Objective To investigate the changes of antibiotic resistance and its correlations with antibiotics use density (AUD) in intensive care unit (ICU) after implementation of antimicrobial stewardship. Methods Data on AUDs and synchronous antibiotic resistance in ICU of the Affiliated Hospital of Taishan Medical University during 2010 and 2014 were retrospectively reviewed.Autoregressive integrated moving average ( ARIMA) model was used to identify the correlation between AUDs and antibiotic resistance.Results The total AUD which stood at 163.46 DDDs· 100 person-1 · d-1 in the year 2010 decreased to 68.20 DDDs · 100 person-1 · d-1 in 2014, and the most significant decreases were found in quinolones, imidazole, carbapenems, aminoglycosides, other beta lactam and macrolides. Synchronously, a wide range of improvements in antibiotic resistance of major pathogens were also observed from 2010 to 2014, and the improvements were positively correlated with the decrease of AUDs.However, antibiotic resistance in 2014 was not significantly improved compared with that in 2013. The rate of ciprofloxacin resistance in Pseudomonas aeruginosa and the resistant rates of amikacin, imipenem, and meropenem in Acinetobacter baumannii even increased in 2014.Conclusions With the implementation of antimicrobial stewardship, antibiotic consumption in ICU was decreasing, and antibiotic resistance rate in major pathogenic bacteria was decreasing.But the rebound in antibiotic resistance in some types of bacteria was also observed and should be put on enough caution.

Objective: To observe the clinical effect on treatment of Tourette's syndrome with combination of acupuncture and Chinese herbs. Method: Sixty cases were randomly divided into acupuncture-Chinese group and western drug group, which have been treated with acupuncture plus modified Tranquilizing Liver-wind Decoction and orally taken holoperidol respectively.Result: Therapeutic effect comparison between the two groups showed a significant difference (P＜0.05).Conclusion: Combination of scalp acupuncture and Chinese herbs has good effect in treating Tourette's syndrome, with better result than western drug.

Evaluation of the outcomes of completed projects funded by National Natural Science Foundation of China (NSFC) is a key process of funding management which is of great importance for management improvement and promoting transformation of scientific or technological achievements.Therefore,we evaluated all the projects completed at the end of 2016 funded by NSFC in the field of preventive medicine.The research achievements of selected projects were evaluated,as well as the problems.We hope our work could provide reference and datum for making discipline development strategy in the future.

OBJECTIVE: To analyze the clinical characters, surgical treatments and prognosis of differentiated thyroid carcinoma (DTC) with laryngeal or tracheal invasion. METHOD: Forty-six cases including 33 papillary and 13 follicular were retrospectively reviewed. Thirty-four cases with tracheal invasion received conservative resection (17), window resection (11) and sleeve resection (6). One case with subglottic invasion was performed subglottic partial laryngectomy. Eleven cases with trachea-laryngeal invasion received total laryngectomy(4), 3 shave technique and 4 preservative laryngectomy. RESULT Complications included infections and hypocalcaemia, 15 patients got permanent fistula. 5-year survival rate in cases of tracheal shave resection was 88.2%, while 63.6% in those of window resection and 83.3% in those of sleeve resection. Survival rate within 5 years of patients received preservative laryngectomy was 62. 5%. Conclusion: With meticulous preoperative examination and positive surgical treatment, both survival rate and quality of life could be improved in patients of DTC with laryngeal or tracheal invasion.
Adenocarcinoma ; Humans ; Laryngectomy ; Larynx ; pathology ; Larynx, Artificial ; Neoplasm Invasiveness ; Prognosis ; Quality of Life ; Retrospective Studies ; Survival Rate ; Thyroid Neoplasms ; pathology ; surgery ; Trachea ; pathology

ObjectiveTo observe the treatment effects in 48 cases of advanced lung cancer patients,with the immune therapy of the dendritic cells loading of tumor autologous antigen (DCTAA) combining with the cells induced factor of the killer cells(CIK)from the matched umbilical cord blood cells.MethodsThe peripheral blood mononuclear cell(PBMC)from the matched umbilical cord blood cells was seperated,and induced to CIK and DC with some cytokines in vitro, such as CD3McAb, IL-2, IFN-γ IL-1α, etc. After 12 to 15 days, the amplified CIK cells obtained were obtained, with the strict quality control, infused the CIK cells to the patients body back in six times,about(5-8)×109 CIK cells in each time.In the fifth day of the cultivation,DETAA cells were loaded and DCTAA cells were collected in the eighth day,and then hypodermic injection was done. The patient' s general situation after the immune treatment was observed, such as the size of the tumors, clinical symptom score, the quality of life and immune indexes. Karnofsky score, weight, toxic side effects and the patient's survival were also studied.ResultsIn the 48 cases with the DCTAA-CIK treatment, complete remission (CR), partial remission (PR)was 37 cases, the overall remission rate was 77.1％. The improvement rate of clinical symptom scores was from 78.9 ％ to 84.7 ％, the increasing rate of Karnofsky score was 89.6 ％ (43/48). 1-year survival reached to 80.6 ％. There were significant difference in little toxic side effects(P ＜ 0.01). The proportion of CD3, CD4 and NK cells in peripheral blood cells increased significantly (P ＜ 0.01) after DCTAA-CIK cells treatment[(42.21±6.12)％, (24.42±3.01)％, 0.99±0.34, (24.98±3.02) ％; (71.58±7.64) ％, (37.25±2.13) ％, 1.62±0.45, (35.23±4.11) ％](t = 6.34, 5.67, 0.25, 4.43, P ＜0.01).ConclusionThe DCTAA-CIK immune therapy is benefit for advanced lung cancer,not only improve the immune function but also ameliorate the clinical symptoms.

Objective To examine the prevalence of and risk factors for syphilis among men who have sex with men (MSM) in 16 cities/districts, 6 provinces in China. Methods Based on a previous survey on the entertainment place and population size of MSM, a cross-sectional study was conducted in 2007 using non-probability sampling method among MSM in 16 cities/districts in China.Information about the demography,risk behavior and syphilis infection was collected through questionnaires from MSM. Univariate and multivariate stepwise logistic regression model was constructed to evaluate independent factors associated with syphilis. Results A total of 4211 participants were recruited. The mean age of these participants was 28 years. Among them, 66.7% were self identified as homosexual, 72.5% were unmarried, and 76.4% had an education beyond senior middle school; in the past 6 months, 8.7% had sexual contact with more than 10 male sex partners, 5.6% had ever paid for male sex service, 11.3% had provided commercial sex service to males, and 18.9% had sexual contact with females, while condom was consistently used in only 36.3% of male-to-male anal sexual behavior. Syphilis was diagnosed in 10.6% of these participants. The risk factors independently associated with syphilis included being older than 25 years (adjusted OR = 1.7; 95% CI:1.3-2.0), local residency (adjusted OR = 1.3; 95% CI: 1.0-1.7), being recruited from a bar or a park (adjusted OR = 1.3; 95% CI: 1.1-1.7), having ever paid for a male sex service(adjusted OR = 1.5; 95% CI: 1.0-2.1),inconsistent condom use during male-to-male anal sexual behavior(adjusted OR = 1.2; 95% CI: 1.0-1.5 ), self reported sexually transmitted infection history (adjusted OR = 1.3; 95% CI: 1.0-1.7). Conclusions There is a high prevalence of syphilis in MSM in the 16 Chinese cities where male-to-male commercial sex service and unsafe sexual behavior are common. Further efforts are urgently needed to scale-up the prevention of and treatment program for syphilis among MSM, which should include syphilis and HIV screening as well as education on the use of condom.

Animals ; Biocatalysis ; Cattle ; Enteropeptidase ; chemistry ; metabolism ; Humans ; Models, Molecular ; Oryzias ; metabolism ; Structure-Activity Relationship ; Substrate Specificity

Objective:To compare the clinical efficacy between hand plating system (HPS) and classic suture anchor fixation in the treatment of patellar inferior pole fractures.Methods:The clinical data were analyzed retrospectively of the 56 patients who had been treated for patellar inferior pole fractures at Department of Orthopaedics, General Hospital of Northern Theatre Command from January 2018 to December 2019. They were assigned into 2 groups according to their internal fixation methods. In group A of 30 cases subjected to HPS fixation, there were 18 males and 12 females with an age of (61.7±11.3) years; in group B of 26 cases subjected to suture anchor fixation, there were 16 males and 10 females with an age of (60.0±10.5) years. The incision length, operation time, intraoperative bleeding, fracture union time, pain visual analog scale (VAS)and knee function one year postoperation, and follow-up complications were compared between the 2 groups.Results:There was no significant difference in the preoperative general data between the 2 groups, showing comparability( P>0.05). The operation time in group A [(59.4±10.8) min] was significantly shorter than that in group B [(66.5±12.3) min] ( P<0.05). There was no significant difference in the incision length or intraoperative bleeding between the 2 groups ( P>0.05). The bone union time was respectively(11.2±1.8) weeks and (12.1±2.4) weeks and the postoperative VAS respectively 0.85±0.12 and 0.91±0.14 for groups A and B, showing no significant difference between the 2 groups ( P>0.05). The knee flexion angle (124.5°±14.6°) and knee Bostman score (29.3±3.5) in group A were significantly better than those in group B (113.2°±11.1° and 26.2±2.9) one year postoperation( P<0.05). Follow-up revealed no complication in group A but 2 cases of implant failure in group B. Conclusion:Compared with the classical anchor suture fixation, HPS may obtain stronger fixation, shorter operation time and better knee function.

Objective To develop the duration knowledge requirement questionnaire of myocardial infarction patients, in order to provide tools for understanding duration knowledge requirement of myocardial infarction patients. Methods By literature review and semi-structure interview as the main sources of questionnaire dimensions and items, the primary questionnaire had been formed by experts conference method, but the formal questionnaire was established after the confirmation and perfection by pre-survey and recognition interview. Results The duration knowledge requirement questionnaire of myocardial infarction patients included 5 dimensions 37 items. The Cronbach′s α coefficient of questionnaire reliability was 0. 839, each dimensions′ Cronbach′s αcoefficient was 0. 704-0. 825. The content of validity was 0. 86. Conclusions This questionnaire has favorable validity and reliability, which is suitable for the survey of duration knowledge requirement in myocardial infarction patients.

Objective To evaluate the diagnostic value of MSCT angiography and postprocessing techniques in the diagnosis of spontaneous isolated dissection of superior mesenteric artery(SIDSMA).Methods Twenty patients with SIDSMA performed with MSCT angiography were analyzed retrospectively.The volume data were transferred to the workstation for image postprocessing and performed with various postprocessing techniques such as multi-planar reconstruction(MPR),curved planar reconstruction(CPR), volume rendering(VR)and maximum intensity projection(MIP).Results The dissection length of SIDSMA was positively correlated with visual analogue scale(VAS).MPR,CPR and VR clearly showed the intimal flap,true and false lumen.MPR and CPR displayed more entries of dissection than VR.VR demonstrated the extension of the involved aorta and its branches,but cannot satisfactorily demonstrate the entry of SIDSMA.Conclusion MSCT angiography is of positive applicable value to the diagnosis of SIDSMA.MPR, CPR and VR may be optimal choice as post processing techniques for diagnosis of SIDSMA.