Objective] The study analyzes the current situation of public’s satisfaction and expectation on the grass-roots’work of TCM in our province to make advice on improvement. [Method] From the perspective of service objects, combining with satisfaction theory and using the method of random surveys, the article does the researches on the publics’satisfactions and expectations on 24 projects related to the grass-roots levels of TCM and puts forward corresponding countermeasure against those problems. [Consequence] The degree of satisfaction ranges from 65 to 72, average is 68.685; the highest degree of satisfaction is the therapeutic effects of TCM, but the lowest one is medical costs. The degree of expectation ranges from 79~86, average is 83.931, the highest degree of satisfaction is diagnostic reference level of medical staff from the grass-roots ’work of TCM, the lowest one is characteristic service projects of TCM. [Conclusion] The study analyzes and evaluates the grass-roots ’work of TCM by the related theory of satisfaction, having significant meaning on improving the management services’level of the grass-roots’work and the performance evaluation of government.

PurposeTo study the pharmacokinetic characteristics of omeprazole in Chinese extensive and poor metabolizers.Methods The pharmacokinetics of omeprazole was studied in eighteen healthy volunteers. After a single oral dose of omeprazole capsule(40 mg), the plasma concentrations of omeprazole and its two metabolites, 5-hydroxyomeprazole and omeprazole sulfone, were determined with reversed HPLC method. The plasma concentration-time data were analyzed to estimate the pharmacokinetic parameters. Results Both plasma omeprazole concentration and the pharmacokinetic parameters exhibited marked interindividual variation. The metabolic ratio (MR= plasma omeprazole/5-hydroxyomeprazole) obtained 3.5 h after medication was used to distinguish between extensive and pcr)r metabolizers (EMs, PMs). The variances of AUC(0-12) caused by the two metabolizer phenotypes accounted for 75.4 % of the total interindividual variances. AUC(0-12) of omeprazole was (1 971.78 ±1 221.78)ng·h/ml in EMs( n=12) and (8 587.18±2 855.48) ng·h/ml in PMs (n = 6),respectively (P<0.01),and CL in EMs and PMs was estimated as (16.00±9.71) and (4.79±1.32) L/h (P<0.01). Accordingly,significantly lower level of plasma 5-hyclroxyomeprazole was found in PMs, revealing a slower hydroxylation rate compared with EMs. Conclusions The results suggest that individualized dose regimen of omeprazole, based on identification of metabolizer phenotype, can be of great benefit from the viewpoint of pharmacoeconomics.

Bronchial asthma is one of the most common childhood chronic respiratory diseases characterized by airway hyperresponsiveness and reversible airflow limitation.Air pollution, especially PM2.5(fine particle size ≤2.5 microns)has a significant effect on asthma, through oxidative stress, immune inflammatory injury, airway hyperresponsiveness and other mechanisms.This paper describes the source, composition, physical and chemical properties of PM2.5, the mechanism of PM2.5 induced asthma, and its effects on acute bronchial asthma attack, acute outpatient consultation rate, hospitalization rate, lung function and exhaled nitric oxide(FeNO).

Objective:To analyze the utilization of traditional Chinese medicine (TCM) services and its influencing factors among home-based elderly care population in Zhejiang Province.Methods:A multi-stage stratified cluster random sampling method was used to enroll 2 300 home-based elderly care population aged 65 years and over and lived in the local area for 6 months and above in Zhejiang Province. The basic characteristics, health status and behavior, TCM cultural literacy, TCM cognitive beliefs and TCM service usage of the subjects were collected by face-to-face questionnaires from July 15 to August 15, 2021, and 2 123 valid questionnaires were recovered. Unconditional logistic regression was applied to analyze the influencing factors of TCM service usage among home-based elderly care population.Results:The overall utilization rate of TCM services among home-based elderly care population in Zhejiang Province was 36.46% (774/2 123). The utilization rates of the 6 types of TCM from high to low was oral administration of traditional Chinese medicine (22.00%), external treatment with traditional Chinese medicine (15.12%), acupuncture treatment (11.96%), medicated diet conditioning (7.44%), constitution identification (7.40%) and exercise conditioning (4.57%). Home-based elderly care population lived in urban areas, had never been to school, with education of primary school or high school and above, suffered from chronic diseases, moderate activities or physical exercise, believed in TCM and had attended lectures on TCM knowledge were more inclined to use TCM services (all P<0.05); agricultural laborers, production and transportation workers and family laborers before retirement were less inclined to use TCM services (all P<0.05); women, those with medical insurance, those drinking alcohol and those with better TCM cultural literacy were more inclined to use 2 and more kinds of TCM services (all P<0.05). Conclusions:The utilization rate of TCM services among home-based elderly care population in Zhejiang Province is relatively high; gender, place of residence, education level, occupation before retirement, medical insurance, belief in TCM, and participation in TCM knowledge lectures are the main influencing factors of the use of TCM services among home-based elderly care population.

Objective To explore the application of PDCA nursing management in central venous catheter of elderly patients with malignant tumor patients.Methods Totally 120 cases of elderly cancer patients with PICC were divided into the observation group ( from January 2015 to December 2015, n=60) and the control group ( from January 2014 to December 2014, n=60) according to the time of admission from January 2014 to December 2015. Patients in the observation group were given PDCA nursing management, while patients in the control group were given routine nursing management. The PICC related infections, adverse nursing events occurrence and the nursing effect of two groups were compared.Results The PICC related infection, mechanical phlebitis, unplanned extubation rate, catheter slippage rate and catheter blockage rate of the observation group were lower than those of the control group (P<0.05). The compliance, the success rate of one-time puncture and the satisfaction rate of the observation group were higher than those of the control group (P<0.05); the indwelling catheter time was longer than the control group ( P<0. 05 ) . The nurse communication ability, responsibility, PICC operation skills, service attitude, writing standards, PICC accident and other nursing quality score in the observation group were higher than the control group ( P<0. 05). Conclusions PDCA nursing management can effectively improve the nursing quality of elderly patients with malignant tumor who had PICC;reduce the PICC related infections and nursing accidents; prolong the time of indwelling catheter in patients;and improve the patient′s satisfaction rate.

OBJECTIVETo study the relationship between polymorphism of inducible Nitric Oxide Synthase (iNOS) gene and the susceptibility of intestinal type stomach cancer and stomach cardia cancer in Chinese people.

METHODSA community-based case-control study was designed. Ninety-three intestinal type of stomach cancer and 50 stomach cardia cancer patients with endoscopy and pathology diagnosis were identified as cases. Two hundred and forty-six controls served as controls.

RESULTSC-->T polymorphism was found in exon 16 of iNOS gene, which changed the coding amino acid from serine to leucine, and formed a recognition site identified by Tsp 509 I restriction enzyme (we called it C-->T polymorphism). The T allele gene frequency in the control group was 13.21%. No statistically significant difference was found between C-->T polymorphism alone and the increased susceptibility to intestinal stomach cancer or stomach cardia cancer. A significant type 2 multiplicative interaction was found in increasing both the risk of intestinal stomach cancer and stomach cardia cancer when both C-->T polymorphism and tobacco smoking exposure existed. An additive interaction model, which showed statistically significant difference, was found to increase only the risk of stomach cardia cancer when CagA antibody shared negative but C-->T polymorphism occurred.

CONCLUSIONC-->T polymorphism of iNOS gene was considered as one of the possible susceptible genes, which specifically increased the risk of tobacco-related but CagA negative types of intestinal stomach cancer and stomach cardia cancer.

Antibodies, Bacterial ; blood ; Antigens, Bacterial ; immunology ; Bacterial Proteins ; immunology ; Genetic Predisposition to Disease ; Humans ; Nitric Oxide Synthase ; genetics ; Nitric Oxide Synthase Type II ; Polymorphism, Genetic ; Stomach Neoplasms ; genetics

Background: Microsporum canis is a zoonotic disease that can cause dermatophytosis in animals and humans. Objectives: In clinical practice, ketoconazole (KTZ) and other imidazole drugs are commonly used to treat M. canis infection, but its molecular mechanism is not completely understood.The antifungal mechanism of KTZ needs to be studied in detail. Methods: In this study, one strain of fungi was isolated from a canine suffering with clinical dermatosis and confirmed as M. canis by morphological observation and sequencing analysis.The clinically isolated M. canis was treated with KTZ and transcriptome sequencing was performed to identify differentially expressed genes in M. canis exposed to KTZ compared with those unexposed thereto. Results: At half-inhibitory concentration (½MIC), compared with the control group, 453 genes were significantly up-regulated and 326 genes were significantly down-regulated (p < 0.05). Quantitative reverse transcription polymerase chain reaction analysis verified the transcriptome results of RNA sequencing. Gene ontology enrichment analysis and Kyoto Encyclopedia of Genes and Genomes enrichment analysis revealed that the 3 pathways of RNA polymerase, steroid biosynthesis, and ribosome biogenesis in eukaryotes are closely related to the antifungal mechanism of KTZ. Conclusions The results indicated that KTZ may change cell membrane permeability, destroy the cell wall, and inhibit mitosis and transcriptional regulation through CYP51, SQL, ERG6, ATM, ABCB1, SC, KER33, RPA1, and RNP genes in the 3 pathways. This study provides a new theoretical basis for the effective control of M. canis infection and the effect of KTZ on fungi.

Objective:To observe the clinical efficacy of a new type of "firebreak" drainage with skin preservation in the treatment of Fournier's gangrene.Methods:This technique is suitable for patients with perianal necrotizing fasciitis who can tolerate surgery without large area of skin blackness and necrosis. Procedure and key points: (1) The dividing line between inflammatory tissue and normal tissue was determined according to imaging examination and intraoperative exploration; (2) The abscess cavity was cut along the most obvious part of the abscess fluctuation, with a long diameter of 3~4 cm and a short diameter of 1~2 cm; (3) Necrotic tissue was discreetly separated and removed from the main incision to the outer edge of the infection. A fusiform incision was made every 3 to 5 cm, with a long diameter of 2 to 3 cm and a short diameter of 1 cm, and discreetly separated until the normal tissue, and a hose was hung between the adjacent incisions for drainage. (4) Each adjacent edge cut between the stealth separation and hanging hose drainage, forming a "firebreak"; (5) Rinse the wound repeatedly; (6) If the infection invades the rectum, colostomy is performed as required. The case data of 11 patients with perianal necrotizing fasciitis admitted to the Second Affiliated Hospital of Nanjing University of Chinese Medicine from July 2019 to February 2023 were retrospectively analyzed. All patients were treated with emergency surgical debridement by "firebreak" drainage with skin preservation.Results:All 11 cases were cured with 100%. One case underwent multiple operations. The hospitalization time was 11-46 days, with an average of 22 days. The wound healing time was 28-75 days, with an average of 43 days. Except for 1 patient with trauma, all the other patients had no significant anal function injury after surgery. All the 11 patients recovered and were discharged from hospital with a median follow-up of 136 (115-413) days.Conclusions:The "firebreak" drainage based on skin preservation has the advantages of less trauma and faster recovery, and do not cause obvious anal function damage.

Objective:To observe the clinical efficacy of a new type of "firebreak" drainage with skin preservation in the treatment of Fournier's gangrene.Methods:This technique is suitable for patients with perianal necrotizing fasciitis who can tolerate surgery without large area of skin blackness and necrosis. Procedure and key points: (1) The dividing line between inflammatory tissue and normal tissue was determined according to imaging examination and intraoperative exploration; (2) The abscess cavity was cut along the most obvious part of the abscess fluctuation, with a long diameter of 3~4 cm and a short diameter of 1~2 cm; (3) Necrotic tissue was discreetly separated and removed from the main incision to the outer edge of the infection. A fusiform incision was made every 3 to 5 cm, with a long diameter of 2 to 3 cm and a short diameter of 1 cm, and discreetly separated until the normal tissue, and a hose was hung between the adjacent incisions for drainage. (4) Each adjacent edge cut between the stealth separation and hanging hose drainage, forming a "firebreak"; (5) Rinse the wound repeatedly; (6) If the infection invades the rectum, colostomy is performed as required. The case data of 11 patients with perianal necrotizing fasciitis admitted to the Second Affiliated Hospital of Nanjing University of Chinese Medicine from July 2019 to February 2023 were retrospectively analyzed. All patients were treated with emergency surgical debridement by "firebreak" drainage with skin preservation.Results:All 11 cases were cured with 100%. One case underwent multiple operations. The hospitalization time was 11-46 days, with an average of 22 days. The wound healing time was 28-75 days, with an average of 43 days. Except for 1 patient with trauma, all the other patients had no significant anal function injury after surgery. All the 11 patients recovered and were discharged from hospital with a median follow-up of 136 (115-413) days.Conclusions:The "firebreak" drainage based on skin preservation has the advantages of less trauma and faster recovery, and do not cause obvious anal function damage.

Objective:To prepare the chitin/hyaluronic acid/collagen hydrogel loaded with mouse adipose-derived stem cells and to explore its effects on wound healing of full-thickness skin defects in rats.Methods:The research was an experimental research. Chitin nanofibers were prepared by acid hydrolysis and alkaline extraction method, and then mixed with hyaluronic acid and collagen to prepare chitin/hyaluronic acid/collagen hydrogels (hereinafter referred to as hydrogels). Besides, the hydrogels loaded with mouse adipose-derived stem cells were prepared. Thirty male 12-week-old guinea pigs were divided into negative control group, positive control group, and hydrogel group according to the random number table, with 10 guinea pigs in each group. Ethanol, 4-aminobenzoic acid ethyl ester, or the aforementioned prepared hydrogels without cells were topically applied on both sides of back of guinea pigs respectively for induced contact and stimulated contact, and skin edema and erythema formation were observed at 24 and 48 h after stimulated contact. Adipose-derived stem cells from mice were divided into normal control group cultured routinely and hydrogel group cultured with the aforementioned prepared hydrogels without cells. After 3 d of culture, protein expressions of platelet-derived growth factor-D (PDGF-D), insulin-like growth factor-Ⅰ (IGF-Ⅰ), and transforming growth factor β 1 (TGF-β 1) were detected by Western blotting ( n=3). Eight male 8-week-old Sprague-Dawley rats were taken and a circular full-thickness skin defect wound was created on each side of the back. The wounds were divided into blank control group without any treatment and hydrogel group with the aforementioned prepared hydrogels loaded with adipose-derived stem cells applied. Wound healing was observed at 0 (immediately), 2, 4, 8, and 10 d after injury, and the wound healing rate was calculated at 2, 4, 8, and 10 d after injury. Wound tissue samples at 10 d after injury were collected, the new tissue formation was observed by hematoxylin-eosin staining; the concentrations of interleukin-1α (IL-1α), IL-6, IL-4, and IL-10 were detected by enzyme-linked immunosorbent assay method; the expressions of CD16 and CD206 positive cells were observed by immunohistochemical staining and the percentages of positive cells were calculated. The sample numbers in animal experiment were all 8. Results:At 24 h after stimulated contact, no skin edema was observed in the three groups of guinea pigs, and only mild skin erythema was observed in 7 guinea pigs in positive control group. At 48 h after stimulated contact, skin erythema was observed in 8 guinea pigs and skin edema was observed in 4 guinea pigs in positive control group, while no obvious skin erythema or edema was observed in guinea pigs in the other two groups. After 3 d of culture, the protein expression levels of PDGF-D, IGF-I, and TGF-β 1 in adipose-derived stem cells in hydrogel group were significantly higher than those in normal control group (with t values of 12.91, 11.83, and 7.92, respectively, P<0.05). From 0 to 10 d after injury, the wound areas in both groups gradually decreased, and the wounds in hydrogel group were almost completely healed at 10 d after injury. At 4, 8, and 10 d after injury, the wound healing rates in hydrogel group were (38±4)%, (54±5)%, and (69±6)%, respectively, which were significantly higher than (21±6)%, (29±7)%, and (31±7)% in blank control group (with t values of 3.82, 3.97, and 4.05, respectively, Pvalues all <0.05). At 10 d after injury, compared with those in blank control group, the epidermis in wound in hydrogel group was more intact, and there were increases in hair follicles, blood vessels, and other skin appendages. At 10 d after injury, the concentrations of IL-1α and IL-6 in wound tissue in hydrogel group were significantly lower than those in blank control group (with tvalues of 8.21 and 7.99, respectively, P<0.05), while the concentrations of IL-4 and IL-10 were significantly higher than those in blank control group (with tvalues of 6.57 and 9.03, respectively, P<0.05). The percentage of CD16 positive cells in wound tissue in hydrogel group was significantly lower than that in blank control group ( t=8.02, P<0.05), while the percentage of CD206 positive cells was significantly higher than that in blank control group ( t=7.21, P<0.05). Conclusions:The hydrogel loaded with mouse adipose-derived stem cells is non-allergenic, can promote the secretion of growth factors in adipose-derived stem cells, promote the polarization of macrophages to M2 phenotype in wound tissue in rats with full-thickness skin defects, and alleviate inflammatory reaction, thereby promoting wound healing.