Objective To evaluate the nursing effect of wenjing moxibustion with ginger in zhuang medicine to knee osteoarthritis (KOA), which can provide an effective nursing intervention for KOA. Methods Totally 80 cases were divided into two groups by random number table. There were 40 cases in zhuang moxibution group and 40 in traditional moxibution group. These two groups were taken the same nursing intervention and exercise. However zhuang group were spend 20 minutes and covered by ginger mud on zhuang xiguan point, and fire moxa on the ginger mud. Xuehai, Liangqiu, Neixiyan, and Waixiyan were chosen and fired moxa cone with ginger in traditional group that spent 20 minutes. It was observed the knee pain and swelling before and after 1 week during the treatment. 2 groups were compared with the cost of treatment. Results There was no different in pain and swilling before treatment (P>0.05), but there was significantly difference after 1 week in two groups (t=14.72、12.90;7.04, 2.73, P﹤0.01). It was significantly different in two groups after 1 week treatment (t=-5.06,-3.64, P﹤0.01). There was no significantly difference in the cost of treatment (F=0.041 6, P>0.05). Conclusions these two nursing intervention can release pain and swelling. However it is effective and no different in the cost of treatment when using wenjing moxibustion with ginger in zhuang medicine.

Objective To investigate the iodine nutritional status in the populations of Guizhou Province after implementation of a new standard of salt iodine and to provide a basis in formulating strategy for control of iodine deficiency disorders.Methods In 2011 and 2014,30 units were sampled in Guizhou Province using the sampling method of Probability Proportional to Size.One primary school was chosen in each unit,by the randomized sampling method,40 or 50 students in each school were sampled for examining their urinary iodine level and for testing their household salt iodine level;12 and 50 children were chosen before and after the adjustment,respectively,for testing their urinary iodine level;near the location of the primary school,1 township was chosen,15-20 pregnant women in each township were sampled to test their urinary iodine level.Results Totally 1215 salt samples were collected before adjustment,the median of salt iodine was 32.2 mg/kg;consumption rate of qualified salt was 96.63％;totally 364 urine samples of 8-10 children were collected,the median of urinary iodine (MUI)of children was 308.9 μg/L;450 urine samples of pregnant women were sampled,and their MUI was 216.5 μg/L,among these,121 below 150 μg/L,the proportion was 26.9％.Totally 1 538 salt samples were collected after the adjustment,the median of salt iodine was 26.6 mg/kg;consumption rate of qualified salt was 96.40％;totally 1538urinary samples of 8-10 children were collected,the MUI of children was 218.3 μg/L;and 601 urinary samples of pregnant women were collected,the MUI was 175.1μg/L,among these,241 below 150 μg/L,the proportion was 40.1％.As can be seen from the results,the percentage of sample below 150 μg/L after the adjustment was increased to 13.2％ compared to that before the adjustment,the difference was statistically significant (x2 =19.89,P ＜0.01).Conclusion After implementation of a new standard of salt iodine in Guizhou Province,the iodine nutrition is suitable in residents,but the iodine nutrition of pregnant women is in a trend of declining,which should be noticed.

Objective To investigate the value of platelet, serum sodium and serum creatinine levels in the prognosis of patients with liver failure. Methods The clinical data of 155 patients with liver failure were retrospectively analyzed, and the patients were divided into improvement survival group (87 cases) and deterioration died group (68 cases) according to the prognosis. The hospitalization time of every patient was divided into 4 roughly equal time period, and observed at 5 points of time:T1-T5. The levels and abnormal rates of platelet, serum sodium and serum creatinine were compared. Results The T3 - T5 serum creatinine levels in deterioration died group were significantly higher than those in improvement survival group: (102.14 ± 75.67) μmol/L vs. (78.21 ± 26.68) μmol/L, (116.45 ± 110.64)μmol/L vs. (78.77 ± 29.25) μmol/L, (161.43 ± 153.23) μmol/L vs. (76.40 ± 27.26) μmol/L, and the T1 - T5 serum sodium and platelet levels were significantly lower than those in improvement survival group:(135.05 ± 6.24) mmol/L vs. (137.52 ± 5.26) mmol/L, (137.01 ± 4.99) mmol/L vs. (139.00 ± 3.89) mmol/L, (134.80 ± 16.74) mmol/L vs. (139.15 ± 3.77) mmol/L, (134.40 ± 11.69) mmol/L vs. (138.30 ± 8.75) mmol/L, (133.30 ± 8.93) mmol/L vs. (139.01 ± 9.10) mmol/L, and (122.46 ± 72.59) × 109/L vs. (149.70 ± 71.70) ×109/L, (110.18 ± 65.10) × 109/L vs. (152.09 ± 82.79) ×109/L, (107.32 ± 70.49) ×109/L vs. (169.32 ± 100.65) ×109/L, (97.06 ± 58.15) ×109/L vs. (183.57 ± 112.68) ×109/L, (94.66 ± 57.00) × 109/L vs. (191.36 ± 118.64) ×109/L, and there were statistical differences (P<0.05). The abnormal rates of T3-T5 serum creatinine, T2 - T5 serum sodium and T1 - T5 platelet in deterioration died group were significantly higher than those in improvement survival group, the serum creatinine: 22.06%(15/68) vs. 6.90% (6/87), 27.49% (19/68) vs. 8.05% (7/87) and 42.65% (29/68) vs. 10.34% (9/87), the serum sodium: 32.35% (22/68) vs. 13.79% (12/87), 39.71% (27/68) vs. 14.94% (13/87), 48.53% (33/68) vs. 12.64%(11/87) and 60.29%(41/68) vs. 11.49%(10/87), the platelet:45.59%(31/68) vs. 21.84%(19/87), 55.88% (38/68) vs. 24.14% (21/87), 54.41% (37/68) vs. 25.29% (22/87), 55.88% (38/68) vs. 21.84%(19/87) and 61.76% (42/68) vs. 20.69% (18/87), and there were statistical differences (P<0.05). Abnormal rate of platelet was highest in each time point. Conclusions In the course of pathological changes in deterioration and dead patients, the platelet is the first and most easily affected compare with serum sodium and serum creatinine; the platelet may be a sensitive marker for predicting clinical outcome in patients with liver failure.

Objective To explore the aesthetic results of medial upper Iip repair for skin and soft tissue defects using local flap.Methods According to the location and the size of upper lip defect,the modified rhomboid flap of 60 ° above the defect was designed to repair the wound in philtrum;the O-L flap along philtral column to vermilion border was designed to cover the wound close to the peak and lateral to philtral column.Results Twenty-one postoperative patients that underwent pigmented nevus removal (12 female,9 male;ages 16-33 years) had defects in philtrum for 10 cases and close to the peak and philtral column for 11 cases.The diameter of the defect ranged from 0.5 cm to 1.0 cm.All flaps survived primarily without any complications and follow-up was for 1 to 18 months with excellent outcomes in all cases.All patients were satisfied with contour and functions.No pigmented nevus recurrence occurred.Conclusions The flap designed according to the aesthetic principle could be used to repair medial upper lip defect of medium-sized,which not only obtains functional reconstruction,but also satisfies aesthetic results,with aesthetic subunits saved and scar concealed.

Objective To systematically review the efficacy of multiple doses and single dose of perioperative dexamethasone on pain and recovery after total knee arthroplasty(TKA).Methods PubMed,Embase,Cochrane Library,Web of Science,CNKI,WanFang Data,SinoMed and VIP databases were electronically searched to collect randomized controlled trials(RCTs)on multiple doses and single dose of dexamethasone during perioperative period of TKA from inception of the databases to January 4,2024.Two reviewers independently screened the literature,extracted data and assessed the risk of bias of the included studies.Meta-analysis was performed by using RevMan 5.4 software.Results A total of 6 studies involving 674 patients were included,336 patients in single dose dexamethasone group and 338 patients in multiple dose dexamethasone group.The results of Meta-analysis showed that compared with single dose of dexamethasone,multiple doses of perioperative dexamethasone could significantly decrease the pain scores at rest at 48 h after TKA(SMD=-0.68,95%CI-1.05 to-0.30,P﹤0.001),the pain scores with movement at postoperative 48 h(SMD=-0.86,95%CI-1.37 to-0.34,P=0.001),C-reactive protein(CRP)levels at postoperative 48 h(MD=-4.43,95%CI-6.70 to-2.16,P﹤0.001)and CRP levels at postoperative 72 h(MD=-3.60,95%CI-5.53 to-1.67,P﹤0.001).There was no statistically significant difference between the two groups regarding pain scores at rest at postoperative 24 h and 72 h,pain scores with movement at postoperative 24 h and 72 h,incidence of postoperative nausea and vomiting(PONV),CRP levels at postoperative 24 h,length of hospital stay,and incidence of adverse drug reactions(P>0.05).The results of 5 studies showed that multiple doses of dexamethasone did not increase the dosage or patient proportion of remedial analgesics.Conclusion Current evidence shows that compared with single dose of dexamethasone,multiple doses of perioperative dexamethasone can significantly reduce pain scores at postoperative 48 h,CRP levels at postoperative 48 and 72 h after TKA,but it does not significantly reduce the incidence of PONV,hospital stay,or increase the risk of adverse drug reactions.

Objective: To investigate the prevalence and resistance changes of carbapenem-resistant Enterobacteriaceae (CRE) strains isolated from children patients of Chinese Bacterial Resistance Surveillance Network (CHINET) from 2005 to 2017. Methods: Antimicrobial susceptibility testing was carried out by disk diffusion method (KB method) and automated systems. Results were analyzed according to the Clinical and Laboratory Standards Institute (CLSI) 2017 edition standards. Results: Among the 4 481 CRE clinical strains, the overall prevalence of CRE in children was 6.4%, including 8.8% in neonatal period, 7.3% in infancy, 3.8% in early childhood, 4.0% in preschool, 4.7% at school age and 7.4% of puberty. The CRE prevalence of citrobacter spp. remained stable in 2005-2017, whereas other bacteria showed an upward trend, which was higher than that of the adult group (P<0.01). Among the 4 481 CRE strains, there were 2 905 strains of Klebsiella spp. (64.8%), 813 strains of Escherichia coli (18.1%), 549 strains of Enterobacter spp.(12.3%), and 65 strains of Citrobacter spp.(1.5%). Among the 4 481 CRE strains, 20.7%, 13.3%, and 11.8% were from the intensive care unit (ICU), neonatal department and internal medicine wards, respectively. Specimens were distributed as respiratory (42.8%), urine (26.3%), and blood (14.9%). The results of antimicrobial susceptibility testing exhibited that the CRE strains were highly resistant to most commonly used antimicrobial agents in clinical practice, such as imipenem, meropenem and ertapenem, as well as penicillins and cephalosporins, etc. Conclusion The prevalence of CRE strains in children is increasing year by year, and their antimicrobial resistance to common antibacterial agents in clinical practice is extremely serious, to which serious attention needs to be paid. According to the results of antimicrobial susceptibility testings, the antibacterial agents should be rationally selected to effectively control the spread of CRE.

Objective To investigate the resistance profile of clinical bacterial isolates to antibiotics in Shanghai during 2016.Methods Antimicobial susceptibility testing was carried out for the clinical isolates collected from 47 hospitals according to a unified protocol using Kirby-Bauer method or automated systems.The participating hospitals included 28 tertiary hospitals and 19 secondary hospitals across Shanghai.Results were analyzed according to CLSI 2016 breakpoints.Results A total of 122 548 clinical isolates were collected,including 35 522 (29.0％) strains of gram positive cocci and 87 026 (71.0％) strains of gram negative bacilli.Overall,28.9％ of the isolates were from secondary hospitals and 71.1％ from tertiary hospitals.Gram positive and gram negative isolates accounted for 25.8％ and 74.2％ in secondary hospitals,30.3％ and 69.7％ in tertiary hospitals,respectively.The overall prevalence of MRSA in Staphylococcus aureus was 48.7％ and 77.2％ of MRCNS in coagulase-negative Staphylococcus.The average prevalence of MRSA and MRCNS was 55.9％ and 73.3％ in secondary hospitals,45.9％ and 78.6％ in tertiary hospitals.No strains were found resistant to vancomycin in Staphylococcus.About 77.4％ of the 1 111 strains of non-meningitis S.pneumoniae isolated from children were penicillin-susceptible (PSSP),13.2％ were penicillin-intermediate (PISP) and 9.4％ were penicillinresistant (PRSP).The prevalence of PSSP,PISE and PRSP was 97.8％,2.2％,and 0 in secondary hospitals,76.5％,13.7％,and 9.8％ in tertiary hospitals.Of the 285 strains isolated from adults,94.0％,4.2％ and 1.8％ were PSSP,P1SP and PRSP,respectively.The prevalence of PSSP,PISP and PRSP among the isolates from adults was 93.7％,5.3％,and 1.0％ in secondary hospitals,94.2％,3.7％,and 2.1％ in tertiary hospitals.Overall,37 strains of vacomycin-resistant E.feacium (14 from secondary hospitals and 23 from tertiary hospitals) and 25 strains of vacomycin-resistant E.feacalis (all from tertiary hospitals) were identified.PCR and sequencing analysis indicated that most of these resistant strains were vanA type.The overall prevalence of ESBLs-producing srains was 52.2％ in E.coli,30.9％ in Klebsiella pneumoniae and 29.8％ in Proteus mirabilis.Specifically,the corresponding prevalence of such strains was 55.1％,33.6％ and 34.0％ in secondary hospitals,51.0％,29.7％ and 28.0％ in tertiary hospitals,respectively.Enterobacteriaceae strains were still highly susceptible to carbapenem antibiotics.Overall,8.9％ and 9.1％ of the Enterobacteriaceae strains were resistant to imipenem and meropenem,respectively.The figure was 6.6％ and 7.1％ in secondary hospitals,9.9％ and 10.0％ in tertiary hospitals.Extensively drug-resistant strains were identified in A.baumannii,K.pneumoniae,P.aeruginosa,and E.coli,specifically,223,63,10,and 4 strains in secondary hospitals;224,201,22,and 9 strains in tertiary hospitals.Conclusions Antibicotic resistance is still very serious in the common clinical strains,which poses a critical threat to healthcare facilities.This issue should be taken seriously and effective infection control measures must be put in place.

Objective To analyze the Sichuan salt detection ability and the network running situation in different centers for disease control (CDC) laboratories of Guizhou Province,and to provide reliable laboratory quality assurance for iodine deficiency disorders prevention.Methods The examination results of external quality assessment (EQA) were collected in 2012-2016,and the relative error between Sichuan salt and the given reference value was analyzed.The results of Sichuan salt from all laboratories were evaluated in Guizhou Province.Results In 2012-2016,the feedback rate and qualified rate were all 100.00％ of the provincial and 7 municipal laboratories.The range was 0-4.53％ of relative error at provincial level,and the average relative error was 1.46％-5.28％ at prefecture level.At the county level,the feedback rate was 100.00％,and the qualified rate went from 63.64％ in 2012 up to 100.00％ in 2016,the average relative error was 1.65％-12.12％.Conclusions The testing ability at provincial and prefecture level laboratories is relatively stable.The testing ability at the county level laboratories has been significantly improved through national laboratory network operation and sustained technical training,and they could provide reliable laboratory quality in prevention of iodine deficiency disorders.

Objective:To understand the sales characteristics and salt iodine content in urban and rural salt market of Guizhou Province.Methods:In accordance with the "Guizhou Province 2020 Iodine Deficiency Disorders Monitoring Field Technical Guidance Work Program", 14 counties (cities, districts) from 88 counties (cities, districts) of 9 cities (states) in Guizhou Province were selected in August 2020. Each county (city, district) selected the urban area and a representative township, and at least 2 supermarkets were selected from the urban area, and 5 supermarkets or retail stores from the townships as the investigation sites, to collect the label information of all commercially available salt within the scope of investigation. At the same time, salt samples were collected after excluding the same brand, variety, and specification, and salt iodine was detected by redox titration.Results:A total of 107 labels of commercially available salt were collected, involving 21 brands, of which Biyuan brand had the largest number (53 samples, 49.5%) and the widest sales range, involving 12 counties (cities, districts). Salt producing areas came from 13 provinces, and the salt produced in Sichuan Province was the most widely distributed in the surveyed area (36 samples), followed by Chongqing Municipality (17 samples) and Hubei Province (16 samples). There were 19 brands (75 samples) and 7 brands (32 samples) of salt sold in urban and rural areas, respectively, and the main brand was Biyuan, accounting for 38.7% (29/75) and 75.0% (24/32), respectively. There were 8 brands (27 samples) and 16 brands (80 samples) of salt sold in retail stores and supermarkets, respectively, and the main brand was Biyuan, accounting for 66.7% (18/27) and 43.8% (35/80), respectively. Among 107 salt samples, it was found that the labeled iodine content did not meet the Guizhou Province salt iodization implementation standard (21 - 39 mg/kg), and only 39 samples (36.4%) had electronic anti-counterfeiting traceability codes on their labels. After excluding the same brand, variety, and specification, the median salt iodine of the 51 salt samples was 23.6 mg/kg, ranging from 19.2 to 38.1 mg/kg, and 21 - 39 mg/kg accounted for 96.1% (49/51).Conclusions:There are many salt brands sold in urban and rural areas in Guizhou Province, and the electronic traceability platform needs to be improved. Salt iodine is mainly distributed in the low-value area of the standard range, which brings potential risks to the sustainable and effective prevention and control of iodine deficiency disorders.

Objective:To investigate the oral health knowledge awareness, attitude and behavior of children in endemic fluorosis areas of Guizhou Province, and evaluate the effectiveness of health education, so as to provide a scientific basis for improving oral health.Methods:In September 2020, 6 counties (cities and districts) were selected as survey sites from the historical fluorosis medium and severe areas in Guizhou Province. One township/village primary school was selected from each survey site to carry out health education activities for one school year. A questionnaire survey was conducted among students from grades 1 to 6 to analyze the changes in children's oral health knowledge, attitude, and behavior before and after health education and their influencing factors.Results:Before and after health education, the awareness rate of children's oral health knowledge increased from 79.22% (7 744/9 775) to 94.38% (9 169/9 715), the recognition rate of children's importance of oral health increased from 89.26% (3 490/3 910) to 95.88% (3 726/3 886), and the formation rate of children's oral health behavior increased from 62.59% (6 118/9 775) to 80.38% (7 809/9 715), with an increase of 15.16, 6.62 and 17.79 percentage points, respectively, the differences were statistically significant (χ 2 = 975.62, 15.17, 756.29, P < 0.001). The analysis of influencing factors showed that whether to stay, gender, and ethnic characteristics could significantly affect the overall score ( t = - 3.94, - 3.86, - 3.62, P < 0.001). Conclusion:The implementation of oral health education in endemic fluorosis areas in Guizhou Province has significantly improved the health knowledge, attitude and behavior of oral health among children in endemic fluorosis areas.