OBJECTIVE To understand the epidemic condition on the resistant plasmids and their homology of the Staphylococcus aureus obtained from two hospitals in Gansu Province.METHODS The antibiotic sensitivity test,plasmid elimination,plasmid profile,and restriction endonuclease profile were used in analyzing the S.aureus resistant plasmids.RESULTS We isolated 15 strains of S.aureus from 196 samples in two different hospitals,the isolation rate was 7.7%.From them 86.7% isolates were resistant to the seven commonly used antibiotics in different degree.Only 13.3% strains were just resistant to one antimicrobial,the multi-resistant strains amounted for 46.7%.There were 12 isolates carried plasmids(80.0%).The results of plasmid elimination showed 11 strains carried resistant plasmids,and the one with 38 kb was a popular plasmid.The endonuclease profiles revealed that the same source strains had certain homology,there were similiar endonuclease profiles among strains in different wards.CONCLUSIONS The popular plasmids in different wards have certain homology,and they can be transferred among different strains of bacteria.

Abstract On 18 May 2021, the Center for Disease Control and Prevention (CDC) of X District in P City, Z Province received a co-investigation of a suspected case of intentional HIV transmission from the public security branch, and conducted epidemiological investigations on Zhao and Wang (both males). Wang was confirmed HIV-positive in 2019. Zhao had unprotected sexual encounters several times with Wang in March 2021 without being informed of Wang's HIV infection. Zhao developed fever, sore throat and other symptoms of acute infection phase on 28 March, and were confirmed HIV positive by the CDC of P City on 11 May. Zhao did not have sex with anyone else before or after having sex with Wang. In addition, Zhao had no history of surgery, blood transfusions, drug use or any other history of HIV exposure. Laboratory tests conducted by the CDC of Z Province showed that the HIV nucleic acid sequences between the samples of Zhao and Wang had a high degree of homology. Combined with the epidemiological investigation, laboratory testing and the evidence from the public security branch, it was concluded that Wang intentionally transmitted HIV to Zhao through unprotected anal sex without disclosing his HIV infection status.

Objective: To explore the application of asymmetrical sculpture in the ear reconstruction with autologous cartilage through comparing the difference of the balanced sculpture and asymmetrical sculpture. Methods: We used the method of retrospective survey and classified the patients who had undergone ear reconstruction because of microtia into two groups. Group A included the patients who had undergone operation with the application of balanced sculpture method. Group B included the patients who had undergone operation with the application of unsymmetrical sculpture method. We picked out 35 patients containing 19 patients of group A and 16 patients of group B according to our grouping criteria and exclusion criteria. The number of cases with complications was recorded, such as collapse of framework, exposure of cartilage, necrosis of skin flap and reconstructed ear infection. The clinical outcomes of two methods in refining the delicate structures of the reconstructed ear were evaluated (that is the definition, shape, size, color and projection). The time for sculpture was compared. Then we analysed the results and evaluated the effectiveness, safety and feasibility of asymmetrical sculpture′s application in the ear reconstruction. Results: Group A had 2 cases which suffered skin flap necrosis. One of them had cartilage exposure and then had secondary infection leading to local cartilage necrosis and absorption, but after active treatment and local skin flap transplantation it was cured. Group B had no skin flap necrosis, cartilage extrusion, framework deformation and distortion, framework collapse and necrosis or absorption. Group B had a higher score in definition, shape, size, color and projection, and the difference was significant in definition, shape, color and projection. In our clinical practice, the sculpture time in both group was similarly about 40 minutes after the surgery operator had skillfully mastered both techniques. Conclusions Both methods are safe and feasible. The method of asymmetrical sculpture does not require additional operative time, and the method of asymmetrical sculpture is a better one compared with the method of balanced sculpture in refining the reconstructed ear.

Objective: To compare the clinical efficacy and patient satisfaction of 755 nm semiconductor laser for hair removal during different stages of auricular reconstruction. Methods: From July 2016 to September 2018, 86 patients who had ear reconstruction underwent 755 nm semiconductor laser for auricle hair removal in plastic surgery department of Tongji hospital affiliated to Tongji medical college of Huazhong university of science and technology. There were 39 males and 47 females with an average age 12 years old(from 6 to 28 years old). 28 cases were left ear, 58 cases were right ear. With random grouping, 40 patients underwent auricle hair removal treatment after posterior ear tissue expander implantation (post-operation of stage Ⅰ depilation group) and 46 patients underwent treatment after auricular reconstruction (post-operation of stage Ⅱ depilation group). Auricle hair removal treatments(pulse width 10-20 ms, wave length 755 nm, spot size 10 mm×15 mm, energy density 4-8 J/cm²) were respectively started at different intervention time. Each treatment time were 5-10 minutes. The end of the treatment was slight redness or edema of the local hairy follicle. The treatment was repeated every 4 weeks with a total of 5 times. The number of adverse reactions was recorded as while as the hair density, hair clearance rate and patient satisfaction before treatment and 6 months after the 5th depilation. Results: Patients in both groups successfully were completed the treatment and were followed up to about 6 months (23 to 25 weeks) after the last depilation treatment. There were only 2 cases with scratch in skin preparation and 2 cases with blisters in the postoperative of stage Ⅱ group. None of the other patients had adverse reactions. Hair density after treatment (27.63±7.75 bar/cm²) was less than before treatment (84.55±13.68 bar/cm²) in post-operation of stage Ⅰ depilation group. Hair density after treatment was 40.52±5.92 bar/cm² in post-operation of stage Ⅱ depilation group, less than before treatment (74.78±11.19 bar/cm²). The differences were statistically significant (both P<0.001). After hair removal, the hair density of post-treatment in the post-operation of stage Ⅰ depilation group was less than the post-operation of stage Ⅱ depilation group. The difference was statistically significant (P=0.000). The hair clearance rate of the post-operation of stage Ⅰ (67.32%) was higher than the post-operation of stage Ⅱ(45.81%). The difference was statistically significant (P<0.001). Patients’ satisfaction was 87.5% in the post-operation of stage Ⅰ and 69.5% in the post-operation of stage Ⅱ. The former was superior to the latter. Conclusions Auricle hair removal with semiconductor 755 nm laserstarted at stage Ⅰ that posterior ear tissue expander was implanted has more favorable clinical efficacy, and higher patient’s satisfaction rate.

Objective To reduce the cancer burden in the Jinchang cohort and provide evidence for developing cancer prevention strategies and performing effectiveness evaluation in the Jinchang cohort.We are fitting thirteen years of cancer mortality data from the Jinchang cohort by using six kinds of predicting methods to compare relative fitness and to select good predicting methods for the prediction of cancer mortality trends.Methods The mortality data of cancer in Jinchnag cohort from 2001-2013 were fitted using six kinds of predicting methods:dynamic series,linear regression,exponential smoothing,autoregressive integrated moving average (ARIMA) model,grey model (GM),and Joinpoint regression.Weight coefficients of combination models were calculated by four methods:the arithmetic average method,the variance inverse method,the mean square error inverse method,and the simple weighted average method.Results The cancer mortality was fitted and compared by using six kinds of forecasting methods;the fitting precision of the Joinpoint linear regression had the highest accuracy (87.64％),followed by linear regression (87.32％),the dynamic series (86.99％),GM (1,1) (86.25％),exponential smoothing (85.72％) and ARIMA (1,0,0) (81.98％),respectively.Prediction accuracy of the combination model derived from GM (1,1) and linear regression (＞99％) was higher than that of the combination model derived from ARIMA (1,0,0) and GM (1,1).The combination model derived from the GM (1,1) and linear regression,with weight coefficients based on the arithmetic average method and the mean square error inverse method,had the best prediction effect of the four weight calculation methods.Conclusion Prediction accuracy of the combination model,with accuracy ＞95％,was higher than that of the single prediction methods.

OBJECTIVEThe purpose of this study was to explore the spatial distribution and spatial clustering of hand-foot-mouth disease (HFMD) in Gansu, 2012.

METHODSSpatial autocorrelation and Spatial scanning analysis were used to conduct spatial statistical analyses for the HFMD at the county/district level.

RESULTSHFMD cases did not show a random distribution but with significant spatial aggregation. When Local Autocorrelation analysis was applied at the county/district level, with nine hot spot areas as Jiayuguan, Yumen, Dunhuang, Jinta, Suzhou, Chengguan, Anning, Xigu and Gaolan, were discovered. Four statistically significant HFMD clusters were identified by spatial scan statistics.

CONCLUSIONHFMD was noticed geographically clustered in Gansu in 2012. Results from this study indicated that the spatial autocorrelation and spatial scanning analysis could effectively detect the areas which presenting significant clusters. Cluster Detection System (CDS) could provide evidence for the development of an effective measure concerning the prevention and control of HFMD.

China ; epidemiology ; Cluster Analysis ; Hand, Foot and Mouth Disease ; epidemiology ; Humans ; Spatial Analysis

ObjectiveTo explore the potential influencing factors and complex pathways affecting rehabilitation effect for children with autism spectrum disorder (ASD) from the perspective of parental efficacy in doctor-patient communication, and to provide evidence for improving the quality of rehabilitation service for children with ASD. MethodsAn anonymous face-to-face questionnaire survey was conducted to collect general demographic information of parents of children with ASD at designated rehabilitation institutions in Gansu province. The data included parental efficacy in doctor-patient communication, parental compliance of treatment and children's rehabilitation outcomes were collected. A structural equation model was used to explore the impact mechanism of parental communication efficacy on the rehabilitation outcomes of children with ASD. ResultsData from 519 parents at 37 rehabilitation institutions across 13 cities/counties in Gansu province were collected. Significant positive correlations were found between parental efficacy in doctor-patient communication, doctor-patient relationships, parental compliance with treatment and rehabilitation outcomes for children with ASD (P < 0.05). Through structural equation model analysis, the standardized direct effect of children with ASD from parents' doctor-patient communication efficacy was 0.151 (P = 0.023). The mediating effect of doctor-patient relationship and parental compliance with treatment were 0.160 (P = 0.001) and 0.111 (P = 0.001), respectively, with a chained mediating effect of 0.035 (P = 0.001). The pathway "parental efficacy in doctor-patient communication → doctor-patient relationship → ASD child's rehabilitation outcome" accounted for the highest proportion of the total mediating effect, at 52.29%. ConclusionParental doctor-patient communication efficacy may positively impact on the rehabilitation outcomes of children with ASD directly, and indirectly through the doctor-patient relationship and parental compliance with treatment. Rehabilitation institutions should focus on fostering parental communication skills and enhancing high-quality and humanized rehabilitation services.

OBJECTIVETo investigate the effect of helix and antihelix skin degloving technique in correction surgery of prominent ears.

METHODSTwenty-three cases of prominent ears were corrected by helix and antihelix skin degloving technique. The clinical results were observed.

RESULTSAll the prominent ears were corrected with natural appearance and good symmetry results. The distance from the helix to the skull was decreased obviously (P<0.05). Cranial ear angle, the angle of helix and ear boat were significantly reduced (P<0.05). No complications such as infection, hematoma, skin flap necrosis and deformity recurrence occurred.

CONCLUSIONSThe auricle skin degloving technique has advantages of exact suture position, good shape, no obvious cartilage hurt and simple operation procedure.

Cosmetic Techniques ; Ear Auricle ; surgery ; Hematoma ; Humans ; Necrosis ; Postoperative Complications ; Reconstructive Surgical Procedures ; methods ; Recurrence ; Skin ; pathology

OBJECTIVETo understand the current status of disease burden caused by gastric cancer in Jinchang cohort.

METHODSIn this historical cohort study, the data of gastric cancer deaths from 2001 to 2013 and the medical records of gastric cancer cases from 2001 to 2010 in Jinchang cohort were collected to analyze the mortality, potential years of life lost (PYLL), working PYLL (WPYLL) associated with gastric cancer, and the medical expenditure data were used to evaluate the direct economic burden. Spearman correlation analysis and the average growth rate were used to describe the change trend of disease burden of gastric cancer.

RESULTSA total of 213 gastric cancer deaths occurred in Jinchang cohort from 2001 to 2013. The average annual crude mortality rate of gastric cancer was 38.30 per 100,000 in Jinchang cohort during 2001-2013 and no obvious change was observed. The crude mortality rate in males was 6.84 times higher than that in females. Gastric cancer death mainly occurred in age group 50-79 years (82.62%), while the mortality rates was increasing among the people under 50 years with an average annual increase rate of 0.77%. The annual average PYLL (APYLL) and average WPYLL (AWPYLL) caused by gastric cancer decreased by 8.43% and 10.46%, respectively. No obvious change in medical expenditure of gastric cancer cases was observed in Jinchang Cohort during 2001-2010, and the medical expenditure and average daily cost of hospitalization were 8102.23 Yuan, and 463.45 Yuan per capita, respectively.

CONCLUSIONSThe burden of disease for gastric cancer was heavy in Jinchang cohort. The PYLL and WPYLL had no change, while the APYLL and AWPYLL showed a increasing trend during the last ten years. Direct economic burden of inpatients with gastric cancer had no change.

Aged ; China ; epidemiology ; Cohort Studies ; Cost of Illness ; Female ; Health Expenditures ; statistics & numerical data ; Hospitalization ; economics ; Humans ; Male ; Middle Aged ; Stomach Neoplasms ; economics ; mortality

Metabolic-associated fatty liver disease (MAFLD), which is previously known as non-alcoholic fatty liver disease (NAFLD), represents a major health concern worldwide with limited therapy. Here, we provide evidence that ferroptosis, a novel form of regulated cell death characterized by iron-driven lipid peroxidation, was comprehensively activated in liver tissues from MAFLD patients. The canonical-GPX4 (cGPX4), which is the most important negative controller of ferroptosis, is downregulated at protein but not mRNA level. Interestingly, a non-canonical GPX4 transcript-variant is induced (inducible-GPX4, iGPX4) in MAFLD condition. The high fat-fructose/sucrose diet (HFFD) and methionine/choline-deficient diet (MCD)-induced MAFLD pathologies, including hepatocellular ballooning, steatohepatitis and fibrosis, were attenuated and aggravated, respectively, in cGPX4-and iGPX4-knockin mice. cGPX4 and iGPX4 isoforms also displayed opposing effects on oxidative stress and ferroptosis in hepatocytes. Knockdown of iGPX4 by siRNA alleviated lipid stress, ferroptosis and cell injury. Mechanistically, the triggered iGPX4 interacts with cGPX4 to facilitate the transformation of cGPX4 from enzymatic-active monomer to enzymatic-inactive oligomers upon lipid stress, and thus promotes ferroptosis. Co-immunoprecipitation and nano LC-MS/MS analyses confirmed the interaction between iGPX4 and cGPX4. Our results reveal a detrimental role of non-canonical GPX4 isoform in ferroptosis, and indicate selectively targeting iGPX4 may be a promising therapeutic strategy for MAFLD.