). Lack of parental companionship( OR=10.19, 95%CI =3.12-33.22), irregular breakfast consumption ( OR=10.63, 95%CI =3.20-35.25), and excessive screen time ( OR=8.24, 95%CI =3.02-22.51) increased the risk of difficulty on "Mobility" in being infected individuals ( P <0.05). Irregular breakfast consumption ( OR=1.93, 95%CI =1.31-2.84) and consumption of sweetened beverages and snacks (OR=1.56, 95%CI =1.17-2.10) increased the risk of having lower EQ index in previously infected individuals compared to uninfected individuals. Furthermore, consumption of sweetened beverages and snacks ( OR=1.57, 95%CI =1.21-2.05) and excessive screen time ( OR=1.49, 95%CI =1.12-1.98) also increased the risk of VAS scores being lower in previously infected individuals compared to uninfected individuals ( P <0.05). Conclusion The COVID-19 infection impairs HRQoL, and unhealthy behaviors deteriorate its negative impact. Healthy behaviors and lifestyles should be advocated to reduce the impact of COVID-19 infection on HRQoL.