Congresses as Topic ; Humans ; Milk Banks ; Milk, Human ; North America

In the treatment of human epidermal growth factor receptor 2 (Her-2) overexpressing breast cancer,some patients have drug resistance to trastuzumab.Potential mechanisms of resistance to trastuzumab include impaired access of trastuzumab to Her-2 ; alternative signaling from insulin-like growth factor-1 receptor (IGF-1R),hepatocyte growth factor receptor (HGFR) and so on; aberrant downstream signaling caused by loss of phosphatase and tensin homologs deleted from chromosome 10 (PTEN);phosphatidylinositol 3-kinase catalytic alpha polypeptide gene (PIK3CA) mutation; over-expression of heat shock protein 90 (HSP90) and CD44. Additionally,potential strategies for overcoming resistance to trastuzumab include using new targeted medicines,such as pertuzumab,lapatinib and trastuzumab-DM1.

Objective To realize the current status of central sterile supply departments(CSSDs)in hospitals,and provide the basis for making improvement measures.Methods Field investigation was adopted to study the resource distribution,personnel structure,and the quality of medical instrument cleaning in 78 hospitals in Chongqing.Re-sults Qualified results of 78 hospitals was 24.36% (19/78),basically qualified rate 52.56% (41/78),unqualified rate 23.08% (18/78);inspection results of different types of hospitals were significantly different(Hc= 16.643,P=0.002),qualified hospitals mainly concentrated on city- and county-level hospitals.Unqualified rate of CSSD con-struction area was 78.21% (n= 61),unqualified rate of personal allocation was 75.64% (n= 59),concentrated man-agement of operating rooms and CSSDs was 52.56% (n= 41),mainly concentrated on city- and county-level hospi-tals;decentralized management accounted for 47.44% (n= 37),58(74.36% )hospitals used repeated cleaning stain-less steel tables for receiving,50% didn’t install automated cleaning machine and drying cabinet,42.31% (33/78) performed manual cleaning,40(51.28% )didn’t equip with water treatment system;12(15.38% )hospitals used patched or worn clothing for packing,47 didn’t equip with hard metal container,37(47.44% )had no heat sealing machine,21(26.92% )had no detection equipment for cleaning quality,41(52.56% )had no low temperature sterili-zation instruments;52(66.67% )hospitals performed biological monitoring on high pressure steam sterilizer.Conclu-sion Clean and disinfection equipments in CSSDs in city- and county-level hospitals are well-appointed,procedures of clean and disinfection are standard,and can achieve the standard of clean quality;while hospitals affiliated to fac-tories and private hospitals are not well-appointed,procedures of clean and disinfection are not standard. Construc-tion of CSSD should be standard,so as to ensure the effectiveness of clean,disinfection and sterilization of surgical instruments.

Monitoring data of antibiotic susceptibility from both home and abroad showed that carbapenem-resistant Enterobacteriaceae (CRE) are being on the rise,which represents an increasingly urgent clinical danger and an emerging public health concern worldwide.In order to effectively prevent CRE transmission in healthcare settings,we should not only pay high attention to the capability building of the laboratory of clinical microbiology,but also actively explore into the mechanisms of carbapenem resistance in Enterobacteriaceae.What's more,we should substantially raise the detection capacity of laboratory on CRE,effectively carry out the antimicrobial stewardship program,and strictly implement hand hygiene and contact precautions.(Chin J Lab Med,2013,36:300-302)

Objective To investigate the epidemiological characteristics and clinical features of mumps.Methods The epidemiological characteristics,clinical manifestations and treatment of 198 cases with mumps were retrospectively analyzed.Results The onset age of mumps was less than 15 years old,men more than women,the crowd distribution was mainly the students,especially in winter,spring and summer.The clinical characteristics were as following:corresponding parotid gland enlargement occurred at the onset of mumps,some of the patients may be accompany by fever,nausea,vomiting,chest tightness,palpitation,or had the performance of the headache,dizziness,muscle weakness,sleepiness and nervous system complications.The results of laboratory tests showed that white blood cell(WBC) of most patients was in the normal range; blood,urine amylase obviously increased; a few cases with abnormal myocardial enzyme spectrum and liver function.Chest X-ray and electrocardiogram(ECG) were normal.4 cases had EEG abnormality.All cases received ribavirin antiviral treatment,and were given corresponding symptomatic treatment to the complications,all patients recovered.Conclusion Epidemiological characteristics were local epidemic,obvious seasonal difference,the student was the main body.Common complications were encephalitis,gland inflammation,myocarditis,hepatitis,etc.,mumps vaccine should be advocated in the students.

Objective To understand the protective effects of children after hepatitis B vaccine immunization since 1992,when the hepatitis B vaccine into childhood immunization strategy .Methods Hospitalized children from venous blood,using enzyme-linked immunosorbent assay(ELISA),to investigate and analyze the immune status based hepatitis B immune of hospitalized children (Infection,Pediatric),by five indicators of hepatitis B as the judgment standard.Results The total anti-HBs-positive rate was 55.05%,including infection anti-HBs-positive rate 52.18%, the pediatric anti-HBs-positive rate 55.92%.Male anti-HBs positive rate was 54.17%,the female anti-HBs positive rate was 56.6%,there was no statistical significance among departments and sexs (P>0.05).Conclusion Hepatitis B vaccination is the effective control means for hepatitis B ,however,the anti-HBs positive rate is low in this region after hepatitis B vaccine immunization ,needed to reseed .

Dizziness ; classification ; epidemiology ; Humans ; Vertigo ; classification ; epidemiology

Objective To investigate the application value of tuberculosis infection of T cells spot test in the diagnosis for pulmonary tuberculosis in elderly patients with chronic obstructive pulmonary disease(COPD).Methods According to test different ways,64 elderly COPD patients with pulmonary tuberculosis were divided into the two groups.The control group(n =32)was checked by tuberculosis antibody test,and the study group(n =32)received T cells infected with tuberculosis spot test.The two sets of results were observed and compared.Results The study group by T cell spot test TB infection,29 cases were detected positive(90.63%),3 cases of negative(9.37%);tuberculosis antibody detection by the control group,23 cases were detected positive(71.88%),9 negative patients (28.12%).Compared the two groups,the study group had higher positive rate(χ2 =3.954 7,P <0.05),and nega-tive rate was lower(χ2 =3.914 7,P <0.05).Conclusion Tuberculosis infection T cell spot test in the diagnosis of pulmonary tuberculosis in patients with COPD in the elderly has greater value,more accurate diagnosis,reliability and worthy of promotion.

OBJECTIVE:To analyze the utilization and variation tendency of oral hypoglycemic agents in Wuhan area,and to provide reference for drug selection and enterprise production and sale. METHODS:The utilization of oral hypoglycemic agents in 34 hospitals from Wuhan area during 2011-2013 was analyzed statistically in respects of consumption sum,DDDs and DDC etc. RESULTS:The consumption sum and DDDs of oral hypoglycemic agents increased by 20% and 7% respectively year by year. Acarbose had a market share of over 40%. The drug use frequency of metformin ranked the second place only to acarbose. DPP-4 inhibitor had a promising future,with a consumption sum proportion of more than 10%,while the market share of traditional Chi-nese medicine had fallen below 3%. Except for repaglinide,gliclazide,glimepiride,Xiaoke pills,etc.,the selling of other medica-tions are consistent with the user. CONCLUSIONS:The utilization of oral hypoglycemic drugs is basically rational in 34 hospitals from Wuhan area during 2011-2013.

Airway obstruction in children is a rare,in recent years,with the development of CT technology and the development of fiber bronchoscopy,the number of cases of children with tracheal stenosis has increased year by year,but difficult clinical problem,with no clear agreement on optimal therapeutic approach.Stenting of the airway has been used successfully in adults,and is an attractive alternative in children.Fundamental differences of pediatric compared to adult use include the benign nature of most stenoses,the narrow and soft airways of children,the required long-term tolerance and adaptation to growth.So it is controversial in the indications.