Objective To investigate the causes of hearing loss for people over 60 years old. Methods People more than 60 years old in 14 provinces, 22 districts were investigated with a self-designed questionnaire, and a hearing test was also done for every subject. Results Among all the subjects, the etiological factors of hearing loss were otitis media (10.5%), hereditary deafness (2.9%), noise-induced hearing loss (3%), ototoxic deafness (6.4%), traumatic deafness (2%), presbycusis (33.8%), sudden deafness (1%) and other reasons (36.2%), respec-tively, with 11.3%unknown. Conclusion Presbycusis is the main reason of hearing loss for old people, and otitis media is the second. The cause of hearing loss is different with ages, districts, and whether in rural areas.

This report analyzes the status of schistosomiasis epidemic,surveillance and challenges in transmission?interrupt?ed areas of Jiangxi Province. There are 24 schistosomiasis transmission interrupted counties(cities,districts)among 39 endem?ic counties(cities,districts). Among the 24 counties,there are 6 counties with Oncomelania hupensis snails and 461 villages endemic,with 1.29 million residents. Since 2009,there have not been acute and chronic cases of schistosomiasis and all the pa?tients are historical advanced schistosomiasis cases. The area with snail habitats is 37.02 hm2. Since 2015,the schistosomiasis surveillance has covered the entire transmission interrupted areas. However,there are still many challenges,such as endemic in?stability,weak surveillance capacity,lack of surveillance awareness and other issues. Towards the schistosomiasis elimination, the surveillance should be based on the snail monitoring mainly,supplemented by the mobile population monitoring,and in ad?dition,the capacity building,standardized report of endemic,and snail habitat reform should also be further strengthened.

Inflammatory Bowel Disease(IBD) is concerned with heredity,dysimmunity,environment and others,its characterized by chronic or relapsing inflammation within the gastrointestinal.IBD including two independent disease ulcerative colitis and crohn′s disease.In recent years with the incidence of IBD increased year by year,more women in reproductive age facing drug treatment.This article elucidated the effect of IBD and its treatment on perinatal.

Objective To explore the effects of patient participation-based dietary intervention on nutritional status for patients with gastrectomy.Methods Fifty-two patients with gastrectomy were randomly assigned to the intervention group(n=26) and the control group(n=26).All patients were given general dietary guidance,and patients in the intervention group were provided patient participation-based dietary intervention(PPDI) as well.Height,body weight and body mass index(BMI) were recorded at baseline,2 weeks and 12 weeks after intervention,using PatientGenerated Subjective Global Assessment(PG-SGA),Diet-Related Symptom Scale,Adherence to Dietary Scale and a 3-day food diary.Results There was no obvious change in body weight and BMI before and after 12-week intervention,while outcomes in the control group gradually decreased.For time effect,there was significant difference in PG-SGA between two groups(P＜0.05).For between-group effect,there were significant differences in diet-related symptoms(P＜0.05),dietary intake(P＜0.05) and adherence to dietary(P＜0.05) between two groups.Conclusion Patient participation-based dietary intervention can improve nutritional status for patients with gastrectomy.

In order to have a better basic research of needle sticking, reports regarding basic research of needle sticking in recent years are arranged and summarized, including the concepts of needle sticking, the history origin, manipulation methods, precautions and selection requirements of needles. In the meanwhile, the reinforcing and reducing manipulation in sticking of the needle is preliminarily analyzed, and based on analysis of ancient records, three hypotheses are proposed: (1) needle sticking partly belongs to reinforcing method; (2) needle sticking partly belongs to reducing method; (3) needle sticking can perform reinforcing and reducing effects according to different manipulations. It is also believed that the needle sticking in modern clinical research is mostly used for reducing effects. However reinforcing and reducing manipulation in sticking of the needle still lacks of the support from ancient literature theory and modern clinical application, which needs to be improved.
Acupuncture Therapy ; instrumentation ; methods ; Humans ; Medicine in Literature ; Needles

Erythromycin A is a clinically important macrolide antibiotic with broad-spectrum activity. Its biosynthesis involves the formation of the 14-membered skeleton catalyzed by polyketide synthases, and the modification steps such as hydroxylation, glycosylation and methylation. Based on the understanding of the biosynthetic mechanism, it is reliable to genetically manipulate the erythromycin A-producing strain for production improvement and structure modification. In this paper, we reviewed the progress regarding erythromycin A in high-producing strain construction and chemical structure derivation, to provide insights for further development.
Anti-Bacterial Agents ; biosynthesis ; chemistry ; Erythromycin ; biosynthesis ; chemistry ; Glycosylation ; Hydroxylation ; Methylation ; Multigene Family ; Polyketide Synthases ; metabolism

Objective To study the risk factors for pulmonary fungal infection associated with chronic obstructive pulmonary disease (COPD),and evaluate the efficacy and safety of itraconazole for treatment of pulmonary fungal infection associated COPD.Methods A retrospective analysis were conducted on clinical data of 42 COPD patients who were confirmed pulmonary fungal infection in a respiratory disease department from September 1 ,2007 to May 31 ,2012,and 53 COPD patients who had no pulmonary fungal infection were as control.Results Of 42 patients with COPD and pulmonary fungal infection,8 were confirmed by histopathological examination,34 were confirmed by clinical diagnosis;6 were acute cases,36 were chronic cases;28 were positive for fungal detection,6 of whom were detected Candida albicans ,13 were detected Aspergillus ,7 were detected unclassified fungi,and 2 had mixed fungal infection.Univariate analysis showed that underlying diseases,long-term use of broad-spectrum antimicrobi-als,long-term use of glucocorticoid,hypoproteinemia,invasive procedure,invasive mechanical ventilation,diabetes mellitus,history of invasive fungal infection were major risk factors for pulmonary fungal infection associated with COPD.After patients were treated by itraconazole,the improvement rate of clinical symptoms was 66.67%,fungal eradication rate was 60.71 %,total effective rate was 64.29%.Of 28 cases with positive fungal detection,the im-provement rate of clinical symptoms,fungal eradication rate,and total effective rate was 71 .43%(n=20),60.71 %(n=17),and 67.86%(n=19)respectively.Itraconazole had good therapeutic efficacy on acute and chronic pulmo-nary fungal infection associated with COPD.Adverse drug reaction rate was 23.81 %,most were mild and reversi-ble,and had no obvious impact on the treatment.Conclusion Itraconazole has positive clinical efficacy on treating pulmonary fungal infection associated with COPD,it is highly safe.

Objective To analyze the related influencing factors of progressive ischemic stroke, and to investigate the value of serum markers for prediction of progressive ischemic stroke. Methods Three hundred and six patients with acute cerebral infarction were divided into progressive ischemic stroke (PIS) group (n=91) and non-progressive ischemic stroke (NPIS) group (n=215). Data of gender, age, past medical history, personal history and serum markers were collected and compared in two groups. Binary Logistic regression was used to analyze the influencing factors of PIS. The receiver operating characteristic (ROC) curves of neutrophils to lymphocytes ratio (NLR), fibrinogen and fasting blood glucose were analyzed in two groups. Results Positive rates of hypertension history, diabetes history, hypercholesterolemia history, incidence of large artery atherosclerotic (LAA) stroke were significantly higher in PIS group than those in NPIS group ( P<0.05). The levels of neutrophils, NLR, fibrinogen and fasting blood glucose were significantly higher, but the level of lymphocytes was significantly lower in patients with PIS than those in patients with NPIS (P<0.05). Logistic regression analysis confirmed that diabetes, LAA stroke, NLR, fibrinogen and fasting blood glucose were independent risk factors for the PIS ( P<0.05). The areas under ROC curve by NLR, fibrinogen and fasting blood glucose were 0.777, 0.560 and 0.574, respectively. The sensitivities of NLR, fibrinogen and fasting blood glucose were 72.5%, 59.8%and 47.3%, respectively;and the specificities were 76.7%, 51.2% and 69.8%, respectively. Conclusion The occurrence of PIS is related with blood pressure, blood lipids, inflammatory cells in peripheral bolld, fibrinogen and fasting blood glucose. The level of NLR in peripheral blood can predict the occurrence of PIS, which can be used as an important reference index for early diagnosis of PIS.

Objective To study the relationship between serum uric acid (UA) level and cerebrovascular stenosis in acute ischemic stroke (AIS) patients.Methods Five hundred and thirteen patients with AIS or old IS admitted to our hospital from April 2014 to April 2016 were divided into primary IS group (n=236),recurrent IS group (n=136),and old IS group (n=141).Venous blood samples were taken on admission for biochemical testing.The patients were further divided into serum UA≤255 μmol/L group (n=128),serum UA=256-312μmol/L group (n=129),serum UA=313-371 μmol/L group (n=129),and serum UA＞371 μmol/L group (n=127).Their cerebrovascular stenosis was assessed by CT angiography or magnetic resonance angiography after admission.Results The severity of cerebrovascular stenosis,hypertension,diabetes and hyperlipidemia was significantly different in primary IS group,recurrent IS group and old IS group (27.5％ vs 33.8％ vs 12.8％、24.2％ vs 28.7％ vs 46.8％、61.9％ vs 49.3％ vs 40.4％、71.6％ vs 61.8％ vs 46.8％,P=0.000).Logistic regression analysis showed that serum UA≤ 255 μmol/L was an independent risk factor for cerebrovascular stenosis (OR =2.787,95 ％CI:2.209-3.365,P=0.001).The risk of cerebrovascular stenosis decreased gradually with the elevated serum UA level.Conclusion Serum UA level is not directly related with recurrent IS.Low serum UA level is a risk factor for cerebrovascular stenosis in AIS.

Objective To study the inconsistent relation of twin discordancy and the umbilical artery blood flow parameter of systolic/diastolic ratio.Methods 358 pregnant women were divided into the two groups of develop-mental nonidentity( n=67 ) and developmental identity ( n=291 ) according to the criterion that the differences of twins weight exceeded 25 percent.The umbilical artery blood flow parameter of systolic/diastolic ratio were observed. Meanwhile,the difference of weight and the umbilical artery blood flow parameter of systolic/diastolic ratio in the group of developmental nonidentity were observed.Results A significant difference of the umbilical artery blood flow parameter of systolic/diastolic ratio were found in the two groups of developmental nonidentity and developmental identity(7.81%vs 32.56%,P<0.05).There were 56 cases that twins weight exceeded from 25 to 35 percent,7 cases that twins weight exceeded from 35 to 45 percent and 4 cases that twins weight exceeded 45 percent in the group of developmental nonidentity which the umbilical artery blood flow parameter of systolic/diastolic ratio were (23.66 ± 5.78)%,(27.16 ±7.25)% and (33.16 ±4.23)% correspondingly with significant difference(F=23.21,P<0.05 ) .Conclusion The umbilical artery blood flow parameter of systolic/diastolic ratio has significance in diagnosis of twin discordancy.