Histiocytosis, Langerhans-Cell ; Humans ; Infant ; Male ; Temporal Bone ; pathology

Objective To investigate current status of healthcare-associated infection(HAI)and community-associated infection(CAI)of different levels of hospitals in Xinjiang.Methods Infection,antimicrobial use and pathogen detection in patients in second-class and above hospitals in Xinjiang on March 20,2014 were performed cross-sectional survey by bedside visiting and medical record reviewing methods.Results A total of 66 208 patients in 132 hospitals were investigated,HAI prevalence rate and case prevalence rate was 1.83% and 2.02% respectively;CAI prevalence rate and case prevalence rate was 24.53% and 24.83% respectively.HAI prevalence rate in third-class hospitals was higher than second-class hospitals (2.58% vs 1.44%,P <0.001),while CAI prevalence rate was lower than second-class hospitals (17.84% vs 28.01%,P<0.001).HAI prevalence rate was highest in intensive care unit (14.91%),CAI was highest in pediatric department. The common infection sites were respiratory tract,surgical site and urinary tract.Antimicrobial usage rate was 31.27%, antimicrobial usage rate in second-class hospitals was higher than that of the third-class hospitals([35.95%,n=15 642]vs [22.32%,n=5 064],χ2 =1 288.974,P <0.001),pathogen detection rate in third-class hospitals was higher than that of the second-class hospitals([59.40%,n=2 224]vs [53.59%,n=6 436],χ2 =38.964,P <0.001 )Gram-negative bacilli were main isolated pathogens,the top 3 pathogens were Escherichia coli ,Klebsiella pneumoniae ,and Acinetobacter bau-mannii .Conclusion The cross-sectional survey can reflect infection status of different levels of hospitals,surveillance of targeted microbial detection and rational antimicrobial use should be strengthened,management of infection in high risk population and key sites should be paid close attention.

Drug resistance of Acinetobacter baumannii ( Ab) in surgical ICU from January 2008 to December 2009 was investigated retrospectively. Total 114 clinical strains of Ab were isolated from surgical ICU and 92 strains were from respiratory tract (80.7% ). The prevalence rate of multiresistant Ab in 2009 was higher than that in 2008 (75. 7% vs 50. 0% , x2 = 7. 703, P = 0. 006). The results indicate that to monitor and control drug resistant of Ab constantly is important for the prevention of nosocomial infection.

OBJECTIVE:To provide reference for promoting the prior usage of essential medicines and scientifically selecting of antitumor medicines in the national and local drug reimbursement list. METHODS:Entering the Human Resources and Social Se-curity Bureau websites in 10 cities(Beijing,Shanghai,Guangzhou,Nanjing,Wuhan,Xi’an,Chengdu,Shenyang,Jinan and Gui-yang),drug reimbursement list was downloaded to statistically analyze the containing of antitumor medicines(including 24 essential medicines). RESULTS:In antitumor medicines,there were 5 cities with more than 100 varieties,of which Shanghai had 255 vari-eties,which was far more than other cities;the numbers of medicines in class A were near 30 in all the cities except Beijing(67 va-rieties),and the number of class B was highest in Shanghai and lowest in Beijing. All the drug reimbursement lists in 10 cities con-tained 24 antitumor essential medicines,however,the classification was different according to the dosage forms,among which, parts of formulations of cytarabine(injections),doxorubicin(injections),busulfan (often release oral dosage forms),fluorouracil (often release oral dosage forms,injections),cyclophosphamide(often release oral dosage forms,injections),methotrexate(often release oral dosage forms,injections)and cisplatin were classified as class A medicines in all cities;oxaliplatin(injections)and pa-clitaxel (injections) were classified as class B medicines;busulfan,fluorouracil,cyclophosphamide and methotrexate were classi-fied as class B in Shanghai only. CONCLUSIONS:There are some differences in the distribution of antitumor essential medicines in drug reimbursement list in each city,the varieties in developed cities are relatively more,and developing cities are less. It is sug-gested to consider the tumor epidemiology characteristics and economic situations,reasonably select antitumor essential medicines into drug reimbursement list and reasonably adjust the proportion of class A and B to ensure the basic medication and drugs’reim-bursement.

Objective To optimize the synthesis process of iloperidone 1 for industrial production.Methods Piperi-dine-4-carboxylic acid, acetic acid and acetic anhydride were used as starting materials to generate 2 via amidation, Friedel-Crafts acylation, hydration, oximation, intramolecular cyclization and salification.Compound 2 was treated with 4-(3-chloropropoxy)-3-methoxyphenylethanone through condensation to afford iloperidone.The target compound 1 was prepared with an overall yield of 34.9%.Results and Conclusion Such factors as the ratio of the raw materials, the catalyst, reactive time were investigated and optimized to make the reaction conditions mild and easy to control with less side effects.The structure has been confirmed by IR, 1 H-NMR and MS.

Background and purpose:Myasthenia gravis(MG)is an auto-immune disease affecting neuromuscular joints.1/4 of these patients may have thymoma.Surgical treatment remains the most important method for either MG or thymoma.In this retrospective analysis,we evaluated the clinical effects of surgical treatment for myasthenia gravis patients with thymoma.Methods:32 myasthenia gravis patients with thymoma underwent surgical treatment between Jan 2001 and Dec 2006 in our hospital.The data including age,gender,pathological founding,duration and gravity of myasthenia gravis were analyzed.Tumor recurrence and outcome of myasthenia gravis were documented during follow-up for all patients.Results:All patients received median sternotomy for thymectomy.Resection of pericardium,pleural or part of lungs was taken as needed for complete removal of tumor tissue.One patient died during peri-operative time.The median follow-up period for the the rest of the 31 patients was 37(14-61)months.8 patients received post-operative radiotherapy.Only one patient had recurrent thymoma and was re-operated,achieving tumor-free status.Complete remission of myasthenia was achieved in 7 patients with 13 partial remission,9 stable and 2 progressed.The overall effective rate for myasthenia gravis was 64.5%,and patients with different data has no signifi cance(P

Objective To discuss the effects of cAMP receptor protein(CRP) regulator on the virulence and biofilm formation for the Klebsiella pneumoniae.Methods From August 2012 to February 2014, selected120 Klebsiella pneumoniae strains for PCR detecting expression of CRPregulators, while selected piperacillin, piperacillin +tazobactam, amikacin,ceftazidime, ceftriaxone, cefoperazone +sulbactam, levofloxacinand other antibacterial drugs for the resistance testing and analysis.Inthe biofilm formation experiment, were given the detailed analyzed of theregulation of relative positive expression strains in ordinary liquid cultureand biofilm state situation.Results PCR detection positive rate of CRPregulators were 33.3%, while the CRP regulatory sequences flankingPCR positive strains also amplified target sequence.The resistance ofCRP regulator positive strains for ceftriaxone, levofloxacin, amikacin andceftazidime were higher than the CRP regulators negative strains thatdifference were statistically significant (P <0.05).The CRP regulatorexpression in the biofilm culture group was 0.28 ±0.04, so that was0.08 ±0.05 in the ordinary liquid culture group, the difference betweentwo groups was statistically significant (P <0.05).Conclusion Theexpression of CRP regulators for the Klebsiella pneumoniae is favor ofreducing the bacterial virulence and promote biofilm formation, thereby i nc rease resistance to drugs-related antimicrobial.

Objective To investigate the prognosis of grommet insertions for osecretory otitis media in children and analyze the factors that may influence the results.Methods A retrospective review of 103 children (182 ears) with grommet insertions for osecretory otitis media from January 2011 to December 2011 was performed.They were divided into two groups(A and B) basing on the median age of 6 years old and observed their clinical manifestations,etiology and prognosis through two years' follow-up.The preoperative pure tone audiometry(PTA) hearing threshold,PTA in two weeks after surgery,the proportion of adenoid hypertro phy,the time of tube extrusion,the relapse of osecretory otitis media and repeat operation between two groups were compared.Results The difference of preoperative PTA and post operative PTA were not significant different between two groups(P＞0.05).But post operative PTA was lower than preoperative PTA(P＜0.05).The difference of otitis media recurrence was not significant different between two groups(P=0.088),but adenoid hypertrophy's proportion,tube extrusion's time and relapse were significant different(P＜0.05).Conclusion For school-age children with secretory otitis media need to extend the catheter time to reduce the probability of secondary catheterization.

The protective roles of alpha-lipoic acid in the rat model of mitochondrial DNA (mtDNA) 4834bp deletion in inner ear were investigated. Forty female Wistar rats at 4 weeks of age were divided into four groups: group A (D-galactose group, n=10), group B (D-galactose+alpha-lipoic acid group, n=10), group C (alpha-lipoic acid group, n=10), and group D (control group, n=10). Auditory brainstem response (ABR) was used to detect the hearing threshold. Colorimetry was used to analyze activity of superoxide dismutase (SOD) and concentration of malondialdehyde (MDA). The percentage of mtDNA4834bp deletion in inner ear was identified by real-time PCR. There was no significant difference in ABR threshold shift among all groups. The percentage of mtDNA4834bp deletion in group A was higher than that in other groups, but there was no significant difference in percentage of mtDNA4834bp deletion among groups B, C, and D. The activity of SOD in group A was lower than that in other groups. The concentration of MDA in group A was higher than that in other groups. It was concluded that there was no significant hearing loss when the percentage of mtDNA4834bp deletion was lower than 12.5%. alpha-Lipoic acid could prevent the reactive oxygen species (ROS)-induced mtDNA4834bp deletion in inner ear of rats.

Objective To analyze the incidence,mortality and survival rates of pancreatic cancer in Pudong New Area of Shanghai from 2002 to 2010.Methods The residents in Pudong New Area of Shanghai were recruited in this study during the period 2002 ～ 2010,the incidence,mortality were calculated according to different age groups and genders.The standardized morbidity and mortality of pancreatic cancer were calculated by world standard population.Logarithmic linear regression was used to calculate the annual percentage change (APC) of incidence and mortality.The 1 ～ 5 year survival of pancreatic cancer patients was analyzed by Kaplan-Meier method and COX regression analysis,and the survival of patients with different TNM staging,with or without operation was determined.Results Among 3089 newly occurred pancreatic cancer cases during 2002 ～ 2010,1707 and 1382 cases were males and females,respectively,with an average age of (69 ± 12) and (73 ± 12) years old,the crude incidence for both genders was 13.32/100 000,and it was 14.71/100 000 for males,which was higher than that in females (11.93/100 000).The ratio of male and female for incidence of age standardize was 1.57:1.There were 2963 death in total,including 1627 males and 1336 females,with a crude mortality rate of 12.78/100 000.The crude mortality rate for males was 14.02/100 000,which was higher than that in females (11.53/100 000).The ratio of male and female ASR for mortality was 1.55:1.Both incidence and mortality significantly increased for males aged over 35 and females aged over 40.The peak of morbidity and mortality appeared in male over 80 years old,and in female over 85 years old.The 1 ～ 5 year survival rates of pancreatic cancer patients were 16.59％,7.31％,5.23％,4.33％ and 3.87％,respectively.The differences in 1 ～5 year survival rates between surgical and non-surgical management groups were statistically significant (P ＜ 0.05).The median survival time of TNM 0 ～ Ⅱ,Ⅲ and Ⅳ staging was (250.00 ± 33.37),(224.00 ± 15.82),(86.00 ± 4.52) d.There was a statistically significant difference among the survival of TNM-Ⅳ and TNM 0 ～ Ⅰ,TNM Ⅲ (P ＜ 0.001).Conclusions The incidence and mortality of pancreatic cancer in males are higher than those in females in Pudong New Area of Shanghai.The survival is associated with TNM staging at diagnosis and whether surgical operation is performed.