OBJECTIVE:To analyze the current situation and developing trend of drugs used in hospitals of Chengdu.METHODS:The data of drugs purchased by 16 hospitals in Chengdu in the years 1997～2000 was collected and analysed.RESULTS:The drug expenses increased faster in years 1998～1999 and the drug expense in 2000 was 3 times as much as that in 1997.The proportion of sum of money spent on anti-infectives was decreasing year by year,which equaled that in developed cities of east China.CONCLUSION:The sum of money of drugs consumed will increase year by year,however,the growth rate may decrease.The proportion of consumption of imported drugs will continuously decrease.

Objective To investigate the change of dynamic expression of t-PA and PAI-1 during early venous crisis after free perforator flap transplantation.Methods Thirty healthy New Zealand white rabbits weighed 2.5-3.0 kg were chosen and randomly divided into experimental group (n =15) and control group (n =15).Free transplantation of superficial epigastric artery perforator flap (SEAPF) was implemented in all rabbits firstly.Then the model of venous crisis was established by ligating the anastomosis vein in order to interrupt venous blood outflow in experimental group.The blood supply of all flaps was monitored by observing their color,swelling degree and the filling reaction of the capillaries after operation.Peripheral blood was drawn from femoral artery at different time point for measuring the concentration of t-PA and PAI-1 by Elisa.Partial flap tissue was harvested for pathological examination at corresponding time point.Data analysis was performed by using SPSS 17.0 statistical software.P ＜ 0.05 was considered statistically significant.Results One rabbit died of anesthesia,and the venous congestion was observed in 1 rabbit in control group.The models of free transplantation of SEAPF and venous crisis were established successfully in the remaining rabbits.No significant appearance change was observed within 1 h after the outflow vein being ligated,while typical appearance of venous crisis could be observed 2 hours after the outflow vein being ligated.Compared with the control group,the concentration of t-PA was lower,but the concentration of PAI-1 was higher in experimental group at 2 hours,4 hours,6 hours,8 hours after the outflow vein being ligated(P ＜ 0.05).However,there was no obvious differences between two groups at other time points (P ＞ 0.05).The pathological examination showed the red cells gradually got together and adhered to the venous wall,eventually the microcirculation had been blocked completely and theflap became necrosis after venous crisis being occurred.Conclusion t-PA and PAI-1 can't be used to diagnose early venous crisis of perforator flap transplantation.

OBJECTIVE To compare the effects of Glutaraldehyde(GA) and Electrolyzed Acid Water(EAW) on the disinfection of the soft endoscope.METHODS The field tests for the digestive endoscope disinfection: GA group,a total of 60 cases(Gastroscopy 43 cases,17 cases of colonoscopy);EAW group,totaling 60 cases(37 cases of gastroscopy,colonoscopy 23).RESULTS None of samples from both groups was positive for test of bacterial culture.GA group had a more time comsumption than EAW group(20.6 VS 10.4,P

Objective:To investigate the dynamic changes of the luminal microbiota in the jejunum following administration of proton pump inhibitors (PPIs) in a rat model.Methods:Rats were randomized into six groups (n =6 each group).A group of rats were sacrificed just after anesthesia as normal control (0 d) and,other five groups were continuously administered with omeprazole (10 mg/kg twice daily,intraperitoneally) and were euthanized at 5,9,14,21,28 days following the treatment,respectively.Total DNA in the luminal contents of jejunum was extracted and was used for polymerase chain reaction (PCR) amplification with the primer set targeted the hypervariable V3 region of 16S ribosomal RNA genes.Subsequently,the amplicons were separated by denaturing gradient gel electrophoresis (DGGE).After the gels were stained and photographed,the bands were cut out and sequenced to determine the closest bacterial relatives with the BLAST.The DGGE profiles were analyzed to evaluate the shifts of the microbiota composition and diversity following treatments.Results:Changes of the jejunal microbiotas in rats were observed at 5 and 9 days post PPI administration,as characterized by outgrowth of Streptococcus pneumonia,Clostridium saccharolyticum and Lactococcus garvieae compared to those of the controls (0 d).With time extension of PPI treatment,the mictobiotas significantly shifted toward dysbiotic state,in which the opportunistic pathogens,including Ertterococcus faecalis and Clostridium difficile,were strikingly expanded,especially 21 days later.However,the commensals such as Lactobacillus reuteri and Weissella koreensis were markedly declined in PPI-treated animals compared with the controls.The similarity of the jejunal microbiotas between PPI-treated animals and controls was markedly reduced following PPI treatment,reaching (56.1 ± 16.7) ％ at 28 days.Conclusion:Our data demonstrate that the gastric acid suppression could induce shifts of the jejuna microbiota in a rat model.More importantly,long-term use (＞ 14 d) of PPI could lead to the dysbiosis of the jejunal microbiota,which might be related causally to increased susceptibility to enteric infection.

Objective To analyze the relationship between 1082 site A/G polymorphism in interleukin-10 gene and different virulence factors of Helieobacter pylori in Gansu Province and susceptibility to gastric cancer genesis. Methods Polymerase chain restriction fragment length polymorphism and direct sequencing were performed to analyze the genotype of the A/G polymorphism in its-1082 site of promoter region, and immunoblotting was performed to test different virulence factors antibody of H. pylori. Results respectively in the gastric precancerous lesion group. The frequency of AG + GG genotype was statistically higher in the gastric precancerous lesion group compared to the control group (P =0. 018), the risk gastric frequency of AA, AG, GG genotypes were 58.4% ,35.8% ,5.8%, respectively in the gastric cancer group. The frequency of AG + GG genotype was higher in the gastric cancer group compared to the control group (P =0. 010), moreover, individuals with the IL-10-1082AG + GG genotype rose to 2. 31 fold risk for gastric there was an increased risk of gastric precancerous lesion and developing gastric cancer for those carrying both AG + GG genotype and seropositive H. pylori I, with 9.73 fold risk. Conclusion There was a relationship between IL-10-1082 A/G polymorphism and susceptibility to gastric cancer.

BACKGROUND AND PURPOSE: There is conflicting evidence in the literature on the association between benzodiazepines (BDZs) and the risk of dementia. This meta-analysis aimed to determine the relationship between the long-term usage of BDZs and the risk of dementia. METHODS: The PubMed and Embase databases were systematically searched for relevant publications up to September 2017. The literature search focused on observational studies that analyzed the relationship between the long-term use of BDZs and the risk of dementia. Pooled rate ratios (RRs) with 95% confidence interval (CI) were assessed using a random-effects model. The robustness of the results was checked by performing subgroup and sensitivity analyses. RESULTS: Ten studies were included: six case–control and four cohort studies. The pooled RR for developing dementia was 1.51 (95% CI=1.17–1.95, p=0.002) in patients taking BDZ. The risk of dementia was higher in patients taking BDZs with a longer half-life (RR=1.16, 95% CI=0.95–1.41, p=0.150) and for a longer time (RR=1.21, 95% CI=1.04–1.40, p=0.016). CONCLUSIONS: This meta-analysis that pooled ten studies has shown that BDZ significantly increases the risk of dementia in the elderly population. The risk is higher in patients taking BDZ with a longer half-life (>20 hours) and for a longer duration (>3 years).
Aged ; Benzodiazepines* ; Cohort Studies ; Dementia* ; Half-Life ; Humans

Objective: To examine the influence of school adaptation on depression among high school students, as well as the mediating effects of social avoidance and distress and learning burnout on the relationship between school adaptation and depression among high school students, so as to provide a basis for the mental health promotion among high school students. Methods: A convenience sampling method was used to select 1 207 first year high school students from two high schools as the research subjects in Guiyang City. The School Adaptation Scale(SAS), Social Avoidance and Distress Scale(SAD), Learning Burnout Questionnaire(LBQ), Patient Health Questionnaire-9(PHQ-9) were used to conduct surveys at three time points: October 2021 (T1), May 2022 (T2), and March 2023 (T3). Common method biase was tested using the Harman s single factor method,and bias correction was conducted via the Bootstrap method, utilizing 5 000 resamples to analyze the 95% confidence intervals(95% CI ) of parameter estimates. Results: School adaptation at T1 was negatively associated with depression of high school students at T3 ( β =-0.13, P <0.01). The mediation analysis showed that the mediating effect of social avoidance and distress at T2 between school adaptation at time point T1 and depression among high school students at time point T3 was-0.100 (95% CI =-0.134--0.071, P <0.05). The mediating effect of learning burnout at T2 between school adaptation at time point T1 and depression among high school students at time point T3 was-0.157 (95% CI =-0.211--0.106, P <0.05). The chain mediation effect of social avoidance and distress and learning burnout at T2 between school adaptation at time point T1 and depression among high school students at time point T3 was -0.022 (95% CI =-0.037--0.012, P <0.05). Conclusions Good school adaptation can directly alleviate depressive mood, and can indirectly reduce depression through social avoidance and distress and learning burnout among high school students. Families and schools should pay attention to the school adaptation of high school students and provide timely interventions and assistance to students with poor adaptation.

Objective:To analyze the risk factors of carbapenem-resistant Klebsiella pneumoniae（CRKP）infection in tumor patients. Methods:The clinical data of hospitalized tumor patients with Klebsiella pneumoniae（KP）infection admitted in Hangzhou Cancer Hospital during January 2021 to December 2022 were retrospectively analyzed. Patients were divided into CRKP group（ n=37）and carbapenem-sensitive Klebsiella pneumoniae（CSKP）group（ n=142）according to drug sensitivity. The risk factors of CRKP infection were analyzed by univariate and multivariate Logistic regression. Results:Univariate analysis showed that cardiovascular disease（ χ2=4.554， P=0.033），carbapenem use ≥7 days（ χ2=53.483， P<0.001）and hospital stay >7 days（ χ2=3.871， P=0.049）were significantly associated with CRKP infection in tumor patients. Multivariate Logistic analysis showed that carbapenem therapy for ≥7 days（ OR=18.280，95% CI 6.533-51.147， P<0.001）was an independent risk factor for CRKP infection in tumor patients. Conclusion:Tumor patients with long-term use of carbapenems are prone to CRKP infection.

Objective: To understand the knowledge of disinfection and its influencing factors among caregivers in childcare centers in Huangpu District, Shanghai, in order to provide a basis for the future development of targeted training programs and the work plan to enhance the professional level of disinfection practitioners in childcare centers. Methods: A total of 423 caregivers from 62 childcare centers (including nursery schools) in Huangpu District were selected for a questionnaire about disinfection knowledge, influencing factors, and training needs in March 2023. Differences in disinfection knowledge among subjects with different characteristics were compared using χ 2 tests, and influencing factors were analyzed using a multi factor binary Logistic regression model. Results: The overall knowledge rate of disinfection among caregivers was 50.12%, and those in public kindergartens, private ones, and nursery schools were 51.35%, 46.18%, and 42.57%, respectively, with statistically significant differences ( χ 2=14.25, P < 0.05 ). The caregivers in the highest level kindergartens ( OR =4.50, 95% CI =1.97-10.29), in first level ones ( OR =4.29, 95% CI = 1.98-9.33), in the institutions had clusters of outbreaks ( OR =1.87, 95% CI =1.14-3.07), in which the number of children to caregivers ratio being less than 10∶1 ( OR =21.81, 95% CI =2.55-186.59), with 6-14 years of working experience ( OR =3.51, 95% CI = 1.59 -7.75) had better knowledge of disinfection( P <0.05). Conclusions Knowledge of disinfection among caregivers of childcare institutions is low in Huangpu District, Shanghai. Training of caregivers disinfection knowledge should be strengthened for caregivers with fewer years of experience, in childcare institutions, to improve caregivers disinfection expertise and skills.

Insulin therapy plays an essential role in the treatment of diabetes mellitus. However, frequent injections required to effectively control the glycemic levels lead to substantial inconvenience and low patient compliance. In order to improve insulin delivery, many efforts have been made, such as developing the nanoparticles (NPs)-based release systems and oral insulin. Although some improvements have been achieved, the ultimate results are still unsatisfying and none of insulin-loaded NPs systems have been approved for clinical use so far. Recently, nano‒protein interactions and protein corona formation have drawn much attention due to their negative influence on the