OBJECTIVE：To analyse the distributing proportion of amoxicillin/clavulanate K(CA) in β-lactmas and the popularzing rate of CA in hospitals.The proportions of different drug dosage forms of CA were compared.METHODS：The sums of money of the antiinfectives,β-lactams(penicillins) and CA consumed in 13 cities of China in 1999 were analysed.RESULTS：The distributing proportion of CA in β-lactams(penicillins)accounted for 18.3％ ,the popularzing rate of CA in 13 cities was 74.4％ ,of which,oral dosage form amounted to 41.7％ and powdered form for injection 58.3％ .CONCLUSION：The results can provide reference for rational use of drugs in hospital.

Objective: To evaluate the impact of loss of a spouse on self-rated health among middle-aged and elderly populations in China, so as to provide insights into health promotion among middle-aged and elderly populations with loss of a spouse. Methods: Based the 2018 China Health and Retirement Longitudinal Study (CHARLS) database, married and separated individuals or individuals with loss of a spouse at ages of 45 years and older and with monthly household consumption of no less than 100 yuan were enrolled. Subjects' age, gender, educational levels, marital status, monthly household consumption, number of chronic diseases and self-rated health were collected. Subjects were classified according to loss of a spouse, and the impact of loss of a spouse on self-rated health was evaluated among middle-aged and elderly populations using propensity score matching (PSM). In addition, heterogeneity test was performed to evaluate the gender- and educational level-stratified impacts. Results: Totally 3 272 valid subjects were enrolled, including 1 618 men (49.45%) and 1 654 women (50.55%), and there were 512 subjects with loss of a spouse (15.65%). There were 656 subjects with very good self-rated health (20.05%), 622 with good health (19.01%), 1 534 with fair health (46.88%), 376 with poor health (11.49%) and 84 with very poor health (2.57%). There were 3 152 couples with successful nearest neighbor matching, and there was no significant difference between the subjects with and without loss of a spouse after adjustment for variables (P>0.05), while the overall fitting degree of the model was good following matching. PSM showed that the self-rated health became poor following loss of a spouse among middle-aged and elderly populations, with average treatment effect (ATT) of 0.055 to 0.061, and a remarkably negative effect of loss of a spouse on self-rated health was seen in women, with ATT of 0.192 to 0.223, while no remarkable effect was seen in men. Loss of a spouse showed a remarkably negative effect on self-rated health among individuals receiving junior and senior high educations, with ATT of 0.048 to 0.057, but presented no remarkable effect on self-rated health among individuals receiving primary educations. Conclusions Loss of a spouse presents a negative effect on self-rated health among middle-aged and elderly populations, and remarkably negative effects are seen among women and individuals receiving high educational levels.

Depression is a devastating mental disorder and major depressive disorder (MDD) that afflicts 16％ of the global population at some point in their lives. Currently available classical antide-pressants (SSRIs, SNRIs, TCAs and MOIs), require a minimum of 2–4 weeks of continuous treat-ment to elicit therapeutic relief in depressed patients and are associated with high rates of non-respon-siveness, and limited duration of efficacy. Therefore, faster-acting antidepressant therapies are need-ed,particularly for patients at risk for suicide for current therapies for depression.Although the molecu-lar mechanisms underlying the pathogenesis of depression are still largely unclear, previous studies have suggested that modulators of mammalian target of rapamycin complex 1 (mTORC1) signaling may have beneficial neuroprotective and antidepressant effects. Here, we review recent advances in understanding mTORC1 signaling in depression and potential therapeutic strategies resulting from modulation of the mTORC1 signaling network. We also highlight recent studies considered to support mTORC1 signaling modulation as a rapid-acting antidepressant therapy (e.g. ketamine, scopolamine, GLYX-13, (2R,6R)-HNK, Ro-256891 etc.) and discuss future research directions. Studies on prospec-tive next-generation rapid-acting antidepressant therapies should focus on developing more selective glutamate receptors(e.g.α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptors(AMPARs) agonists or activators)that activate the mTORC1 signaling pathway free of ketamine's adverse effects.

OBJECTIVETo observe the efficacy of the treatment of refractory wound by VSD combined with platelet-rich plasma.

METHODSFrom April 2010 to June 2012,15 patients with refractory wound were treated including 11 males and 4 females with an average age of 35.2 years old ranging from 18 to 45 years old. The formation time of wound was from 6 to 24 months, which was unhealed after long-term medication or repeated treatment. The VSD combined with autologous platelet-rich plasma was applied to treat the wound. The wound healing was an indicator and treatment and clinical features were summarized.

RESULTSAll the patients were followed up for 3 to 8 months (means 5 months). The wound of all patients were healed without recurrence.

CONCLUSIONThe curative effect of VSD combined with platelet rich plasma for treatment of refractory wounds is obvious. It could reduce the treatment course and the treatment cost.

Adolescent ; Adult ; Drainage ; methods ; Female ; Humans ; Male ; Middle Aged ; Negative-Pressure Wound Therapy ; methods ; Platelet-Rich Plasma ; metabolism ; Wound Healing ; Wounds and Injuries ; metabolism ; physiopathology ; therapy ; Young Adult

Objective To explore the effect of failure mode and effect analysis (FMEA) on reducing the unplanned extubation rates for patients with severe craniocerebral injury. Methods FMEA model was used to analyze the main reasons of unplanned extubation patients with severe craniocerebral injury, 7 failure modes with higher RPN scores was selected. The nursing intervention for the fixation of the catheter were improved. The control group with 181 cases of patients without FMEA application were given routine care. FMEA group owning 196 cases were given the optimization process. The incidence rate of unplanned extubation of two groups was compared. Results After improvement of the nursing process of patients with severe craniocerebral injury for fixing the catheter, the RPN of 7 failure modes was lowered. Compared with the control group, the total rate of unplanned extubation in FMEA group decreased to 1.1% (9/832), less than 5.1% (40/779) of the control group. The statistical difference was significant (χ2=22.410, P < 0.01) . The rate of UEX in gastric tube, urinary catheter and central venous catheter were 3.1%(6/196), 1.0%(2/196), 0, lower than 8.8%(16/181), 4.9%(9/181), 3.9%(7/181) in the control group. The statistical difference was significant(χ2=5.718, 5.224, 7.724, P < 0.05). No statistical difference in tracheal cannula and drainage tube of head between the two groups was found(P>0.05). Conclusions The FMEA model can be effective in reducing the rate of unplanned extubation .

Objective To study the prevalence and the distribution of several chronic diseases which affect the life quality and the health of the Shanghai elderly people. Methods Stratified cluster sampling method was used in the survey of the prevalence rate of several common chronic diseases (self reported) in 12 590 residents ≥60 years of age in 22 urban and 14 rural communities in Shanghai. Results The total prevalence rate of several chronic diseases in the elderly is 60 3%, with male being 59 4% and female being 61 9%. The total prevalence rate in the urban elderly was 66 5%, significantly higher than that of the rural elderly(53 9%). In urban areas, female's prevalence was higher than the males. While in rural area no difference between male and female was observed. In urban areas, the prevalence from high to low stood hypertension(33 6%), cataract(18 3%), chronic obstructive pulmonary disease (COPD)(11 9%), coronary heart disease(9 1%), other heart diseases(7 9%), diabetes mellitus(5 9%). In rural areas, the prevalence from high to low stood hypertension (20 9%), COPD(15 2%), cataract(7 0%), deafness(5 7%), other heart diseases(4 3%), osteoideformed or osteoporosis(4 2%). Conclusions The distribution and the status of the chronic diseases in rural areas are significantly different from that of urban areas. We should carry out different strategies according to different conditions for enhancing the health and life quality of the elderly.

OBJECTIVE:To put forward the tentative idea of the application of the access and benefit-sharing regime in the field of Chinese medicine.METHODS:The existing problems of protecting biological diversity in the field of Chinese medicine and what problems the access and benefit-sharing regime could solve were analyzed.RESULTS & CONCLUSION:Our preliminary idea for applying access and benefit-sharing regime in the field of Chinese medicine is to set up a special department for negotiation,identify the rights and subject,construct registration system and informed consent procedure,improve the source disclosure system and add the benefit-sharing regulation.

Methamphetamine is a powerful stimulant of amphetamine type in the central nervous system (CNS),and recently it has become the major drugs of abuse.A lot of research results show that MA may induce dopaminergic neurotoxicity in the animal and human striatum.The mechanisms include effects on dopaminergic signaling and dopamine oxidation,glutamate induced excitotoxicity,oxidative stress and inflammatory cytokines,disruption of mitochondfia,apoptosis,activation of glial cells and hyperthermia.However the mechanisms by the MA-induced dopaminergic neurotoxicity are not completely understood.The paper reviewed recent progress of study on them to provide reference materials for related research.

Objective To investigate the delivery mode of pregnant women with prior cesarean section in Northern China,and their clinical characteristics.Methods A multi-center observational study of 1 068 women who had prior cesarean delivery in 24 medical centers in Northern China was conducted between December 2013 and May 2014.The clinical data,including general condition,antenatal examination results,delivery mode,and maternal and fetal outcomes,were collected and compared between vaginal delivery and cesarean section.Mann-Whitney U test and Chi-square test were used for statistical analysis.Results The median age of the 1 068 women were 32 years (range,18-45 years).Thirty-seven (3.5％) had a history of prior vaginal delivery.There were seven twin pregnancies and all delivered by cesarean section.Thirty-five women had suspected uterine rupture and underwent cesarean section,but were confirmed without uterine rupture during the operation.There was no maternal and fetal/neonatal death.Of the 1 068 women,43(4.0％) had successful vaginal birth and 1 025 (96.0％) underwent repeat cesarean sections.Compared with cesarean section group,vaginal delivery group tended to have a greater thickness of the lower uterine segment in the third trimester as shown by ultrasound [(3.3 ± 0.9) vs (2.9± 1.1) mm,Z=-2.240,P=0.025],a higher percentage of prior vaginal delivery [16.2％(6/37) vs 4.6％(31/673),x2=9.570,P=0.009],a lower rate of regular antenatal examination [58A％(25/43) vs 73.2％(742/1 0t3),x2=4.737,P=0.026],a shorter hospital stay[(3.7±2.4) vs (5.9±3.8) d,Z=-6.043,P=0.000],and lower 1-min Apgar score (9.1 ±2.2 vs 9.9±3.9,Z=-2.410,P=0.016),but without difference in the 5-min Apgar score (9.9±0.4 vs 9.6± 1.3,Z=-0.947,P=0.344).Conclusions Rate of vaginal delivery for women with prior cesarean section in Northern China is low.Vaginal birth with prior cesarean section is relatively safe,especially for those with a previous history of vaginal delivery.

Objective: To investigate the clinical effect of Gynecologic Qianjin Tablets (Radix Codonopsis, Radix Angelicae sinensis, Folium Mahoniae, Caulis Millettiae Reliculatae, Herba Andrographis, etc.) for treating chronic pelvic inflammatory disease. Methods: 30 cases with chronic pelvic inflammatory disease in study group were treated by Gynecologic Qianjin Tablets, which has the effects of boosting Qi and blood and clearing away heat and wet in 2 weeks, 3 times per day and 6 tablets per time; and meanwhile, 30 cases treated by tablet of Jinji Tablets in control group were also observed. Results: The response rate in study group was 83.33% , while in control group was 63.33% ( P