Objective To investigate the current status of multidrug-resistant organism (MDRO) infection in the general surgery department of a tertiary first-class hospital, and understand the efficacy of comprehensive intervention measures.Methods Targeted monitoring on MDROs was implemented among patients who were hospitalized in a general surgery department for>48 hours between March 2015 and October 2016, comprehensive intervention measures were taken since January 2016.MDRO infection before and after intervention was compared.Results Between March 2015 and October 2016, a total of 6 406 hospitalized patients were monitored, 155(2.42%) developed MDRO infection.The most common infection sites were abdominal cavity(hydrops, bile) (n=76, 49.03%) and surgical site (n=43, 27.74%).MDRO infection rate dropped from 2.79% (99/3 549) before intervention (March-December, 2015) to 1.96% (56/2 857) after intervention (January-October, 2016) (x2=4.612, P=0.032).There was no difference in MDROs between before and after intervention, the major were both Escherichia coli.Conclusion Comprehensive intervention measures can reduce the incidence of MDRO infection in the general surgery department of this hospital.

Diabetes mellitus is an independent risk factor for ischemic stroke. Epidemi-ological studies have shown that intensive glucose control can reduce stroke risks in patients with type 2 diabetes. However, the current prospective clinical trials have failed to validate a definite causal relationship between them. This article reviews the clinical trials about the roles of intensive glucose control in patients with type 2 diabetes in the primary and secondary prevention of stroke.

Objective To investigate the role of CTLA4-Ig and anti-CD40L monoclonal antibody in the acute rejection of pancreaticoduodenal transplantation model of rats.Methods Pancreaticoduo- denal transplantation model was established from the donor F344 rats to the Lewis recipients(diabetes models).The models were divided into 4 groups:groups A,B,C and D with 12 rats in each group. Two days after transplantation,recipients were injected intraperitoneally with saline,CTLA4-Ig(200?g),anti-CD40L monoclonal antibody(200?g),CTLA4-Ig(200?g)combined with anti-CD40L monoclonal antibody(200?g)respectively.On the day 1,4,7,10 after transplantation,the grafts were harvested for histopathological examination and RT-PCR to determine the levels of interleukin (IL)-2,interferon(IFN)-?,IL-4 and IL-10;The blood CD3~+,CD4~+and CD8~+ T cells were detected by flow cytometry.On the day 4 after transplantation,the CD4~+ CD25~+ T cells in the grafts were de- tected by flow cytometry.Results As compared with group A,the severity of the rejection of grafts in groups B,C and D were depressed;Down-regulation of IL-2 was observed in the groups B,C and D, and the levels in group D were lowest.Down-regulation of IFN-7 was detected in the groups B,C and D,but there was no significantly difference between groups D and B or groups D and C.Up-regulation of IL-4 was observed in the groups B and C,and the levels in group D were lower than in groups A,B and C.Up-regulation of IL-10 was observed in groups B and C,and there was significant difference between groups D and B or groups D and C.The CD3~+,CD4~+ and CD8~+ T cells in groups B,C and D were less,but more CID4~+ CD25~+ T ceils in transplanted pancreas were observed,more notably in group D than in group C.Conclusions Combined use of CTLA4-Ig and anti-CD40L monoclonal anti- body can remarkably diminish the severity of the rejection,which might be mediated by altering the balance in Th1/Th2 and increasing the number of CD4~+ CD25~+ regulatory T cells.Co-stimulation blockade with CTLA4-Ig and anti-CD40L monoclonal antibody induction seems to be an attractive strategy to control allograft rejection.

Objective To establish a normal lumbar spine 3-dimensional(3D) finite element model(FEM) and discuss the biomechanics of the lumbar motions. Methods A geometrical model was constructed on the basis of a healthy adult male's lumbar CT image.The lumbar spine FEM was established by finite element analysis software.After setting the boundary and loading the burden,the lumbar spine's range of motion and stress distribution in different institutions such as anterior flexion,posterior extension,left or right bending and axial rotating were recorded. Results The lumbar spine FEM included 114 953 tetrahedron units.The results of the FEM matched the results of the in vitro experiment of biomechanics. Conclusion The lumbar spine FEM can imitate the motions of the lumbar spine.

Objective To compare the efficacy and safety of transurethral plasmakinetic resection of prostate (PKRP) and transurethral resection of prostate (TURP) for benign prostatic hyperplasia (BPH). Methods The clinical and follow-up data of 186 patients with BPH were analyzed retrospectively. Two groups of BPH patients (90 patients in PKRP group,96 patients in TURP group) were treated by PKRP and TURP,respectively. The clinical date and therapeutic result were measured and compared for both in-tra-and inter-groups. Results In PKRP group,the operative time,intraoperative bleeding,the rates of damage of prostate surgical membranes,secondary hemorrhage (within 1 month),the rates of postoperative temporary urinary incontinence (within 2 months) were (65.3 ± 12.8)min,(213.6 ± 78.2)ml,5.6%(5/90),2.2% (2/90)and 21.1% (19/90),respectively,while in TURP group,these parameters were (83.6 ± 17.5) min,( 397.4 ± 142.7 )ml,17.7%( 17/96 ),11.5% ( 11/96 )and 36.5% ( 35/96 ),respectively. There were signif-icant differences between the 2 groups (P < 0.05 ). In PKRP group,the international prostate symptom score (IPSS),quality of life(QOL),Qmax and PVR were (4.7 ± 1.3 )scores,(1.1 ± 0.4)scores,( 18.7 ± 5.6)ml/s,(8.9 ± 2.5)ml,respectively,while in TURP group,these parameters were (5.3 ± 1.0)scores,(1.2 ± 0.5) scores,(20.4 ± 4.3 )ml/s,(11.2 ± 3.2)ml,respehively. These parameters were significantly improved after both procedures(P < 0.05),but there was no significant difference in the above parameters between the 2 groups (P > 0.05). Conclusions PKRP and TURP have similar efficacy in the treatment of BPH,but PKRP ap-pears to have an advantage of more safety and easier blood controls with less physical damage and complica-lion than those in TURP. PKRP is a better treatment option for BPH.

Objective To investigate the effect of the side of cerebral lesion on the outcome in patients with ischemic stroke.Methods A total of 407 consecutive anterior circulation ischemic stroke patients within 14 days after symptom onset were recruited prospectively.The basic data ofthe e,~ISes were collected,such as the National Institutes ofHealth Stroke Scale (NU-ISS)and the side ofcerebral lesion.The modified Rankin Scale(mRS)was used to evaluate the prognosis of the patients at 6 raomhs.Results Of the 407 patients recruited,230 patients (56.5%)Were left hemisphere stroke,177(43.5%)were fight hemisphere stroke.After multivariable logistic recession analysis,the age(odds ratio[OR]1.022,95% confidence interval[CI]1.001-1.043,P=0.040),the side of lesion(OR 1.999.95%CI1.179.3.389.P=0.010),the time from onset to admission(OR1.006,95%(7/1.002-1.010,P=0.007),the outcome of the anterior circulation ischcmic stroke at 6 months aftel"onset.The outcome of the right hemisphere stroke Was significantly worse than that of the left hemisphere stroke.The onset-admission time in patients with right hemisphere stroke(median 12 h,median 39.61 h)was significantly delayed compared to the patients with left hemisphere stroke(median 12 h,median 22.72 h;Z=-2.962,P=0.003).Condusions The outcome of the left hemisphere stroke at 6 months after onset is superior to the right hemisphere stroke,and it mau be associated with the delayed admission.

Objective To study a possible correlation between the duration of reproductive period ( from puberty to menopause) and the prognosis of ischemic stroke. Methods Female in-patients with acute ischemic stroke confirmed by CT/MRI in the Neurology Department of the First Affiliated Hospital of Zhengzhou University from 09/03/2006 to 08/30/2008 were enrolled in this study. The probable risk factors of prognosis were analyzed and recovery was assessed by modified Rankin score (MRS) at 6 months followup. Multivariate Logistic regression was used for statistic analysis. Results 371 female patients were enrolled. The average age was (66. 2 ± 10. 0) years; average menopause age was (48. 5 ± 3.9 ) years and average duration of reproductive period was (33.3 ± 4. 3) years. There is a negative correlation between the duration and MRS (OR =0. 285, 95% CI: 0. 095-0. 850, P =0.024). There is no correlation between menopause age and prognosis of stroke. Conclusions Duration of reproductive period is a predictor for prognosis of ischemic stroke. Patients with longer reproductive period have better prognosis.

The effects of ultrafine grinding on the dissolution rates of the effective components in Sanjie Zhentong capsule (SZC) were studied in this experiment. Fine and ultrafine powder of SZC intermediates were made by ordinary grinding and ultrafine grinding technology, and then granulated by wet granulation. SZC were prepared by fine powder, ultrafine powder and ultrafine granules, respectively. With resveratrol and loureirin B as investigated indexes, dissolution rates of the four intermediates in SZC were determined by cup method and HPLC. The dissolution rates of resveratrol in SZC prepared by fine powder, ultrafine powder and ultrafine granules were 26.11%, 63.27%, 67.49%, respectively; and the dissolution rates of loureirin B were 7.160%, 20.29%, 23.05%, respectively. The dissolution rate of resveratrol and loureirin B in SZC prepared by ultrafine granules was the best. D90 size of ultrafine grinding was 13.221 μm and could improve the dissolution rates of resveratrol and loureirin B in SZC.
Capsules ; chemistry ; Drugs, Chinese Herbal ; chemistry ; Particle Size ; Silicones ; chemistry ; Solubility ; Technology, Pharmaceutical ; methods

Objective To investigate the application of statins in secondary prevention of ischemic stroke and transient ischemic attacks (TIA) in different risk groups,and to identify the factors influencing the compliance of statins. Methods Data were prospectively collected on consecutively encountered ischemic stroke or TIA patients admitted to the First Affiliated Hospital of Zhengzhou University from April 2009 to January 2010.All clinical characteristics and possible factors influencing the compliance of statins were collected; the application of statins was investigated at 3-month follow-up.The multivariate Logistic regression analysis was used for the analysis of influence factors of the compliance of statins.Results All 369 patients were collected,52.8％ of cases were prescribed statins for therapy during hospitalization.The application rate of statins in accordance with guidelines in high-risk group,extremely high-risk Ⅱ group and extremely high-risk Ⅰ group was 25.0％ (16/64),44.1％ (30/68) and 71.4％ (135/189),respectively. Logistic regression analysis showed that the statins application during hospitalization was associated with diabetes history ( P =0.032,OR =1.789,95％ CI 1.052-3.043 ) and the presence of carotid vulnerable plaques(P =0.000,OR =5.308,95％ CI 3.340-8.434).The general application rate of statins was 22.3％ (81/363),which was significantly lower than that during hospitalization. The application rate of statins in accordance with guidelines in high-risk group,extremely high-risk Ⅱ group and extremely high-risk Ⅰ group was 9.7％ ( 6/62 ),25.8％ (17/66) and 29.4％ (55/187) respectively.Logistic regression analysis showed that good compliance of statins was associated with discharge instructions on statins application ( P =0.000,OR =34.852,95％ CI 14.673-175.452 ). Conclusions The compliance of statins in secondary prevention of ischemic stroke and TIA is poor,and there is still a large gap between clinical practice and guidelines; Discharge instructions on statins application increase the compliance of statins.

OBJECTIVETo systematically review the clinical efficacy of acupuncture on the patients with low back pain (LBP).

METHODSRandomized controlled trials (RCTs) about pure acupuncture therapy versus other treatments in treating LBP were electronically searched in PubMed, CBM, EMbase, The Cochrane Library, CNKI, VIP and Wanfang Data from January 2004 to May 2014. The observed index on the results were the changed scores of VAS, ODI, JOA and RMDQ. Two reviewers independently screened the literatures according to the inclusion and exclusion criteria, as well as the extracted data, and assessed the methodological quality. The results of Meta-analysis was conducted by RevMan 5.2 software.

RESULTSTen RCTs involved 751 patients were finally included. The results of Meta-analysis indicated that the role of pure acupuncture group in improving the VAS score was better than that of the control group, and the combined effect size was RR = -.32, 95% CI (-1.41, -1.22); Z=27.28, P<0.00001; the role of pure acupuncture group in improving the ODI score was better than that of the control group, and the combined effect size was RR = -5.07, 95% CI (-7.50, -2.65); Z=4.10, P<0.0001; the role of pure acupuncture group on improved JOA score was better than that of the control group and the combined effect size was RR=2.83, 95% CI (2.02, 3.63), Z=6.90, P<0.00001. The role of pure acupuncture group in improving the RMDQ score was better than that of the control group, and the combined effect size was RR = -2.80, 95% CI (-3.49, -2.11), Z=7.95, P<0.00001.

CONCLUSIONThe result of meta-analysis demonstrates that pure acupuncture may have a favorable effect on self-reported pain and functional limitations in LBP patients.