Objective To investigate condition of single drug or multiple drug resistance and sensitivities of different combinations of antibiotics in Helicobacter pylori (H.pylori) infected patients of different ages in Jiaxing City,Zhejiang Province.Methods From January 2007 to December 2011,a total of 6280 patients underwent gastroendoscopy examination were enrolled,the average age of them was 50.8 years old.Among them,129 cases were less than 20 years old,1802 cases were between 20 and 40,3016 cases were between 40 and 60,and 1333 cases were over 60.The mucosa of gastric antrum was collected for H.pylori culture.Drug sensitivity of isolated H.pylori strains was tested with metronidazole,amoxicillin and gentamycin,furazolidone,clarithromycin and levofloxacin.x2 test was performed for the comparison of drug resistance among different age groups.Results Among 6280 specimens,H.pylori culture of 2311 cases was positive (positive rate 36.80％).The positive rate of patients aged between 40 and 60 was the highest (38.43％,1159/3016),and that of patients over 60 was the lowest (33.76％,450/1333).The drug resistance rate of metronidazole in patients between 20 and 40 years reached 98.02％ (644/657) and was the highest.The drug resistance rate of clarithromycin in patents over 60 years old was the highest,which was 22.67％(102/450).The drug resistance rates of the levofloxacin,furazolidone,amoxicillin and gentamicin were low of all ages.Mixed resistance of two antibiotic appeared in 586 strains,mixed resistance rate of metronidazole and clarithromycin was the highest (259 strains,15.23 ％).Mixed resistance of three drugs appeared in 49 strains,mixed resistance rate of metronidazole,clarithromycin and levofloxacin was the highest (32 strains,12.88％).A total of 1691 strains were sensitive to the combination of amoxicillin and gentamycin,the sensitive was rate 99.41％.The sensitive rate of the combination of amoxicillin and furazolidone,gentamycin and furazolidone was both 94.24％.Conclusions Metronidazole presented high drug resistance of all ages,and should not be chosen.The combination use of amoxicillin and gentamicin is the ideal antibiotic combination for different ages.The combination of gentamycin and furazolidone is recommended for patients who are allergic to penicillin.

Promoting medical preventive integration and improving its collaborative mechanism is an inevitable requirement for achieving the transformation of China′s medical and health care system from " disease centered" to " people′s health centered" and providing comprehensive and comprehensive health services for the people.This study established a research framework based on the SFIC model on the basis of clarifying the collaborative subjects of medical preventive integration, sorted out the dilemma of medical preventive integration collaborative governance in China from five aspects, including external environment, starting conditions, facilitative leadership, institutional design and collaborative process.In order to break the dilemma of medical preventive integration and promote collaborative governance among multiple subjects, the authors proposed such optimization strategies, including further improving relevant laws, regulations, and policy systems, filling resource gaps, attracting multiple entities to participate, providing reference for promoting China′s medical preventive integration work.

Objective:To explore the problems of medical and preventive integration at primary healthcare institutions in China, for references for promoting the development of medical and preventive integration in China.Methods:This study searched for literatures covering the integration of medical and preventive at primary healthcare institutions on CNKI, Wanfang, and VIP databases(from the establishment of the database until March 1, 2023), and extracted text mentioning problems of the medical and preventive integration in primary healthcare institutions. The macro model of the health system was used for problem classification analysis, while the social network analysis method was used to measure the network density, point centrality, and intermediary centrality of the problem, and determine the key issues.Results:A total of 25 papers were included, and 28 problems of medical and preventive integration at primary medical and health institutions were extracted, including 6 problems at the external environment level, 15 problems at the structural level, 6 problems at the process level, and 1 problem at the result level. The results of social network analysis showed that the network density of these problems was 0.71. The point centrality and intermediary centrality of key problems were both high, including the lack of incentive mechanisms for medical and prevention integration (point centrality=69, intermediary centrality=21.44), fragmentation of health information systems(68, 15.70), insufficient awareness of medical and prevention integration among grassroots personnel(65, 17.47), shortage of talent at primary medical and health institutions(64, 11.69), weak service capabilities of primary medical institutions(50, 19.23), and insufficient information sharing(48, 15.80).Conclusions:A variety of problems were found in the integration of medical and preventive at primary medical and health institutions in China, which were closely interrelated. It was urgent to solve six key problems, including the lack of incentive mechanisms, talent shortage, and information system fragmentation, etc. It was suggested that primary medical and health institutions should further improve the incentive mechanism for medical and preventive integration, strengthen the construction of grassroots health talent teams, promote health information exchange and sharing, and enhance the awareness of medical and preventive integration.

Objective To observe the value of augmented reality(AR)navigation system for assisting CT-guided puncture of pulmonary nodules in dog models.Methods Five healthy dogs were selected,and 4 target lung rings were implanted in each dog to build pulmonary nodule models.Deferring to crossover design,CT-guided punctures were performed with or without AR navigation 2 and 4 weeks after successful modeling,respectively,while punctures with AR navigation were regarded as AR group and the others as conventional group,respectively.The time duration of puncturing,the times of CT scanning,of needle adjustment,and the deviation distance between needle pinpoint to the center of pulmonary nodule shown on three-dimensional reconstruction were compared between groups.Results The duration time of puncture in AR group and conventional group was(13.62±5.11)min and(20.16±4.76)min,respectively.In AR group,the times of CT scanning,of needle adjustment,and the deviation distance was 2.40±0.50,2.75±0.44 and(2.94±1.92)mm,respectively,while in conventional group was 3.10±0.64,3.70±0.57 and(4.90±3.38)mm,respectively.The introduction of AR navigation was helpful to shortening the duration of puncture,reducing times of CT scanning and needle adjustment,also decreasing positioning error of needle pinpoint(all P＜0.05).In contrast,the variance of puncture sequences and dogs had no obvious effect on the results(both P＞0.05).Conclusion AR navigation system could improve accuracy and efficiency in CT-guided puncture of pulmonary nodules in dog models.

Objective To evaluate the application value of percutaneous angle positioning system based on augmented reality in improving the accuracy of liver puncture.Methods A canine liver with an embedded marking ring was used as the target for puncture.A skilled physician with over 5 years of experience in liver puncture and a novice physician with limited experience in liver puncture separately performed liver puncture using either the augmented reality-based percutaneous angle localization system(navigation)or CT-guided technique alone(non-navigation).The corresponding puncturing data of non-navigation skilled group(Group A),non-navigation non-skilled group(Group B),navigation skilled group(Group C),and navigation non-skilled group(Group D)were obtained.The differences in the evaluation indicators,including the number of CT scans,number of needle adjustment,time spent for operation,and distance of error,between Group A and Group B,between Group C and Group D,between Group A and Group C,and between Group B and Group D,were analyzed.Results Statistically significant differences in the number of CT scans,number of needle adjustment,time spent for operation,and distance of error existed between Group A and Group B,between Group A and Group C,and between Group B and Group D(all P＜0.0 5),while the differences in the number of CT scans,number of needle adjustment,time spent for operation,and distance of error between Group C and Group D were not statistically significant(all P＞0.05)Conclusion In performing liver puncture,the use of percutaneous angle localization system can reduce the number of CT scans,number of needle adjustment,time spent for operation and distance of error,and improve the puncture accuracy as well,which provides a basis for the clinical utilization of this system and the employment of this system-guided puncture technology in primary hospitals.(J Intervent Radiol,2024,33:507-511)

Purpose To explore the application value of contrast enhancement boost(CE-Boost)technique in image quality of tumors and their feeding arteries in preoperative evaluation of renal cancer patients.Materials and Methods A total of 36 renal cancer patients in People's Hospital Affiliated to Shandong First Medical University from August 2022 to May 2023 with pathologically confirmed were retrospective collected.All patients underwent renal enhanced CT.The cortical phase images were post-processed using the CE-Boost technique to obtain CE-Boost images.The cortical phase images were set as group A and the CE-Boost images were set as group B.The CT value and image noise(SD)of abdominal aorta,renal artery,tumor and its adjacent renal cortex,and SD of the vertical spinal muscle on both sides of the spine of two groups were measured and recorded,and then the signal-to-noise ratio and contrast-to-noise ratio of tumor,abdominal aorta and renal artery were calculated.The image quality of the tumor,tumor feeding artery and renal artery was scored on 4 points by 2 doctors with double-blind method.Results The signal-to-noise ratio,contrast-to-noise ratio and CT value of group B were significantly higher than those of group A(t=-27.385--5.267,all P<0.05).The SD of tumor,abdominal aorta,right and left renal artery were not significantly different between group A and B(t=-1.849-0.993,all P>0.05).The subjective score of tumor in group A and B were no significant difference(Z=-1.490,P=0.136).However,the subjective score of tumor feeding arteries and renal arteries were significantly higher in group B than in group A(Z=-3.512,P=0.000;Z=-2.127,P=0.033).Conclusion The CT CE-Boost technique can improve the image quality of renal enhanced CT and provide visualization of tumor feeding arteries.