Objective To assess the clinical effects of uterine arterial embolization on uterine leiomyoma.Methods We treated 21 patients with uterine leiomyoma by Seldinger's uterine arterial embolization. The 4.0 F Cobra catheter was placed into the double uterial arteries with Polyvinyl Alcohol Foam(PVA) particles as the embolizer. At 3 and 6 months postoperatively, we investigated the effects of the embolization. Results After uterine arterial embolization, the volume of uterine leiomyoma decreased and menorrhagia was under controlled. The symptoms of anemia and oppression were relieved. The physiologic functions of ovary and uterus were preserved completely.Conclusions Uterine arterial embolization is an effective and less invasive way to treat uterine leiomyoma.

OBJECTIVE To investigate the distribation of the AmpC enzyme in Acinetobacter baumannii isolated from burned patients. METHODS Susceptibility tests were used to detect antibiotic resistance to 20 kinds of antimicrobial drugs in 20 strains of A. baumannii isolated from burned patients, AmpC enzyme genes were detected by PCR and partial positive products were chosen to sequence. RESULTS Drug resistances to ?-lactam antibiotics in 20 strains of A. baumannii isolated from burned patients had exceeded 85% except levofloxacin or cefoperazone/sulbactam. Of ADC genes 95% were positive, but all DHA genes were negative. Through sequence and Blast analysis, partial ADC positive products were identical with that of EF546445. CONCLUSIONS The multidrug resistance of A. baumannii isolated from burned patients to ?-lactam antibiotics is serious. AmpC enzyme mediated by chromosome, ADC, prevails in A. baumannii isolated from burned patients.

OBJECTIVE To investigate the disseminateion of the carbapenemase in Acinetobacter baumannii isolated from burned patients.METHODS Susceptibility tests of 20 strains of A.baumannii isolated from burned patients to 20 kinds of antimicrobial drugs were detected.Subsequently,seven genes encoding carbapenemase,including OXA-23,OXA-24,OXA-51,OXA-58,IMP,VIM and SIM,were detected by PCR and genes of partial positive products were sequenced.RESULTS Drug resistances to ?-lactam antibiotics of 20 strains of A.baumannii isolated from burned patients all exceeded 85% except to levofloxacin or cefoperazone/sulbactam.Nineteen strains(95%) were OXA-23 genes positive and all other genes were negative.Through sequence and Blast analysis,OXA-23 gene products were identical with that of CAB69042.1.CONCLUSIONS The multidrug resistance of A.baumannii isolated from burned patients to ?-lactam antibiotics is critical.Carbapenemase of OXA-23 prevails in A.baumannii isolated from burned patients.

Objective To investigate the prevalence of mobile genetic elements in Acinetobacter baumannii strains isolated from burn patients. Methods Polymerase chain reaction (PCR) was used to detect the genes encoding the integron, transposon, conjugative plasmid and insertion sequence in 20 strains of Acinetobacter baumannii isolated from burn patients. Results tnpU and ISaba1 genes were detected in all 20 strains, and int Ⅰ gene was detected in 19 strains (95.0%). Other genes were all negative. Conclusion Mobile genetic elements carrying multi-drug resistant genes are found in Acinctobacter baumannii strains isolated from bum patients.

Objective To investigate the prevalence of multidrug resistant genes in Klebsiella pncumoniae.MethodsTwenty strains of multidrug resistant Klebsiella pneumoniae were isolated from burn patients.Susceptibility of these strains to 14 antibiotics was detected by KB method.PCR was used to detect oqxA,smrKpn,qacE,tehA,mdfA and qacEΔl-sul1 genes.ResultsThe antibiotic sensitivity rates of 20 multidrug resistant Klebsiella pneumoniae isolates to antibiotics tested were ＜ 30％ except that to imipenam.The positive rates of efflux pump genes mdfA,qacEΔl-sull and oqxA were 65％,100％ and 100％,respectively; while those ofsmrKpn,qacE and tehA were 0％,0％ and 15％.ConclusionoqxA gene has been detected in multidrug resistant Klebsiella pneumoniae from burn patients with high positive rate.

OBJECTIVE To investigate drug resistant genes associated with beta-lactamases,aminoglycosides and sulfonamides in Pseudomonas aeruginosa isolated from burned patients.METHODS Common drug resistant genes associated with beta-lactamases,aminoglycosides and sulfonamides of 20 strains of P.aeruginosa isolated from burned patients were detected by PCR.RESULTS The positive rates of genes of TEM,aac(6′)-Ⅰb,sul1 and ant(3″)-Ⅰwere 85%,85%,90% and 10%,respectively and genes of CARB and aac(6′)-Ⅱ were both positive(100%).Genes of oprD2 were all absent and genes of SHV,GES,IMP,VIM,DHA and armA were all negative.Furthermore,drug resistant genes of strains isolated from different sites of one patient on different time could be different.CONCLUSIONS Drug resistant genes of CARB and aac(6′)-Ⅱprevail in P.aeruginosa isolated from burned patients.Detections of drug resistant genes in P.aeruginosa isolated,especially continuously isolated from burned patients are essential.

Objective To analyze the fairness of human resource allocation in professional public health agency (PHA) in Guangdong Province in 2022. Methods Health technical staff, other technical staff, and management staff from PHAs in Guangdong Province, such as disease prevention and control centers, specialized disease prevention and treatment institutions, maternal and child health institutions, health education centers, emergency centers/stations, blood collection and supply institutions, health supervision agencies, and family planning service centers under health departments, were selected as the study subjects. Data on human resource allocation in PHAs were collected, and the Lorenz curve, Gini coefficient, and Theil index were used to analyze the fairness of personnel allocation based on three dimensions: year-end resident population, geographical area, and regional gross domestic product. Results The number of PHA personnel per 10 000 population in four regions of the Pearl River Delta, eastern, western and mountain area in Guangdong Province was (7.49±3.74), (4.74±0.87), (8.73±1.67) and (10.33±1.80), respectively. There was no correlation between the per capita regional gross dumestic product of each prefecture level city and the number of PHA personnel (Spearman′s rank correlation coefficient=0.43, P>0.05). PHA resource allocation based on year-end resident population was more equitable than allocations based on geographical area or regional gross dumestic product, as indicated by the Lorenz curve being closest to the 45° standard line and the lowest Gini coefficient. The fairness of personnel allocation from high to low was ranked as follows: practicing (assistant) physicians, health technicians, registered nurses, managers personnel, and other technical personnel, with Theil indices of 0.035 0, 0.036 4, 0.044 6, 0.048 4, and 0.053 5, respectively. The differences in configuration fairness were derived from within group differences, with contribution rates of 76.0%, 73.9%, 71.8%, 82.9%, and 92.2%. The Lorenz curve, Gini coefficient, and Theil index were consistent in the distribution of permanent residents at the end of the year. Conclusion The fairness of professional human resource allocation in Guangdong Province based on the distribution of permanent residents at the end of the year is better than that based on geographical area and regional gross domestic product. The fairness of the allocation of practicing (assistant) physicians is better than that of other professional categories. Regional differences are the main reason for the relatively unfair allocation of PHA human resources in Guangdong Province.

Catheter-associated urinary tract infection (CAUTI) is one of the common nosocomial infections in burn patients. It not only extends the length of hospital stay of patients, increases the economic burden on family and society, but also seriously affects the prognosis and quality of life of patients, increases the risk of death of patients. In this paper, the epidemiological characteristics, influencing factors, and prevention measures of CAUTI in burn patients are reviewed to draw high attention of clinical medical staff and to provide some reference for clinical practice.

Objective:To know the current situation of kinesiophobia in patients after cardiac surgery under cardiopulmonary bypass, and to clarify its influencing factors, so as to provide reference for developing intervention strategies to improve kinesiophobia level.Methods:This was a cross-sectional study. From February 2022 to September 2022, the patients after cardiac valve surgery under cardiopulmonary bypass in the Second Affiliated Hospital Zhejiang University School of Medicine were investigated by convenience sampling methods. The survey was conducted using the General Information Questionnaire, The Tampa Scale for Kinesiophobia Heart, Exercise Self-Efficacy Scale, Pain Catastrophizing Scale, and Adaptation, Partnership, Growth, Affection and Resolve(APGAR) as research tools, and the influencing factors were analyzed using univariate and binary Logistic regression analysis.Results:A total of 219 patients were included, of which 97 patients (44.3%) had kinesiophobia. The results of binary Logistic regression analysis showed that monthly family income level, first time out of bed after operation, fear of falling, the family APGAR, and pain catastrophizing were significant influencing factors of kinesiophobia in patients after heart valve surgery under cardiopulmonary bypass (all P<0.05). Conclusions:The prevalence of kinesiophobia is high among patients after heart valve surgery under cardiopulmonary bypass. Clinicians should pay attention to patients with low monthly family income level, late first time out of bed after surgery, and fear of falling, as well as strengthen communication with patients and families, focus on the management of acute postoperative pain. In order to reduce or avoid the occurrence of kinesiophobia and enable patients to benefit from early ambulation.

Objective To retrieve,extract,evaluate,and integrate the relevant evidence of postoperative pulmonary rehabilitation management in patients with lung cancer complicated with chronic obstructive pulmonary disease,so as to provide an evidence-based basis for improving the quality of postoperative pulmonary rehabilitation.Methods Relevant literature on postoperative pulmonary rehabilitation of lung cancer complicated with chronic obstructive pulmonary disease were searched by computer from clinical decisions,guideline websites,professional association websites,and comprehensive databases.The types of the literature included clinical decisions,guidelines,expert consensuses,evidence summaries,systematic reviews,meta-analyses,and randomized controlled trials.The retrieval time limit was from the establishment of the database to September 2023.Results A total of 19 articles were included,including 4 clinical decisions,3 guidelines,6 expert consensuses,1 evidence summary,3 systematic reviews,and 2 randomized controlled trials.Through reading,extraction and classification,23 pieces of best evidence were finally formed,including multidisciplinary cooperation,evaluation,pulmonary rehabilitation strategies and health education.Conclusion This study summarizes the best evidence for postoperative lung rehabilitation management in patients with lung cancer and chronic obstructive pulmonary disease.Clinical medical staff can implement practical evidence for postoperative lung rehabilitation based on actual situations,and promote the transformation of evidence-based knowledge into practice.