Medline is the most popular method for understanding foreign development of traditional Chinese medicine. However, be-cause of the difference of concept description in traditional and western medicine, incomplete of literature indexing, mapping deficiency of ATM to traditional Chinese medicine concept, it leads to the lack of comprehensive restdts. The paper proposes the fundamental principle for traditional medicine literature retrieval in Medline and analyzes the retrieval ideas and disciplines of single durg, compound, treatment by traditional Chinese medicine.

Objective To develop a conceptual framework for the synopsis of information of health examination reports (HERs) and its style sheet so as to provide a reference for information collection and management in health examination institutions.Methods A conceptual framework for the synopsis of information of HERs and its core data elements were developed based on HERs items from 11 health examination institutions,and a style sheet for the synopsis of information of HERs was then designed.Results The conceptual framework included 4 dimensions (e.g.identification information,health-related information,health exam summary,health evaluation and guidance),16 sub-dimensions,52 core data elements and 25 value domains.The structure and content of the designed sheet were consistent with the dimensions,subdimensions and core data elements of the conceptual framework.Conclusions The developed synopsis of information of HERs could be a feasible solution for structured and standardized representation of clients' health examination information.The selection and filling of some items should be validated and refined in the future.

Objective To investigate the correlation between matrix metalloproteinase-3 (MMP-3)serum level and polymorphism(5A/6A) and the stability of carotid plaque in Chinese Han population.Methods Two hundred and eighty acute cerebral infarction patients from the department of neurology of Taizhou Hospital were divided into carotid vulnerable plaque group and carotid stable plaque group according to the results of carotid B-mode uhrasonngraphy.Serum MMP-3 level waa measured by means of enzyme-linked immunosorbent assay (ELISA).At the same time, genotype was determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) for the common 5A/6A functional promoter polymorphism of the MMP-3 gene.The serum MMP-3 level and genotype frequencies of the MMP-3 gene between the two groups were analyzed.Results The genotype frequencies of the MMP-3 gene 5A/6A polymorphism of the two groups were in Hardy-Weinberg equilibrium The genotype distribution of the MMP-3 promoter 5A/6A polymorphism between the carotid vulnerable plaque group and the carotid stable plaque group was significantly different(χ2 =6.13, P =0.01, OR = 1.90, 95% CI 1.14-3.15).The frequencies of 5A allele were 20.6% and 12.8% in the carotid vulnerable plaque group and the carotid stable plaque group respectively (χ2=6.09, P=0.01, OR =1.76, 95%CI 1.12-2.77).Serum level of MMP-3 in the carotid vulnerable plaque group was higher than that in the carotid stable plaque group (t = 3.39, P =0.00).Conclusion The present findings suggest that serum level of MMP-3 and genetic polymorphism of 5A/6A in MMP-3 promoter are related with carotid vulnerable plaque in Chinese Han population and 5A allele may be a susceptible predictor of carotid vulnerable plaque.

Objective To evaluate the validity and reliability of learning attitude scale among nurses in continuing nursing education in hospital.Methods We designed a nurse learning attitude scale in continuing education on the basis of a learning attitude questionnaire for teacher-training by Jiao Weiting. In July 2015, totally 207 nurses of the Third Hospital of Mianyang who received continuing education in hospital were selected as the research object by cluster sampling method. We investigated their learning attitudes. The reliability of the scale was assessed by Cronbach's α coefficient and test-retest reliability. The validity was assessed by factor analysis and Pearson's correlation.Results The test-retest reliability of the scale were as the following:cogni-tive level (0.82),experience of emotion (0.89),tendency of behavior (0.91),total scale (0.88);Cronbach's α co-efficients were as the following:cognitive level (0.85),experience of emotion (0.94),tendency of behavior (0.83), total scale (0.89). According to the result of Pearson's correlation,the total scale of learning attitude exhibited a positive correlation with cognitive level,experience of emotion and tendency of behavior (P<0.01). Four prin-cipal components were extracted by factor analysis and the constructs of the instrument obtained were consistent with the conceived concept in essence.Conclusions The scale learning attitude could measure the learning attitude of nurses in continuing nursing education with better reliability and validity.

Objective To explore the effect of lean management on cost control of single disease in patients with acute cerebral infarction (ACI) in stroke center. Methods A retrospective study was conducted. The patients with ACI who underwent intravenous thrombolysis in the stroke center of Taizhou Central Hospital in Zhejiang Province were enrolled. Thirty patients adopted traditional management procedures from July 2016 to September 2017 were enrolled in the control group, and 32 patients received lean management from October 2017 to December 2018 were enrolled in the lean group. The patients in the control group were treated with traditional intravenous thrombolysis, and the patients were sent to the neurology ward for intravenous thrombolysis. The patients in the lean group applied lean management value stream to optimize process management, the lean management team of the stroke center was established, and the green channel for stroke treatment was established to eliminate the waiting time as far as possible. The location of thrombolysis was changed from neurology ward to the neurological intensive care unit (NICU) in emergency department. The patients in the two groups were compared in terms of intravenous thrombolytic door-to-needle time (DNT), admission time to the neurologist's visit time (T1), CT examination time to neurology ward or NICU admission time (T2), neurology ward/NICU visit time to medication time (T3), and the proportion of patients with DNT controlled within 40 minutes, recovery of neurological impairment 7 days after thrombolysis [national institutes of health stroke scale (NIHSS) score], activity of daily living assessment (Barthel index), length of hospital stay, cost of hospital stay and patient satisfaction. At the same time, the main process quality and the implementation rate of easily missed indexes of cerebral infarction single disease were recorded. Results Compared with the control group, DNT, T1 and T2 in the lean group were significantly shortened [DNT (minutes): 39.56±11.12 vs. 63.03±19.63, T1 (minutes): 16.23±6.79 vs. 33.48±12.63, T2 (minutes): 13.45±3.84 vs. 17.47±5.56, all P < 0.01], T3 was slightly shortened (minutes: 9.88±1.95 vs. 10.95±2.69, P > 0.05), and the proportion of DNT control within 40 minutes was significantly increased [75.0% (24/32) vs. 16.7% (5/30), P < 0.01], the 7-day NIHSS score was decreased significantly (8.66±4.12 vs. 13.00±5.63, P < 0.01), 7-day Barthel index was increased significantly (71.6±16.7 vs. 54.7±17.1, P < 0.01), the length of hospital stay was significantly shortened (days: 9.69±4.06 vs. 12.47±3.83, P < 0.01), the hospital costs were significantly reduced (Yuan: 16 338±5 481 vs. 19 470±5 495, P < 0.05), the satisfaction of patients was improved significantly [(91.38±2.69)% vs. (86.53±2.78)%, P < 0.01]. In terms of the implementation rate of quality indicators such as pre-application evaluation of thrombolytic drugs, evaluation of dysphagia, and evaluation of vascular function, health education of ACI, rehabilitation evaluation and implementation within 24 hours, etc., the lean group was significantly improved as compared with the control group [(87.5% (28/32) vs. 53.3% (16/30), 96.9% (31/32) vs. 73.3% (22/30), 78.1% (25/32) vs. 43.3% (13/30), 100.0% (32/32) vs. 76.7% (23/30), 75.0% (24/32) vs. 33.3% (10/30), all P < 0.05]. Conclusion Lean thinking can realize the standardization of stroke center process, effectively utilize medical resources, improve medical quality and reduce the cost of cerebral infarction single disease.

Objective To understand the prevalence of group sex in men who have sex with men (MSM) and related factors in Taizhou,Zhejiang province.Methods From March 2013 to September 2015,a cross-sectional survey was conducted among MSM recruited from gay bars or bath houses in Taizhou by using questionnaire to collect the information about their sexual behavior and HIV test.Results A total of 1 435 MSM were recruited,179 of them (12.5％) were HIV infected,231 (16.1％) reported group sex during the past year.Compared with MSM without group sex,more MSM with group sex had more than ten male sexual partners (53.7％ vs.19.0％,x2=125.527,P＜ 0.01),had both male and female sexual partners (86.6％ vs.68.2％,x2=31.935,P＜0.01),used no condom at sex with female partners during the past year (28.1％ vs.19.8％,x2=6.540,P＜0.05).After adjusted for educational level and occupation,group sex was associated with age [≥ 50 years old vs.≤ 24 years old,adjusted odds ratio (aOR)=2.25,P=0.027],marriage with female (divorced or widowed vs.unmarried,aOR=0.29,P=0.001),census registering (local resident vs.non-local resident,aOR=1.56,P=0.023),number of male seuxal partners (≥21 vs.2-5,aOR=8.06,P＜0.001;11-20 vs.2-5,aOR=3.25,P＜0.001) and number of female seuxal partners (≥6 vs.0,aOR=2.63,P=0.005;2-5 vs.0,aOR=2.58,P=0.001;1 vs.0,aOR=2.01,P=0.010).Conclusion The prcvalcncc of group sex in MSM was high in Taizhou,and their poor condom use and complex sex behaviors would result in higher HIV infection rate and risk of transmission.

Objective To explore the effect of omni-directional health education on self-management level and blood glucose control in patients with type 2 diabetes mellitus. Methods A total of 100 diabetic patients admitted to the department of neurology of Taizhou Central Hospital from January to December 2016 were randomly divided into an observation group and a control group, 50 cases in each group. All patients were given conventional medication according to their systemic conditions, the control group used conventional nursing care, while the observation group was supplemented with omni-directional health education (including diet control therapy, exercise therapy, blood glucose control, hypoglycemic drug use and observation, foot care, blood glucose self monitoring) on the basis of routine nursing;the course of treatment was 2 weeks in the two groups. The differences in self-management level and the effect of blood glucose control were compared between the two groups. Results On the return visits, the self-management scores were significantly higher in both groups than those before education (the control group was 35.2±9.2 vs. 30.1±5.2, the observation group was 78.6±11.5 vs. 29.8±5.4, all P < 0.05), fasting blood glucose [FBG (mmol/L): the control group was 8.8±2.5 vs. 14.8±2.9, the observation group was 6.1±1.6 vs. 15.1±2.7, both P < 0.05) and 2 hours postprandial blood glucose [2 h PBG (mmol/L): the control group was 12.5±3.4 vs. 22.5±3.8, the observation group was 9.1±2.2 vs. 21.9±3.6) were obviously lower than those before education (all P < 0.05), the degrees of improvement of the observation group were more significant than those of the control group [self management score: 78.6±11.5 vs. 35.2±9.2, FBG (mmol/L): 6.1±1.6 vs. 8.8±2.5, 2 hours PBG (mmol/L): 9.1±2.2 vs. 12.5±3.4, all P < 0.05]. Conclusion Omni-directional health education can improve the self-management level of diabetic patients, and the patient's blood glucose control is relatively better.

Objective To investigate the antimicrobial resistance in the A cinetobacter baumannii strains in different parts of China during 2012 .Methods A total of 8 739 clinical isolates of Acinetobacter were collected from 13 general hospitals and two children’s hospitals ,of which most were A . baumannii (89 .6% , 7 827/8 739 ) . Antimicrobial susceptibility testing was carried out by means of Kirby-Bauer method according to the unified protocol . The susceptibility testing data were analyzed by WHONET 5 .6 software according to CLSI 2013 breakpoints .Results Majority (85 .4% ) of the Acinetobacter strains were isolated from inpatients .The remaining 14 .6% were from outpatients and emergency room patients .Of the 7 827 strains of A .baumannii , 10 .9% ,35 .2% ,35 .7% and 43 .4% were resistant to tigecycline ,minocycline ,cefoperazone-sulbactam and amikacin , respectively .The percentage of A .baumannii resistant to imipenem and meropenem was 63 .5% and 68 .2% ,respectively . The antimicrobial resistant pattern varied in different hospitals . The resistance of A . baumannii varied between different clinical departments .A number of pandrug resistant (PDR) (20 .0% ,1 567/7 827) and multidrug-resistant (MDR) (45 .0% , 3 521/7 827 ) A . baumannii were identified . Conclusions A . baumannii is the most popular pathogenic bacteria among Acinetobacter .The antibiotic resistance of A .baumannii is still increasing .Cefoperazone-sulbactam and minocycline has good in vitro antibacterial activity against A .baumannii .The antibiotic resistance of A .baumannii varies greatly with hospital and department .

Objective To investigate the distribution and antibiotic resistance of clinical Enterobacter isolates .Methods A total of 3 031 clinical strains of Enterobacter were collected from 15 hospitals from January 1 through December 31 , 2012 . Antimicrobial susceptibility testing was performed with Kirby-Bauer or minimum inhibitory concentration method .The results were analyzed according to CLSI 2012 breakpoints .Results Enterobacter cloacae and Enterobacter aerogenes accounted for 73 .0% (2 212/3 031) and 23 .9% (725/3 031) of all the Enterobacter strains .The isolates of other Enterobacter species accounted for 3 .1% (94/3 031 ) . The main source of the isolates was respiratory tract specimen , accounting for 53 .2% (1 612/3 031) .Most (> 89% ) of the Enterobacter strains were resistant to cefazolin and cefoxitin . Generally ,54 .4% ,47 .5% and 34 .3% of the strains were resistant to cefuroxime ,cefotaxime and cefazidime ,respectively . About 6 .6% to 26 .3% of the strains were resistant to amikacin ,gentamicin ,piperacillin-tazobactam ,cefepime ,cefoperazone-sulbactam ,ciprofloxacin and trimethoprim-sulfamethoxazole .Imipenem ,meropenem and ertapenem showed the highest activity , to which only 3 .5% ,3 .7% and 10 .3% of the strains were resistant ,respectively .About 8 .9% (269/3 031) of the strains were resistant to at least imipenem ,meropenem or ertapenem .Four Enterobacter strains were extensive-drug resistant (XDR) .Conclusions The prevalence of antibiotic resistance in Enterobacter isolates decreased slightly in 2012 compared to the data in 2011 ,but the situation is still very serious .We should continue to take effective measures to control the resistant strains .

Objective To investigate the distribution and susceptibility of carbapenem-resistant Enterobacteriaceae (CRE) isolates in 2012 from CHINET surveillance .Methods Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated Systems .Results were analyzed according to the breakpoints of CLSI 2012 M100-S22 .Results A total of 1 499 CRE isolates were collected from January to December 2012 ,of which K lebsiella spp .,Enterobacter spp .and E .coli accounted for 63 .5% ,15 .1% and 13 .7% ,respectively .Of the 1 499 isolates , 48 .2% and 29 .3% were from respiratory tract and ICU , respectively . The results of antimicrobial susceptibility testing showed that the resistance rate of CRE isolates to most antimicrobial agents was 70 .0%-100% except amikacin (46 .9% ) and trimethoprim-sulfamethoxazole (49 .8% ) .CRE isolates from adults were more resistant to ciprofloxacin ,aminoglycosides and trimethoprim-sulfamethoxazole than those from children .Conclusions The antibiotic resistance of CRE isolates is very high . The spread of CRE strains in a specific region such as ICU and neurosurgery ward poses a serious threat to clinical practice and implies the importance of strengthening infection control .