Objective To investigate the current situation of healthcare-associated infection(HAI)management in grassroots medical institutes in a province.Methods Forty-six grassroots medical institutes in 13 cities of the prov-ince were selected randomly for the survey,questionnaires about the current situation of HAI management in grass-roots medical institutes were filled out,and related data were analyzed.Results Forty-four qualified questionnaires were adopted for analysis,and 2 unqualified questionnaires from public hospitals were excluded.HAI management in 44 medical institutes (100.00%)was in the charge of major leaders in medical institutes.Only 2 institutes(4.55%) set up independent HAI management departments,and 10 institutes(22.73%)established basic regulations and po-sition responsibilities of HAI management,38.67% of medical institutes established regulations of HAI prevention and control in key departments and responsibilities for key positions.The score for the establishment of basic regu-lations and position responsibilities of HAI management in village clinics was lower than the other medical institutes (F =5.762,P <0.01 ).Except aseptic technique,the core regulations of HAI management weren’t implemented well in village clinics compared with the other institutes(P <0.05).Conclusion Organizational settings,HAI man-agement of key departments,and core regulations of HAI management are not performed well in grassroots medical institutes in this province.Village clinics perform the worst in HAI management among all types of grassroots med-ical institutes.More measures,including education and surveillance,should be taken to improve HAI management in grassroots medical institutes.

Objective To observe the vertebrobasilar artery and its branch courses,diameters and the included angles in the starting part,offering morphological basis for clinic intervention and vascular image.Methods Layer by layer dissecting head,neck and chest of nine adult specimens affused with red latex,and after affused carotid artery with red latex,the origin,course,branches,distribution,anastomosis,and accompanying of the vertebrobasilar artery were observed in three normal adult corroded specimens.Results The degree of the left included angle between subclavian artery and vertebral was (91.70 ± 0.90) ° and that of the right one was (115.80 ± 1.60) ° (P ＜ 0.05).A percentage (14.1％) of them contacted with vagus and glosssopharyngeal nerve.The degree of the left included angle between posterior cerebal lower artery and vertebral artery was (118.60 ± 3.70) ° and that of the right one (77.60 ± 7.90) °.A percentage (27.6 ％) of itself contacted or pressed by root of facial nerve.The degree of the included angle on the left side between anterior cerebellar lower artery and brobasilar artery was (91.60 ± 2.40) ° and that of the right one was (27.10 ±2.70)°(P ＜0.05).The degree of the left included angle between posterior cerebral artery and basilar artery was (93.90 ± 3.40) ° and that of its right one was (130.80 ± 3.20) ° (p ＜ 0.05).Conclusions Both vertebral artery in every part out of skull and the data of the each branch pipe diameter,the starting included angle of vertebrobasilar artery had statistical significance,which should select personalized catheter or operation method in endovascular intervention or craniocervical surgery.

OBJECTIVE: To explore the hemostatic and analgesic effect of Gonghuan Zhixue Tablet (GHZXT) on mice and to produce experimental evidence for exploiting new drug for endometrorrhagia caused by Cu-intrauterine contraceptive device (Cu-IUD). METHODS: Compared with 6-aminocaproic acid and notoginseng, the effects of GHZXT on clotting and bleeding time of mice with capillary method and severed tail were investigated; and compared with aspirin, the analgesic effects of GHZXT on mice were investigated with hot plate and torsive body method. RESULTS: The clotting time of mice was remarkably shortened with a rising of the dosage of GHZXT and the difference between each therapeutic group and distilled water group was remarkable. As compared with distilled water group, the bleeding time of each dosage group of GHZXT was obviously shortened; and each dosage of GHZXT could prolong the time of pain reaction to hot plate and decrease the degree of torsive body of the mice. CONCLUSION: Pharmacological experiment has proved that GHZXT has evident hemostatic and analgesic function.

Objective To investigate the effect of continuous renal replacement therapy on the levels of IL-27 in peripheral blood of patients with chronic heart failure concurrence acute kidney failure. Methods 78 patients with chronic heart failure were enrolled from June 2012 to December 2013 in Zhujiang hospital affiliated Southern medical university. According to patient′s condition, 38 patients with chronic heart failure concurrence acute kidney failure undertaking CRRT, 40 patients with chronic heart failure undertaking conventional therapy. Heart function were determined by cardiac ultrasound, the levels of IL-27 and BNP were determined by ELISA. Results Compared with chronic heart failure patients, the levels of IL-27 were decreasing but BNP were increasing in patients with chronic heart failure concurrence acute kidney failure (P < 0.05). After CRRT, the levels of IL-27 were increasing but BNP were decreasing in patients with chronic heart failure concurrence acute kidney failure. Correlation analysis showed that the levels of IL-27 is negatively correlated with the levels of BNP , but positively correlated with LVEF (P<0.05). Conclusion IL-27 participated in the development of chronic heart failure concurrence acute kidney failure. CRRT regulating and controlling the heart and kidney function may partly through effecting on immune-inflammatory mechanism.

OBJECTIVETo investigate the therapeutic effect of Yiqi Huaju Recipe (YHR) combined with routine therapy on the blood pressure, the blood pressure variability and other cardiovascular risk factors in hypertension patients complicated with metabolic syndrome (MetS).

METHODSTotally 43 hypertension patients complicated with MetS were recruited in this study and randomly assigned to the treatment group (22 cases, treated with basic routine treatment +YHR) and the control group (21 cases, treated with basic routine treatment + placebo). The treatment course was 12 weeks. Detected were parameters such as 24-h ambulatory blood pressure monitoring (ABPM), body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), homeostatic model assessment for insulin resistance (HOMA-IR), fasting glycosylated hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), 2 h postprandial plasma glucose (2 h PPG), fasting plasma insulin (FPI), serum lipid, etc.

RESULTSThe anthropometric parameters and plasma glucose levels (except HbAlc) were obviously lowered after treatment than before treatment in the treatment group (P < 0.01, P < 0.05). Besides, better effects were obtained in the WC, WHR, 2 h PPG, FPI and HOMA-IR (P < 0.05). The average blood pressure amplitude, the blood pressure variability, and blood pressure load at any time point were more obviously improved in the two groups after treatment than before treatment (P < 0.01, P < 0.05). Besides, partial indices were better in the treatment group than in the control group (P < 0.01, P < 0.05).

CONCLUSIONSYHR combined with routine therapy exhibited better effect on reducing the blood pressure amplitude, the blood pressure variability, and the blood pressure load in hypertension patients complicated with MetS. It could also effectively decrease the risk of other vascular disease.

Adult ; Blood Pressure ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hypertension ; complications ; drug therapy ; Male ; Metabolic Syndrome ; complications ; Middle Aged

To observe the effect of Ligusticum wallichii-containing serum on the expressions of Toll-like receptor 4 and myeloid differentiation factor 88 in hepatic stellate cells. Clean-grade SD rats were randomly divided into 5 groups and orally given L. wallichii decoction, colchicine and normal saline for 7 d to prepare L. wallichii-containing serums. Except for the blank group, all of the remaining groups were stimulated with LPS 1 mg x L(-1) for 24 h. After being intervened, the L. wallichii-containing serums were cultured in 5% CO2 incubator at 37 degrees C for 24 hours. The expression of TLR4 and MyD88 were detected by RT-PCR and Western blot. After HSC was stimulated with LPS, TLR4 and MyD88 mRNA and protein expressions were significantly higher than the blank control group (P < 0.01). After being intervened with L. wallichii-containing serum, TLR4 and MyD88 mRNA and protein expressions were notably lower than the model group (P < 0.05 or P < 0.01). In conclusion, L. wallichii-containing serum could regulate the TLR4 signaling pathway and show the anti-fibrosis effect by inhibiting the expression of TLR4 and MyD88 in LPS-induced HSCs.
Animals ; Female ; Hepatic Stellate Cells ; drug effects ; metabolism ; Ligusticum ; Lipopolysaccharides ; pharmacology ; Liver Cirrhosis, Experimental ; drug therapy ; Myeloid Differentiation Factor 88 ; genetics ; physiology ; Phytotherapy ; RNA, Messenger ; analysis ; Rats ; Rats, Sprague-Dawley ; Toll-Like Receptor 4 ; genetics ; physiology

Seventy-two strains of endophytic fungi were isolated from the healthy bark, branches and leaves of Cephalotaxus hainanensis L.. Sixty-eight of them were morphologically classified into Fungi Imperfecti, thirty-three sporulated were identified to five genera. For those did not sporulate, one was identified to Rhizoctonia sp., the rest were tentatively classified into Mycelia Sterilia. Four were identified to Basidiomycetes. The result indicated the endophytic fungi of C. hainanensis show a degree of tissue specificity. There were significant differences about the quantity, genera and composition between the fungi isolated from bark and those from branches and leaves.

Seventy-two endophytic fungi isolated from Cephalotaxus hainanensis Li were screened for antitumor and antimicrobial activities. The results showed that 9 strains presented cytotoxic activities to at least one of the tested tumor cells, five strains exhibited strong antimicrobial activity against Staphylococcus aureus, one strain had inhibitory effect on Phytophthora parasitica. It was evidently that the endophytic fungi of C. hainanensis are potential resources to find valuable bioactive components.

Background Experimental data have shown tnat polymorpnisms in tne angiotensm-converting en- zyme 2(ACE2)gene are related to echocardiographically determined parameters of left ventricular mass,structure or function in the general population whether ACE2 genotype influences the effect of angi0tensin Ⅱ receptor blocker which improve left ventricular remodeling and function is unknown.Objective To investigate the association be- tween ACE2 gene G9570A polymorphism and the effect of irbesartan on left ventricular structure and function in hy- pertensive patients.Methods Two hundred and five male patients and 190 female patients who were preliminaryly diagnosised with mild and moderate essential hypertension were treated with irbesartan for 48 weeks with initial dose of 150 mg/d and titrated to 300 mg/d to reach the targed BP.Gene polymorphisms of ACE2 G9570A were detected by PCR-RFLP methods.The association between changes in the SBP,DBP,parameters of left ventricular struc- ture and function and genotypes of the ACE2 gene locus were analyzed.Results Irbesartan reducted in blood pres- sure in all patients(P

Abstract: Objective　To analyze the epidemiological characteristics of 151 cases of melioidosis and the drug resistance of Burkholderia pseudomallei (BP), in order to provide the basis for diagnosis, treatment and reasonable prevention of melioidosis. Methods　A total of 151 inpatients and outpatients from the Second Affiliated Hospital of Hainan Medical University from January 1, 2013 to August 31, 2022 were collected, and clinical specimens were submitted for examination to isolate and identify BP strains. The clinical data of 151cases of melioidosis and the drug resistance characteristics of pathogenic bacteria were retrospectively analyzed, and using SPSS26.0 software for statistical analysis. Results　Among 151 cases with BP infection, there were 138 males (91.4%) and 13 females (8.6%); the most patients were aged from 45-<60 years old, accounting for 74 cases (49.0%); melioidosis incidence was concentrated in October (19.2%), November (19.2%), August (9.9%) and July (8.6%), and; the number of confirmed cases showed an increasing trend and the time for confirmation was <10 d; Internal medicine system (31.1%), surgery system (26.5%) and intensive care department (20.5%) were the common departments for treating melioidosis; blood (49.0%), sputum (9.9%) and wound secretion (8.6%) were the main clinical specimens for detecting BP; pulmonary infection (68.2%), sepsis (35.1%) and local suppurative infection (23.8%) were the top clinical manifestations in patients with BP infection; the effective rate of treating melioidosis was 74.8%; abnormal liver function was a risk factor for the curative effect of melioidosis (χ2=5.010, P<0.05); the sensitivity rates of BP strains to sulfamethoxazole-trimethoprim (SXT), doxycycline (DOX), imipenem(IPM), ceftazidime (CAZ), amoxicillin/clavulanate (AMC) and tetracycline (TCY) were generally more than 90%, with sensitivities of 98.7%, 97.2%, 96.7%, 94.0%, 93.2% and 90.7%, respectively. Conclusions　It can be concluded that misdiagnosis or missed diagnosis of melioidosis is easy to occur, and the understanding of the epidemiological characteristics and risk factors in this area should be strengthened. The sensitivity of BP to commonly used antibiotics has shown a certain downward trend, clinical use should be standardized, and drug resistance monitoring should be strengthened to improve the efficacy of melioidosis treatment.