Objective To identify the genotypos of extended spectrum β-1actamase (ESBLs)-producing of Escherichia coli ( E. coli) clinical strains isolated from the Macao and compare the results with the genotypes of clinical strains collected in the first Clinical College, China Medical University (CMU) in Shengyang. Methods The clinically isolated E. coli strains including 209 strains from Macao and 150 strains from CMU were collected. Based on the standard of CLSI2006, the ESBLs-producing strains was identified and its isoelectric point(pI) value was detected by isoelectric focusing (IEF) method. The pI values were used to design the primers for PCR amplification. The amplified DNA sequences were then compared with the GenBank and the ESBL genotypes were confirmed. Results ( 1 ) The positive rate of ESBLs-producing strains of E. coli was 30. 1% (62/209) from Macao and 54. 0% (81/150)from CMU. (2)The genotype of 56 (90. 5% ) β-lactamase(ESBLs)-producing E. cull strains from Macao was CTX-M56. Most of them were CTX-M-14 (76. 2% ), other genotypes including CTX-M-9 (4. 8% ), CTX-M-22 (3.2%), CTX-M-24(3.2%), CTX-M-27(1. 6% ), and CTX-M-15( 1.6% ) were found. Six strains were unidentified. (3)The genotype of 74(91.5% )β-lactamase(ESBLs) -producing E. coli strains from Shenyang was CTX-M. Most of them were CTX-M-14 (65.4%), other genotypes including CTX-M-3 ( 13.6% ), CTX-M-24 (4. 9% ),CTX-M-22(2.5%), CTX-M-15(2.5%), CTX-M-9(1.2%) and CTX-M-28(1.2%) were found. Seven strains were unidentified. Conclusions CTX-M genotypo was the mostly identified ESBL-preducing E. Coli strains from Macao and the results were similar with that from CMU. Among them, the CTX-M-14 was the major genotype. Other genotypes included CTX-M-9, CTX-M-15, CTX-M-22, CTX-M-27, and CTX-M-24.However, two genotypes of CTX-M-3 and CTX-M-28 were not found in the clinical isolates in Macao and one genotype of CTX-M-27 was not found from the CMU clinical isolates.

Objective:To evaluate the effect of a hand hygiene culture program on hand hygiene compliance in a three grade A hospital .Methods:Direct observation methods were used to assess the hand hygiene compliance and hand hygiene quality .Results:After the hand hygiene culture program , the hand hygiene compliance rate and the hand hygiene accuracy rate of doctors raised from 30 .2%and 66 .7%to 65 .3%and 85 .8%.Those of the nur-ses raised from 52.2%and 80.0%to 87.6%and 93.3%.Conclusion:The hand hygiene program increased the hand hygiene compliance and reducing thd risk of hospital infection occurred .

Objective: To observe the clinical efficacy and safety of Yiqi Tongluo Decoction in the intervention of early traditional Chinese medicine (TCM) syndromes after ischemic cerebrovascular disease (ICVD) intervention. Methods: From October 2020 to July 2023, a randomized, double-blind, placebo-controlled study was conducted to include 60 patients with qi deficiency, blood stasis, and phlegm obstruction syndrome after ICVD interventional therapy. They were assigned to the Yiqi Tongluo Decoction treatment group (30 cases) and the TCM placebo routine treatment control group (30 cases) according to the randomized block design. Both groups received routine standardized treatment of Western medicine, including dual antiplatelet, lipid regulation, and control of risk factors for cerebrovascular disease. The treatment group was treated with Yiqi Tongluo Decoction based on the control group. The course of treatment was 60 days and follow-up was carried out 2 and 6 months after the operation. The improvement of qi deficiency syndrome, blood stasis syndrome, phlegm syndrome score and TCM syndrome score, modified Rankin score (mRS), Barthel index (BI) score, Fatty acid-binding protein 4 (FABP4) level, incidence of transient ischemic attack (TIA) and ischemic stroke (IS) and incidence of adverse reactions, Head and neck CT angiography (CTA) or digital subtraction angiography (DSA) examination were collected. The clinical efficacy of the patients 2 months after the operation was taken as the main outcome index to preliminarily evaluate the early and long-term efficacy of Yiqi Tongluo Decoction after the ICVD intervention. The early and long-term clinical efficacy and safety of Western medicine standardized treatment combined with TCM Yiqi Tongluo Decoction on patients with qi deficiency, blood stasis and phlegm obstruction syndrome after ICVD intervention were evaluated. The safety of Yiqi Tongluo Decoction in the treatment of patients after ICVD intervention with white blood cell (WBC), C-reactive protein (CRP), fibrinogen (FIB), plasminogen time (PT), recurrence of cerebral ischaemia and restenosis in patients at 2 and 6 months after treatment were evaluated. Results: Compared to the control group, the TCM syndrome scores for qi deficiency, blood stasis and phlegm syndrome in the treatment group reduced significantly, the clinical efficacy improved significantly, the mRS score and FABP4 were reduced, and the BI score was increased. Adverse events such as cerebral ischaemia were fewer in the treatment group than in the control group, but the difference was not statistically significant; levels of CRP, WBC and PT were reduced, and levels of FIB were reduced at 6 months post-treatment, all P<0.01, and images were intuitively compared. The treatment group was superior to the control group. Conclusion Yiqi Tongluo Decoction combined with Western medicine standard treatment can improve the early clinical efficacy of ICVD patients with qi deficiency, blood stasis and phlegm obstruction syndrome after interventional surgery, improve neurological impairment and daily living ability, reduce the state of qi deficiency syndrome, blood stasis syndrome and phlegm syndrome after interventional surgery, and improve the clinical efficacy of TCM. At the same time, it can reduce the level of FABP4, the target of atherosclerosis and restenosis after interventional surgery, reduce the level of inflammation after interventional surgery in patients with ICVD, regulate coagulation function, and reduce the incidence of long-term recurrence of cerebral ischemia after interventional surgery, with good safety.