Objective To investigate the genotype distribution of extended-spectrum?-lactamases(ESBLs) and AmpC?-lacta- mases produced by Escherichia coli and Klebsiella pneumoniae in 10 teaching hospitals of China.Methods 90 clinical strains of E.coli and 61 strains of K.pneumoniae isolated in 2003 and confirmed to produce ESBLs were collected from 10 teaching hos- pitals in China.Analytical isoelectric focusing was used to measure the pI of the?-lactamases.Conjugation experiment was used to study the transfer of cefoxitin resistance.Plasmid-mediated AmpC enzyme genes were amplified and sequenced by multiplex polymerase chain reaction (MPCR).Results The prevalence of ESBL-producing E.coli and K.pneumoniae was about 50% in Wuhan,Nanjing and Jinan.The prevalence of ESBL-producing E.coli was lower than K.pneumoniae in Beijing.However,in other hospitals the prevalence of ESBL-producing E.coli was a little higher than K.pneumoniae.About 24.4% of ESBL-pro- ducing E.coli isolates and 19.4% of ESBL-producing K.pneumoniae isolates were resistant to cefoxitin.Cefoxitin-resistant i solate was identified in all hospitals except Shenyang.Major genotype of ESBL-producing isolates was CTX-M.The CTX-M-9 group was the most common group,followed by CTX-M-1.More K.pneumoniae isolates produced both ESBLs and AmpC en- zyme than E.coli.The genotype was CTX-M/DHA-1.The PCR results of 3 transconjugants producing both ESBLs and AmpC enzyme were the same as their donor isolates.Conclusions The genotype of ESBL-producing isolates is mainly CTX-M-9 group in these teaching hospitals.More K.pneumoniae isolates produced both ESBLs and AmpC enzyme than E.coli.Most of these isolates are due to geno type CTX-M/DHA-1,which can spread through plasmid.

Objective This paper focuses on the investigation of the occurrence and influential factors of post-traumatic stress disorder (PTSD)in SARS patients, hospital staffs and the public expo sed to SARS. Methodes Three groups were assessed by scale of self-compiled stressor Questionnaire, impact of event scale-revised (IES-R) , PSSS, SCSQ, SES and EPQ. Results 1. The incidence of PTSD symptoms in the three groups were 55.1% ,25.8 % and 31.18 %. 2. The main cause of the different incidence was the difference of the stressor intensity and characters. Negative coping was the risk factor of SARS patients and the public; Self-esteem was the protected factor of SARS patients and the hospital staffs; Social support was a protected factor on the hospital staffs. 3. Comparing to the first investigate in September,2003 ,the data of follow-up study in September,2004 showed that the prevalence items significant decreased. Conclusions 1. The investigation concludes that all three groups of people exposed o SARS exhibit PTSD symptom. SARS patients have the highest occurrence ( P ＜ 0.01 ). 2. The main influencing factors of different incidence of PTSD in different groups are intensities and characteristics of stressors. Different people who had PTSD symptoms have different influencing factors. 3. With the change of time , the PTSD symptoms significant relieve with the attenuation gradually of exposure degree of stressor.

Objective To assess response of rectal carcinoma to preoperative chemoradiation therapy(CRT)using DWI and tumor ADC values,and to investigate the value of ADC in predicting and monitoring therapeutic effect of CRT.Methods Twenty-six patients with primary rectal carcinoma undergoing preoperative CRT were recruited to the study.DWI was performed on a 1.5 T MR scanner in all patients at the time point of pre-therapy,the end of the 1st,2nd week of therapy and pre-operation,respectively.ADC values of the tumors were calculated on the workstation.Randomized block design was applied to analyze change in ADCs following treatment Results All patients were divided into T-downstaging group(n=12)and T-non-downstaging group(n=14).In T-downstaging group,the mean tumor ADC values were(1.10±0.13)×10~(-3),(1.32±0.19)×10~(-3),(1.35±0.13)×10~(-3),(1.32±1.00)×10~(-3) mm~2/s at the time point of pretreatment,week 1,week 2,pre-operation,respectively(F=16.420,P＜0.01).The mean tumor ADC value in T-non-downstaging had a slight increase from(1.16±0.16)×10~(-3) mm~2/s to(1.23±0.13)×10~(-3) mm~2/s at the time of week 1(P＞0.05).The ADC value in T-non-downstaging group continuously increased to(1.30±0.16)×10~(-3) mm~2/s at the end of the 2nd week of CRT(F=5.023,P＜0.01)and appeared statistical difference.The evolution of tumor ADC values in the two groups was significantly different.Early increases in tumor ADC were observed in T-downstaging group.Regarding the increase percentage of ADC value at 1st week as a diagnostic marker of tumor downstaging,when it was set as 11.6%,the sensitivity,specificity,positive predictive value and negative predictive value is 75.0%,78.6%,75.0% and 78.6% respectively,the area under curve(Az)was 0.774(95% confidence interval:0.583 to 0.964).Conclusions An early significant increase of mean tumor ADC value in rectal carcinoma has a potential to predict therapeutic effect of CRT.One week after beginning CRT is an early time point to monitor therapy efficacy.

Objective To evaluate the efficacy of different three-dimensional CTA methods on 64-slice sprial CT in the preoperative assessment of gastric arteries and their variations.Methods Sixty-six consecutive patients with gastric cancer who underwent 64-slice spiral CT examinations preoperatively were retrospectively studied.To get the STS-MIP images, the thickness of slab was adjusted according to the inner diameter of targeted blood vessels and their cross-layer distribution.After four weeks, the AVVR images of all cases was got by the auto-vessel technique.The demonstration rates and origins of the direct and indirect feeding arteries were analyzed on AVVR and STS-MIP.McNemar tests were used to compare the detection rates of gastric feeding arteries by STS-MIP and AVVR.The relationship between CT value and display rate of vessels was analyzed using independent-samples t test The variations of blood vessels were analyzed.Results The display rate of indirect feeding arteries were all 100% (66/66) by STS-MIP and AVVR.The display rates of left gastric artery (LGA) and right gastroepiploic artery (RGEA) were 98.5% (65/66), 100.0% (66/66) and 97.0% (64/66), 100.0% (66/66) by STS-MIP and AVVR respectively.The display rates of right gastric artery (RGA), left gastroepiploic artery (LGEA), short gastric artery (SGA) and posterior gastric artery (PGA) by AVVR were lower than those of STS-MIP with statistical significances [RGA:68.2%(45/66) vs.98.5% (65/66), P<0.01; LGEA: 53.0% (35/66) vs.97.0% (64/66), P<0.01; SGA: 7.6% (5/66) vs.59.1 %(39/66), P<0.01; PGA: 18.2% (12/66) vs.63.6% (42/66), P<0.01 ].The demonstration rates of LGEA, RGEA and SGA increased accompanied with the increasing of CT value in celiac axis (LGEA: 35 cases displayed with mean CT value of (272±44) HU, 31 cases did not display with mean CT value of (229±42) HU, t=4.043, P<0.01; RGEA: 64 cases displayed with mean CT value of (256±44) HU, 2 cases did not display with mean CT value of (141 ±26)HU, (=3.641, P<0.01; SGA:5 cases displayed with mean CT value of (298 ±39),61 cases did not display with mean CT value of (249±47)HU, t=2.278,P<0.01). Thirteen cases (19.7%) with accessory left hepatic artery were identified, and seven cases (10.6%) with celiac axis variances were depicted.Conclusion 64-slice spiral CT can clearly demonstrate gastric feeding arteries and related variations, which may provide useful information for the operation of gastric cancer.Stomach neoplasm; Tomography, X-ray computedAVVR.The display rates of left gastric artery(I,GA) and fight gastroepiploic artery(RGEA)were 98.5%(65/66),100.0%(66/66)and 97.0%(64/66),100.0%(66/66)by STS-MIP and AVVR respectively.The display rates of right gastric artery(RGA),left gastroepiploic artery(LCEA),short gastric arterysignificances [RGA:68.2%(45/66)VS.98.5%(65/66), P<0.01;ICEA:53.0%(35/66)VS.97.0%(64/66),P<0.01;SGA:7.6%(5/66)VS.59.1%(39/66),P<0.01;PGA:18.2%(12/66)VS.63.6%(42/66).P<0.01 1.The demonstration rates of I.GEA,RGEA and SGA increased accompaniedwith the increasing of CT value in celiac axis(LGEA:35 cases displayed with mean CT value of(272±44)HU,31 cases did not display with mean CT value of(229±42)HU,t=4.043,P<0.01;RGEA:64 cases displayed with mean CT value of(256±44)HU,2 cases did not display with mean CT value of(141±26)HU,t=3.641, P<0.01;SGA:5 cases displayed with mean CT value of(298±39),61 casesaccessory left hepatic artery were identified.and seven cases(10.6%) with celiac axis variances werevariations.which may provide useful information for the operation of gastric cancer.

Objective To explore the prevalence of health literacy in China in 2011-2013.Methods The eligible studies were identified by searching China National Knowledge Infrastructure (CNKI),Chinese BioMedical Literature Database (CBM),VIP Database for Chinese Technical Periodicals (VIP),Wanfang database,PubMed and Embase.The Meta-analysis was applied with Stata 12.0 software.Subgroup analysis and sensitivity analysis were performed to test the robust of the results.Results A total of 28 studies,including 53 308 residents,were finally included in the review.Meta-analysis revealed the prevalence of health literacy in China to be 16％ (95％CI 15％-16％),and the prevalence of health concepts and knowledge was 25％ (95％CI 25％-26％),and healthy lifestyles and behaviors was 13％ (95％CI 12％-14％),and health skills was 32％ (95％CI 31％-32％).Conclusions The health literacy levels of residents showed a rising trend.There were differences between rural and urban health literacy levels and different regions.Rural residents' health literacy level increased more significantly than that of the city.Due to limited kinds of methods,more scientific and effective methods were needed to evaluate the health literacy.

Objective:To evaluate the radiologic and clinical outcomes of supramalleolar dome osteotomy in the treatment of varus-type ankle arthritis.Methods:From June 2018 to December 2019, 13 patients with varus-type ankle arthritis underwent supramalleolar dome osteotomy at Department of Foot and Ankle Surgery, Beijing Jishuitan Hospital. Of them, 13 (5 males and 8 females) were included in the study. Their average age at surgery was 47.2 years (range, from 16 to 65 years). By the modified Takakura staging for arthritis, 3 cases were stage 2, 4 cases stage 3a and 6 cases stage 3b. Comparisons were made between preoperation and the last follow-up in ankle-hindfoot score of American Orthopedic Foot and Ankle Society (AOFAS), foot function index (FFI), visual analogue scale (VAS), Takakura staging, dorsal extension, plantar flexion, range of motion (ROM), tibial anterior surface angle (TAS), tibial lateral surface angle (TLS), and talar tilt (TT).Results:This cohort were followed up for 12 to 29 months (average, 17.2 months). At the last follow-up, AOFAS score (86.5±8.0), FFI (14.5±1.6), VAS score (1.5±1.0), Takakura staging (2.7±1.3), ROM (39.4°±8.0°), TAS (92.4°±6.0°), TT (3.7°±4.4°) were significantly improved than the preoperative values (68.3±14.4, 43.7±3.0, 4.2±1.4, 3.2±0.8, 43.3°±7.6°, 78.2°±8.3° and 7.0°±5.1°), and dorsal extension (10.9°±4.4°) was significantly smaller than the preoperative value (13.6°±5.1°) (all P<0.05). There were no significant differences between preoperation and the last follow-up in plantar flexion (29.7°±4.6° versus 28.5°±5.2°) or TLS (77.8°±4.5° versus 78.1°±5.3°) ( P>0.05). Conclusions:Supramalleolar dome osteotomy has shown promising short-term clinical efficacy in the treatment of varus-type ankle arthritis. It can significantly relieve pain, improve function, substantially correct deformity and retard progression of arthritis, but it may affect dorsal extension.

OBJECTIVE: Dynamic observation of Epstein-Barr virus (EBV) DNA load before and after the treatment in patients with Nasopharyngeal carcinoma (NPC), predicting the incidence of distant metastasis and offering more personalised choice of therapies. METHOD: Fifty-four cases of patients with NPC were taken by fluorescence quantitative PCR assay of EBV DNA load before and after the treatment, all patients were followed up according to plan and carried out the progression-free survival (PFS) and overall survival (OS). RESULT: EBV DNA load in plasma of patients with NPC can partly reflect the clinical characteristics of patients; EBV DNA load in some patients with distant metastasis was higher than those patients with continuous remission when they were not started treatment (P < 0.05); For those patients whose EBV DNA copies were lower than 20,000 copies/mI before the treatment, the progression-free survival and overall survival rates were higher than those high expression patients, and the difference were statistically significant (PF < 0.01 and P < 0.05). CONCLUSION The EBV DNA load in the plasma of NPC patients can partly predict the occurrence of distant metastases before treatment.
Adolescent ; Adult ; Aged ; Carcinoma ; DNA, Viral ; blood ; Female ; Herpesvirus 4, Human ; genetics ; Humans ; Male ; Middle Aged ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; therapy ; virology ; Neoplasm Metastasis ; Viral Load ; Young Adult

OBJECTIVETo explore the situation and cause of new reported HIV/AIDS cases and death of HIV cases in Henan province from 2008 to 2009.

METHODSThe data of HIV/AIDS cases in Henan province before the end of 2009 was downloaded from "the history card downloading site" of the national online case reporting system on Jan. 5(th), 2010. There were 6990 HIV/AIDS new cases reported from 2008 to 2009, and 1214 cases died. Descriptive study was implemented including population characteristics of new reported HIV/AIDS cases and dead cases from 2008 to 2009. Survival time and cause of death were analyzed.

RESULTSAmong all the dead cases, the Han nationality accounted for 99.0% (1202 cases), and males were more than females (62.0% (753 cases) vs 38.0% (461 cases)), 64.7% (786 cases) were married, those under junior high school education level accounted for 93.7% (1137 cases), AIDS patients accounted for 93.2% (1131 cases) and 6.8% (83 cases) were HIV carriers; 65.5% (795 cases) were former plasma donors and transfusion blood/blood produces. The main cause of death were AIDS-related diseases, the proportion was 71.9% (873 cases). The median survival time after confirmed HIV positive was 62 days (Q(L) = 14 d, Q(U) = 151 d), 35.9% (436 cases) cases died in one month and 79.0% (959 cases) cases died in six months after confirmed HIV positive.

CONCLUSIONThe newly reported dead cases of HIV/AIDS were mainly infected through former plasma donation and transfusion blood/blood produces in 2008 and 2009. The main cause of death was AIDS-related diseases.

Acquired Immunodeficiency Syndrome ; epidemiology ; mortality ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cause of Death ; Child ; Child, Preschool ; China ; epidemiology ; Female ; HIV Infections ; epidemiology ; mortality ; Humans ; Infant ; Male ; Middle Aged ; Young Adult

0.05). Conclusion Preproghrelin-Leu72Met is not significantly associated with T2DM and DN in Shanghai Han populations,while T2DM with AA genotype is characterized by significant declination in urine microalbumin when compared with CA and CC genotypes.Leu72Met polymorphism(C→A)may postpone the development of microalbuminuria in T2DM subjects.

Objective Clinical data of 19 Chinese patients with 21 hydroxylase deficiency (21OHD) were analyzed to improve the diagnosis and treatment level. Methods Clinical features and laboratory data were collected from 19 patients with 21OHD before and after treatment. Results In male patients, the average age of early appearance of secondary sexual character was (9.3?2.8)yrs, and excess androgen resulted in phallic enlargement. Primary amenorrhea was the most common complaint in female(87.5%), and the signs included a varying degree of labioscrotal fusion and clitoral enlargement. The average level of 17-hydroxy progesterone(17OHP) was (63.42?35.07) ?g/L, and adrenocorticotrophic hormone(ACTH), dehydroepiandrosterone(sodium) sulfate(DHEAS) and testosterone(T) were obviously elevated. CT scan showed bilateral adrenal hyperplasia. The level of 17OHP was significantly decreased after treatment[(63.42?35.07) ?g/L vs (3.15?2.71) ?g/L](P