Objective To investigate the radiosensitization effect and underlying mechanism of Paeonol on human lung adenocarcinoma cell line A549 in vitro. Methods Cells were assigned to following groups:control,Paeonol alone,irradiation alone,Paeonol combined with irradiation.The effect of Paeonol on cell proliferation was evaluated by the MTT assay. Clonogenic assay was performed to measure the radiosensitization effect of Paeonol under three concentrations around 20％ IC50.Cell apoptosis was determined by TUNEL assay and flow cytometry (FCM).The expression of Survivin protein was analyzed by Western blot.Results Cell growth was inhibited by Paeonol in a dose-dependent manner and the IC50 of Paeonol was (25.2 ± 2.1 ) mg/L. Clonogenic assay showed that Paeonol could markedly enhance cell radiosensitivity and the sensitizing enhancement ratio (SER) was 1.29.After the pretreatment of Paeonol with different concentrations,radiation-induced apoptosis increased with the doses at 24,48,and 72 h post-irradiation ( t =4.95,3.03,3.78,4.59,2.88,3.70,5.54,P ＜ 0.05 ). Moreover,the protein expression of Survivin was obviously down-regulated by 22.6％ - 56.7％ ( t =4.15,7.30,13.47,P ＜0.05 ) due to the treatment of Paeonol.When the Paeonol-treated cells were further irradiated with 6 Gy X-rays,the expression of Survivin was reduced to 22.2％ - 69.4％ ( t =4.30,8.36,16.34,P ＜ 0.05 ).Conclusions Paeonol had radiosensitization effect on the human lung adenocarcinoma cell line A549 in vitro,where the down-regulated Survivin protein might be involved.

Objective To analyze the present medical teaching textbooks and practice skill guidelines,and explore the profound causes of poor hand hygiene idea among doctors.Methods Three sets of unified textbook series used for domestic medical colleges and universities and two sets of manipulation skill guidelines were studies.Statistical method was conducted to analyze whether concepts and methods of hand hygiene,hand-washing and antiseptic han-drubbing were included in these teaching textbooks;as to eight aseptic manipulation skills,coverage of knowledge, steps of hand-washing and antiseptic handrubbing in manipulation skill guidelines were also analyzed.Results The mentioning rate of hand hygiene,hand-washing and antiseptic handrubbing in 8-year and 5-year program teaching textbooks were both 0 ,in nursing teaching textbooks was 1 00 % ;as to 8 aseptic manipulation in 2 sets of skill practice guidelines,mentioning rate of hand washing was 37 .50 % ,and method and steps of antiseptic handrubbing were both 0 .Conclusion School teaching and skill assessment are the basis,it is difficult to form the right idea by only relying on continuing education without basic education.Hand hygiene should be stressed in the written of teaching textbooks,guidelines should be written following the newest progress,so as to form the correct idea of hand hygiene among doctors.

Objective To study whether methicillin-resistant Staphylococcus aureus (MRSA)will increase the burden of patients with hospital-acquired pneumonia (HAP).Methods Patients with Staphylococcus aureus HAP in a hospital between January 1 ,2013 and November 31 ,2014 were selected,patients with MRSA HAP were as case group,patients with methicillin-sensitive Staphylococcus aureus (MSSA)HAP were as control group,propen-sity score matching (PSM)analysis were conducted to compare the prognosis of MRSA HAP and MSSA HAP (length of hospital stay, duration from infection to discharge, mortality, total therapeutic cost ). Results APACHE II score in case group was higher than control group before PSM was conducted,length of hos-pital stay and duration from infection to discharge were both longer than control group (40[20,94]d vs 28[21 ,53] d;19[10,46]d vs 17[8,29]d,respectively,both P <0.05).APACHE II score in case group and control group af-ter conducting PSM was not significantly different(P >0.05 ),data were balanced and comparable;there were no significant difference in length of hospital stay between two groups (28[21 ,52]d vs 28[21 ,53]d),duration from in-fection to discharge (15[9,25]d vs17[8,29]d),mortality(10.87% vs 15.22%),and total therapeutic cost (121 013.5[80 747.21 ,176 200]yuan vs 119 911 .2[66 994.08,241 184.7]yuan)(all P >0.05).Conclusion APACHE II score is an important factor affecting prognosis;after balancing this factor,there is no difference in the prognosis of patients with MRSA and MSSA HAP,MRSA HAP can not increase the burden of disease.

Objective To evaluate the direct economic loss due to surgical site infection(SSI)from a medical eco-nomics perspective,and provide basis for health administrative departments to make strategies.Methods SSI in pa-tients undergoing breast,stomach and colorectal operation between March 2008 and February 2010 were selected for 1∶1 case-control study,patients with SSI were as SSI group,without SSI during the same period were as control group,difference in medical expense and length of stay between two groups were compared,economic loss due to SSI was evaluated.Results A total of 1 523 operation cases were investigated,75(4.92%)developed SSI.69 effec-tive pairings were obtained.Wilcoxon signed rank test revealed that difference in medical expense between two groups was statistically significant(Z =6.586,P <0.001),the median of average medical expense of SSI group was 6 828.60 yuan higher than control group,all kinds of medical expense in SSI group were all higher than control group;the median length of stay of SSI group was 10 days longer than that of control group (Z = 5.939,P <0.001).Conclusion SSI can prolong hospitalization,increase medical expense,decrease bed turnover rate,and in-fluence economic income and medical quality.

Objective To realize the effect of WHO multimodal hand hygiene improvement strategy (MHHIS)on improving hand hygiene compliance of health care workers(HCWs).Methods From June to December 2012,HCWs in a hospital was intervened by adopting MHHIS,hand hygiene compliance rate before and after intervention was com-pared,and effectiveness of intervention was assessed.Results Hand hygiene compliance of doctors and nurses improved from 14.06%(35/249)and 28.62%(81/283)before intervention to 31.73%(79/249)and 57.60%(163/283)after inter-vention respectively(both P <0.05).Except outpatient and emergency department,hand hygiene compliance of the other departments significantly improved (all P <0.05);hand hygiene compliance of various hand hygiene indicators significantly improved except ‘after contact with patient surrounding’(all P <0.05),the differences were statistically different (P<0.05).Conclusion Using WHO MHHIS can effectively improve hand hygiene compliance of HCWs.

Objective To investigate the relationships among free triiodothyronine( FT3 ), free thyroxine (FT4 ), and thyroid-stimulating hormone( TSH) in both plasma and breast milk of patients with thyroid diseases. Methods A total of 102 female subjects with hyperthyroidism(GD), normal thyroid function(NC), and Hashimoto′s hypothyroidism(HT or hypothyroidism)were enrolled. Their plasma and breast milk were collected for measurement of FT3 and FT4 , and TSH. Meanwhile, 11 infants of patients with hyperthyroidism and another 11 infants of patients with hypothyroidism were selected, blood FT3 , FT4 , and TSH content were determined during lactating period and 2 months after lactation. Results (1) FT3 and FT4 contents in breast milk among 3 groups were different[(1. 48 ± 0. 81), (7. 79 ± 3. 56), and (0. 77 ± 0. 42)pg/ ml; (2. 94 ± 1. 43), (14. 78 ± 7. 40), and (1. 51 ± 0. 40)pg/ ml, P<0. 05], TSH in breast milk was similar between hyperthyroidism and normal groups(P>0. 05). (2) FT3 ratio of breast milk to plasma of the hyperthyroidism group was different to other 2 groups(0. 42 ± 0. 04 vs 0. 35 ± 0. 03, 0. 36 ± 0. 03, P<0. 05), but no difference existed in FT4 and TSH among 3 groups(both P>0. 05). (3)Blood FT3 , FT4 , and TSH contents from infants of patients with hyperthyroidism and hypothyroidism were different, both during lactating period and 2 months after lactation[(5. 06 ± 1. 76)vs (6. 51 ± 2. 23)pg/ ml, (17. 39 ± 2. 78)vs (19. 87 ± 3. 26)pg/ ml, (1. 34 ± 1. 33)vs (0. 74 ± 0. 78)mIU/ L; (1. 43 ± 0. 74)vs (1. 83 ± 0. 91)pg/ ml, (4. 28 ± 1. 55)vs (5. 00 ± 1. 75)pg/ ml, (6. 48 ± 2. 70) vs (5. 49 ± 2. 39) mIU/ L; all P<0. 05]. (4) FT3 and FT4 contents were positively correlated in plasma and breast milk(all P<0. 05), while TSH contents were positively correlated only in hypothyroidism group(P<0. 05). Conclusion FT3 , FT4 , and TSH in blood and breast milk are correlated.

Objective To compare the postoperative extubation time and length of PACU retention between patients who had undergone retroperitoneal laparoscopic unilateral adrenal pheochromocytoma resection and other adrenal tumor resection.Methods A retrospective study of 57 hypertensive patients who had undergone retroperitoneal laparoscopic unilateral adrenal tumor resection under the general anesthesia was conducted.Nineteen patients with adrenal pheochromocytoma were assigned to group S,and other 38 patients were assigned to group D.We recorded and compared the gender ratio,ASA grade,age,weight,height,duration of operation and anesthesia,dosage of anes thetics,extubation time,and length of PACU retention between the two groups.Results There were no significant differences in gender ratio,ASA grade,age,weight,height,duration operation and anesthesia,as well as doses of propofol,midazolam,fentanyl and muscle relaxants between the two groups.As to extubation time and length of PACU retention,those of group S were both significantly longer than those of group D [30.0(25.0-42.5)min vs 20.0(15.0-20.0)min;70.0(57.5-82.5)min vs 45.0(33.5-55.0) min,P＜0.05,respectively].Conclusion Retroperitoneal laparoscopic unilateral adrenal pheochromocytoma resection might lead to postoperatively longer extubation time and length of PACU retention.It does not relate to the dosage of anesthetics used perioperatively.

Objective To investigate medication adherence and its influencing factors in community-based hypertensive patients in the Pearl River Delta of Guangdong Province, and lay the foundation for the development of targeted compliance interventions. Methods Between July 2015 and October 2016, a multi-stage cluster sampling method was used to conduct a community-based diagnostic survey in the Pearl River Delta region.A total of 1 829 community-based hypertension patients in this survey population were used to investigate medication adherence, the factors of which were derived through a multi-factor logistics regression analysis.Results The average medication-adherence score of hypertensive patients surveyed in this study was (4.6 ± 1.8), and patients with good medication adherence accounted for 62.82%(1 149/1 829).There were significant differences in medication adherence among patients according to their age, household registration types, marital status, level of education, employment status, medical payment methods,per capita monthly household income,drinking status,and family history of hypertension (P<0.05).Multivariate logistic regression analysis found that medication adherence was affected substantially by the type of household registration:local household types (OR= 0.537, 95% CI: 0.415-0.695); education level: college,bachelor and above (OR=2.139,95% CI:1.100-4.160); employment status: self-paying (OR=0.591, 95% CI: 0.376-0.930); and a family history of hypertension (OR= 1.279, 95% CI: 1.012-1.617).Conclusions It is necessary to pay more attention to medication adherence in patients with hypertension in communities.Given the influencing factors and characteristics illuminated by this study,it is suggested that various measures be taken to prevent and intervene in poor medication adherence, to improve the curative effect of hypertensive patients in communities.

OBJECTIVEThe aim of this study was to explore the association between acquired multi-drug resistant organism (MDRO) and ventilator-associated pneumonia (VAP) in patients hospitalized at the intensive care unit(ICU).

METHODSReal-time monitoring system for hospital infection was used to track VAP patients. The period of study was from January 1, 2013 to December 31, 2013. Both a nested case-control study design and logistic multivariable regression model were performed to explore the association.

RESULTSA total of 142 VAP cases and 342 non-VAP controls were available in this study. Duration of Hospital stay, ICU stay and mechanical days were statistically significant between the case and the control group (P≤0.001). Compared with MDRO negative patient, the MDRO colonization or infection patients showed an 3.05-time increase on the risk of VAP (adjusted OR = 4.05, 95% CI:2.51-5.46). Remarkably,MDRO-positive patients were significantly associated with increased duration of mechanical ventilation and antimicrobial drug use (P < 0.001).

CONCLUSIONMDRO colonized and infection patients would significantly increase the risks of VAP, with prolonged hospitalization and ICU stay. Effective measures should be taken to promote and control patient's safety at the hospital.

Case-Control Studies ; China ; epidemiology ; Cross Infection ; microbiology ; Drug Resistance, Multiple, Bacterial ; Humans ; Intensive Care Units ; Length of Stay ; statistics & numerical data ; Logistic Models ; Multivariate Analysis ; Pneumonia, Ventilator-Associated ; epidemiology ; Respiration, Artificial ; statistics & numerical data ; Time Factors

Gradual distraction with an external fixator is a widely used treatment for severe postburn ankle contracture (SPAC). However, application of external fixators is complex, and conventional two-dimensional (2D) imaging-based surgical planning is not particularly helpful due to a lack of spatial geometry. The purpose of this study was to evaluate the surgical planning process for this procedure with patient-specific three-dimension-printed models (3DPMs). In this study, patients coming from two centers were divided into two cohorts (3DPM group vs. control group) depending on whether a 3DPM was used for preoperative surgical planning. Operation duration, improvement in metatarsal-tibial angle (MTA), range of motion (ROM), the American Orthopedic Foot and Ankle Society (AOFAS) scores, complications, and patient-reported satisfaction were compared between two groups. The 3DPM group had significantly shorter operation duration than the control group ((2.0±0.3) h vs. (3.2±0.3) h,