AIM and METHOD To investigate the antibacterial activity (ED 50 value) of cefoperazonesodium and tazobactam sodium (4∶0 5) in vivo using minor modified Karbers method,which will offer some important evidences for clinical trial and therapy RESULTS The ED 50 value of cefoperazone sodium and tazobactam sodium(4∶0 5) and Cefoperazone sodium and sulbactam sodium (1∶1) in vivo protested against zymogenic staphylococcus aureus and Escherichia coli in mice infected by these bacteria were 92 0 mg?kg -1 and 3 4 mg?kg -1 ,164 0 mg?kg -1 and 6 9 mg?kg -1 ,respectively,and 256 5 mg?kg -1 and 38 9 mg?kg -1 in single composed compound of cefoperazone sodium,cefoperazone sodium and tazobactam sodium (4∶0 5) in vivo had more potent antibacterial activity compared with cefoperazone sodium and sulbactam sodium (1∶1) and single composed compound of cefoperazone sodium. The ED 50 value of cefoperazone sodium and tazobactam sodium (4∶0 5) protested against pseudomonas aeruginosa in mice infected was lower than that of Cefoperazone sodium and sulbactam sodium and single composed compound of cefoperazone sodium CONCLUSION Cefoperazone sodium and tazobactam sodium made in China has an markedly therapeutic effect on antibacterial activity protected against zymogenic staphylococcus aureus and Escherichia coli and pseudomonas aeruginosa in mice infected by these bacteria

Background and purpose:Cervical conization, including high frequency loop electrosurgical excision procedure(LEEP) has been widely used in the treatment of cervical diseases, but how to deal with the patients with pathological positive margin is a problem for clinicians.The purpose of this study was to discuss the option of adjuvant treatment after cervical conization with positive margins for patients with cervical neoplasm.Methods:The data of 528 patients who had cervical conization from 1998 to 2008 was reviewed, among which 54 patients with pathological positive margin was retreated and analyzed.Results:Fifty-four patients were divided into observation group and treatment group, 17 cases were in observation group and 37 cases in treatmeat proup.The recurrence / duration / progress rate was 17.6%(3/17), in treatment group it was 2.7%(1/37) in observation.CINⅠ-Ⅱ positive margins in both group had no recurrence;among 14 patients with CINⅢ, 1 lesion persisted, and 1 progressed to cervical squamous cell carcinoma, none in treatment group was recurrent;For those 10 patients with micro-invasive margin-positive cases, 1 progressed to squamous cell carcinoma, the remaining 9 cases were followed up for 26 months without recurrence after operation.One case in invasive cancer group had recurrence.Conclusion:The patients with CINⅢ margin-positive patients after conization should receive individualized treatment.The patient with microinvasive carcinoma should be retreated with either re-conization or hysterectomy;if with margin-positive CINⅢ after conization, or re-conization or directly treated according to guideline addressing for ⅠB, if margin showed microinvasive carcinoma.The patients with margin-positive invasive carcinoma after conization should be treated according to guideline.

Objective:To apply modified proximal femoral nail anti-rotation ( PFNA ) fixation tech-niques performed by percutaneous placement of guide wire combined with true lateral view and to make the procedures simpler.Methods:A retrospective study was used to analyze the clinical data of femoral intertrochanteric fractures cases, which were treated with conventional PFNA fixation or modified PFNA fixation performed by percutaneous placement guide wire combined with true lateral view in our hospital, from March, 2011 to May, 2014.In the study, 60 cases were followed for average 13 months.The oper-ation time, the amount of bleeding, the fluoroscopy time, postoperative radiographic measurements ( tip apex distance, TAD ) and hip function scores were analyzed.Results:In modified PFNA group, the amount of bleeding, the operation time and the fluoroscopy time were (70.5 ±12.5) min, (34.9 ±6.1) mL, ( 63.6 ±9.7 ) s respectively.In conventional PFNA group, they were ( 80.6 ±17.1 ) min, (47.8 ±6.7) mL, (68.5 ±8.7) s respectively.There were significant differences in the above respects between the two groups (P were 0.006, 0.013, and 0.022 respectively).There were no significant differences in TAD, fracture healing time, postoperative hip scores between the two groups (P>0.05). Conclusion:Fracture line is a natural entry point for some cases of femoral intertrochanteric fractures when we use proximal femoral nail anti-rotation to fix the fracture.Applying percutaneous insertion of the guide pin combined with true lateral view could reduce the operation time, amount of bleeding, and fluo-roscopy time significantly, make the procedures simpler and acquire satisfactory results .

Objective To compare 2 mini-invasive surgical treatments,Achillon versus sponge forceps,for acute Achilles tendon rupture.Methods Between December 2010 and January 2015,35 patients with acute Achilles tendon rupture were treated at our department.They were 32 males and 3 females,with an average age of 36.4 years (range,21 to 64 years).The interval between injury and operation was 1 to 13 days (average,3.2 days).Sixteen of them were treated by Achillon while 19 by sponge forceps.The 2 groups were compatible with no significant differences in general clinical data (P ＞ 0.05).Rehabilitation was carried out 4 weeks after immobilization with brace.American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scoring system was used to evaluate the function of the affected foot at the last follow-up.The 2 groups were compared in terms of surgery time,hospital stay,AOFAS score,decrease in leg circumference,complications and rerupture rate.Results All the patients were followed up for an average of 9.6 months (from 6 to 19 months).There were no significant differences between the Achillon and sponge forceps groups regarding average AOFAS score (91.8 ± 4.4 versus 93.2 ± 5.8),surgery time (38.3 ± 13.2 min versus 42.5 ± 9.8 min),hospital stay (3.9 ± 1.5 d versus 4.1 ± 1.6 d),or decrease in leg circumference (2.1 ±0.5 cm versus 2.3 ± 0.3 cm) (P ＞ 0.05).No re-ruptures or sural nerve lesion was observed in either group.One case of delayed wound healing occurred in each group.Conclusions Both Achillon and sponge forceps can lead to limited complications and a very low rate of re-rupture in surgical treatment of acute Achilles tendon rupture.Compared with the Achillon technique,sponge forceps may have the advantages of simplicity and lower cost.

Objective To analyze the structural changes in medical resources allocation and service utilization based on Chinese hospital categorization,offering data-backed references for understanding the current states of China's medical service system and exploring the strategic allocation of resources.Methods Utilizing data obtained from publicly available sources on the healthcare industry development in China from 2013 to 2022,indicators such as the number of institutions,healthcare techni-cians,practicing(assistant)physicians,registered nurses,management personnel,outpatient service visits,and hospital admis-sions were selected.The structural change analysis method was applied to describe and analyze the current changes in the alloca-tion of medical resources and service utilization structure in hospitals in China.Results The study observed a consistent annual increase in the absolute number of medical and health service resources,with general hospitals and specialized hospitals ranked as the first two contributors to structural changes.General hospitals presented a negative trend,for the number of institutions,healthcare technicians,practicing(assistant)physicians,registered nurses,management personnel,outpatient service visits,and hospital admissions were all negative during the study period,while specialized hospitals showed a positive trend.Notably,general hospitals experienced a shift from negative to positive in the number of management personnel during 2020 and 2021,while specialized hospitals experienced a shift from positive to negative.Traditional Chinese medicine hospitals,integrated tradi-tional Chinese and Western medicine hospitals,ethnic hospitals,and nursing homes contributed little to the changes in all the in-dicators.Conclusion General hospitals show a negative trend in medical resources and service utilization,while specialized hos-pitals exhibit a positive trend.The trends suggest progresses in China in building a high-quality and efficient integrated medical and health service model on the basis of effectively promoting the increase in the total amount of high-quality resources.However,there is a need to refine the system for selecting,training,and developing management personnel.Traditional Chinese medicine,integrated traditional Chinese and Western medicine hospitals,ethnic hospitals,and nursing homes require enhanced strategic planning and coordination.

Objective To analyze the research hotspots in the training of specialized hospitals in the China National Knowledge Infrastructure(CNKI)database,and through quantitative analysis of literature data,help evaluate the influence and quality of academic research in the field of specialized hospital training,and discover the trends in academic research in this field.Methods Using"specialized hospital training"as the search term,literature from the China National Knowledge Infra-structure(CNKI)database for the past decade from 2014 to 2023 was retrieved.The BICOMB 2.0 bibliographic analysis system was used for quantitative analysis,and statistical analysis software SPSS 26.0 was used for cluster analysis.Results A total of 199 articles were included,and there were two important turning points in the past decade.The top ten journals had more than 4 articles(including 4),with a cumulative percentage of 28.64％.Using the BICOMB 2.0 bibliographic analysis system,15 high-frequency keywords were extracted,accounting for a cumulative percentage of 27.52％of the total frequency.Four research hotspots were identified through systematic clustering analysis using SPSS 26.0 software,including the needs for on-the-job train-ing of nursing staff,pre-employment training needs,training effectiveness in specialized hospitals,and physician training.Con-clusion Specialized hospital training should play a supportive role in national policies and strategies,continuously expanding and improving research ideas in the fields of nursing staff and resident physician training,and further refining research in specialized hospital management personnel and disciplinary fields.With the continuous optimization of resource allocation in specialized hos-pitals and the improvement of professional discipline system construction in our country,there is still great potential and possibili-ty for the research direction and content of training in specialized hospitals.

Objective: To investigate the clinical effect of cervical conization under cervical endoscopy in high-grade cervical intraepithelial neoplasia (CIN). Methods: From June 2017 to June 2019, 100 patients with grade II and III CIN admitted to Harbin First Hospital were divided into control group and observation group with 50 cases in each group by random number table method.The control group was treated with traditional cervical cold knife conization, while the observation group was treated with cervical conization under endoscopy.To compare the therapeutic effects of two surgical methods. Results: The incidence of positive margin were significantly lower than that in the control group(8%(4/50) and 18%(9/50)), and the difference was statistically significant (χ²=4.98, P<0.05). The postoperative follow up was proceed one year.The incidence of cure were significantly higher than that in the control group(96%(48/50)vs.84%(40/50)), and the residual rate and recurrence rate were lower than that of the control group(6%(3/50) and 14%(7/50), 2%(1/50)and 8%(4/50)), the difference was statistically significant (χ²=10.56, 3.98, 13.96, all P<0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group [6% (3/50) and 18% (9/50)], the difference was statistically significant (χ²=11.25, P<0.05). There was no significant difference in bleeding volume, operation time and wound healing time between the two groups (t value was 1.46, 1.26 and 0.98 respectively, all P>0.05). Conclusion The cervical conization through cervical canal endoscope can accurately locate the focus of high-grade CIN, with higher rate of lesion clearance, lower rate of lesion recurrence and complications.

Objective To investigate the prevalence of nutritional risk and undernutrition of geriatric patients with hip fracture in the department of orthopaedics and analyze the relationship between nutritional risk scores and clinical outcomes.Methods In this prospective cohort study,the baseline demographic data of 235 elderly patients with hip fracture in the department of orthopaedics of Ningbo First Hospital were consecutively recorded from November 2013 to December 2015.The prevalence of nutritional risk and undernutrition,infectious complications,and length of hospital stay were also recorded.The infectious complications and length of hospital stay in patients in different age groups(60-69 years,70-79 years,and ≥80 years)and those with different nutritional risks(<3 points,3-4 points,and ≥5 points)were analyzed.Results All patients without PN EN support during hospitalized durations.The incidence of nutritional risk was 62.98％in 235 elderly patients with hip fracture,twenty patients were undernutritioned by multi-item standard based on Nutritional Risk Screening 2002 nutrition disorder score,and 15 patients were undernutritioned by one-item standard with body mass index.Hip arthroplasty patients had significantly higher nutritional risk than those who had undergone internal fixation(74.04％vs.54.20％,P=0.002).Patients with comorbidities had significantly higher nutritional risk than patients without comorbidities(71.56％vs.55.56％,P=0.011).There were significant differences in infectious complications(2.30％vs.3.91％vs.50.00％)and length of hospital stay[(6.35±0.87)d vs.(8.12±1.13)d vs.(10.85±1.52)d,(8.66±2.06)d vs.(10.45±2.43)d vs.(13.25 ±3.65)d] among patients with different nutritional risks(<3 points,3-4 points,and ≥5 points)(P=0.000).Conclusions Elderly patients with hip fracture has relatatively high nutritional risk.These patients tend to have more complications and longer hospital stay.

Lysine specific demethylase1(LSD1)is a flavin adenine dinucleotide(FAD)-dependent monoamine oxidase.Studies have confirmed that aberrant expression of LSD1 is closely related to tumor metastasis and proliferation,and is currently one of the important targets for tumor-targeted therapy.In addition,LSD1 is involved in the development of various conditions such as neurodegenerative diseases,cardiovascular diseases,and inflammatory responses.Currently,several inhibitors have been developed for the clinical research stage.In this paper,the structure and mechanism of action of LSD1 and the research progress of LSD1 inhibitors are briefly introduced to provide some reference for the design and development of novel LSD1 inhibitors.

Objective:To reconstruct and repair forearm and foot injuries with soft tissue defect using medial sural artery perforator flap (MSAP), and to evaluate the curative effects.Method:From May, 2015 to September, 2017, 13 patients (9 males and 4 females) with soft tissue defect on forearm and foot underwent MSAP reconstruction operations. The age was ranged from 19 to 57 (mean 41) years. Six wounds located in forearms and 7 in foot. Ipsilater- al shank was used as donor for the repair of foot. The donor sites were directly sutured. The area of flaps was ranged from 3.0 cm×4.0 cm-7.0 cm×15.0 cm. All cases were followed-up for flap appearance, sensation and donor healing by visit of clinic and WeChat reviews.Results:All 13 flaps survived well without any vascular crisis nor necrosis. Postoperative superficial infections were found in 3 cases, and the wound healed gradually after daily dress changing and anti-infection treatment. Eleven patients were followed-up for 4 to 18 months (average 12 months). Two provincial patients lost to follow-up. No obvious disfunction was found from the donor shanks. The appearance and texture of flaps were in excellent condition and satisfactory. The sensation of 7 flaps was recovered to S 2-S 3. TPD was 6-9 mm. Conclusion:The free MSAP is rational therapeutic strategy for repairing the soft tissue defect of forearm and foot. It has advantages of long vascular pedicle, constant perforation and relatively thin subcutaneous fat.