Objective To understand the epidemic status of Kala azar in Gannan of Gansu Province and to provide a scientific basis for making effective control measures.Methods The epidemic monitoring data of Gannan Kala azar from the infectious disease network direct reporting system and the Gannan County Center for Disease Prevention and Control was collected, descriptive epidemiological method was used to analyze the distribution of Kala azar.Results From 2005 to 2014, a total of 285 Kala azar cases were reported, the incidence rate was 4.21/one hundred thousand (285/6 764 645).The incidence rate in 2005 was the lowest (1.97/one hundred thousand, 13/658 961), in 2011 was the highest (6.39/one hundred thousand, 44/689 104).The cases mainly distributed in the Bailongjiang Valley in Zhouqu County (14.97/one hundred thousand, 200/1 336 150) and Diebu County (14.29/one hundred thousand, 76/531 915).Gannan had reported the cases of Kala azar all year round, and the cases were sporadically distributed.The time of the disease mainly occurred from May to August.The incidence rate in male (58.60％, 167/285), children under 5 years old (43.86％, 125/285) and farmers and herdsmen (25.26％,72/285) accounted for the major parts.In addition to Luqu County and Xiahe County, other counties had cases of imported Kala azar.Conclusion Kala azar in Gannan is happened sporadically year round.Long-term mechanism need to be established;investment funding should be ensured;the monitoring of the epidemic should be strengthened;the epidemic situation of Kala azar should be timely reported in order to effectively prevent and control the epidemic of Kala azar in Gansu.

Clinical pharmaceutical services include: rounds by clinical pharmacists, monitoring of dynamics and adverse effects of drugs, pharmaceutical information services and analyses on use of drugs. Considering the difficulties that clinical pharmacists have encountered in clinical pharmaceutical services like ward rounds and different clinical knowledge structures, corresponding measures have been taken to assess the work load of clinical pharmacists so as to bring into full play the role of clinical pharmacists in clinical pharmaceutical treatment and information services.

Objective To investigate the diagnosis,treatment and prognosis of recurrent epithelial ovarian carcinoma. Methods Fifty-two patients with recurrent epithelial ovarian carcinoma who were admitted in Zhongnan Hospital of Wuhan University between 1997 and 2002 were analyzed retrospectively,and their diagnostic methods and the survival rates were compared. Results The positive diagnostic rate of pelvic examination,CA 125 and ultrasound examination was 73.1%,84.6% and 53.8%,respectively to the recurrent epithelial ovarian carcinoma. The median survival time of group A(surgery+chemotherapy) and group B ( chemotherapy) was 11 and 12 months,respectively. Conclusions The diagnostic methods should include pelvic examination,CA 125 and ultrasound examination. We could not know the exact role of surgery to the management and prognosis of recurrent epithelial ovarian carcinoma. Chemotherapy may have an important role to the management and prognosis of recurrent epithelial ovarian carcinoma.

AIM:To investigate the potential of differentiatng into myocytes of the granulocyte colony-stimulating factor(G-CSF)-mobilized CD34 + cells. METHODS: Three hours after intraperitoneal injecction of isoprenaline(ISO) to develop acute ischemic model, rats' bone marrow hematopoietic stem cells were mobilized to the site of myocardial infarction by G-CSF. The techniques of immunohistochemisty and HE stain were used to detect the infiltration of CD34 + cells and the regeneration of myocytes in the infarct zones. RESULTS: 24 hours after administration of ISO , a large amount of infiltrative monocytes and regenerative myocytes which were CD34 positive expression could be found in the infarct zones of the G-CSF treatment group, while majority of the infiltrative inflammatory cells in control group were neutrophils and there was no infiltrative cells and myocytes which were CD34 positive expressio, 2 weeks after administration of ISO, there were a plenty of scar in control group, but not in the G-CSF treatment group. CONCLUSION: G-CSF-mobilized CD34 + cells possess the potential to differentiate into myocytes and it may be used in treating acute myocardial infarction.

Objective To realize the contamination status of dental unit waterlines (DUWL)in general hospitals, and provide scientific evidence for making preventive measures.Methods Three hospitals were selected for study, water source adopted by hospital A,B and C was running water,reservoir water,and filtered water through reverse osmosis filtration system respectively,specimens of dental handpiece spray water and flushing water of dental chair units were collected quarterly,total bacterial colony in water were detected.Results The qualified rate of source wa-ter,handpiece spray water,and flushing water in hospital A was 75.00%(3/4),0 (0/40)and 0 (0/40)respectively,col-ony count of handpiece spray water and flushing water was (1.20×103 -5.53×104 )CFU/mL(M=3.80×104 CFU/mL) and (2.11×104 -1.66×105 )CFU/mL(M=4.80×104 CFU/mL)respectively.The qualified rate of source water,hand-piece spray water,and flushing water in hospital B was 50.00%(2/4),60.00%(24/40)and 72.50%(29/40)respectively, colony count of handpiece spray water and flushing water was (0.00 -3.71 ×106 )CFU/mL(M=83.00 CFU/mL)and (0.00-2.39×106 )CFU/mL(M=72.00 CFU/mL)respectively.The qualified rate of source water,handpiece spray wa-ter,and flushing water in hospital C was 100.00%(4/4),55.00%(22/40)and 65.00%(26/40)respectively,colony count of handpiece spray water and flushing water was (0.00-6.20×103 )CFU/mL(M=96.00 CFU/mL)and(0.00-1.63×103 )CFU/mL(M=87.50 CFU/mL)respectively.Conclusion Water of DUWL in general hospitals is seriously con-taminated,disinfection and standardized management of source water and DUWL must be strengthened.

Objective To investigate whether ultrasonic coupling agent (UCA)can produce shielding or antago-nistic effect on iodine disinfectant for preoperative skin disinfection.Methods Shielding or antagonistic effect of UCA on iodine disinfectant were detected by laboratory carrier immersion killing test and on-the-spot skin disinfec-tion test.Results Antagonistic effect:after the mixing of iodophor with UCA,the average killing rate of iodophor containing available iodine 2 500mg/L and 625 mg/L to Staphylococcus aureus decreased from 100.00% to 99.67%-99.78% and 96.85 % - 98.25 %,respectively;the average killing rate to Escherichia coli decreased from 100.00% to 99.71 %-99.82% and 95 .93 %-98.56%,respectively.Shielding effect:after smearing with UCA, the average killing rate of iodophor and iodine tincture + alcohol to Escherichia coli decreased from 100.00% to 30.76% and 100.00% to 94.48%,respectively;the average killing rate to Staphylococcus aureus decreased from 99.99% to 55 .55 % and 100.00% to 98.22%,respectively.On-the-spot skin disinfection test:the killing rate of io-dophor and iodine tincture +alcohol to natural bacteria on skin surface were both 99.99%,after skin was smeared with UCA,the killing rate decreased to 92.62% and 93 .57%,respectively.Conclusion UCA remained on the oper-ative field has shielding and antagonistic effect on iodine disinfectant.

AIM: To investigate the effects of granulocyte colony-stimulating factor (G-CSF)-mobilized bone marrow stem cells on treatment of the myocardial infarction in experimental rats. METHODS: Three hours after injected with isoprenaline(ISO) interaperitoneally to develop acute ischemic model, rats' bone marrow stem cells were mobilized by G-CSF and migrated to the site of myocardial infarction. The hearts were harvested from 24 hours to 2 weeks after administration of ISO for histopathological examination. RESULTS: 24 hours after administration of ISO , myocardial infarct zones scattered in the pallium of the control group ,there were a large amoumt of inflammatory cells infiltration around the infarct zones and majority of them were neutrophils. The infarction in the G-CSF treatment group was milder, majority of the infiltrative cells were monocytoid; 48 hours after administration of ISO, infarct zones expanded greatly in control group, while that of the G-CSF treatment group increased just mildly; 2 weeks after administration of ISO, there was no significant scar in the G-CSF treatment group. We also found the regeneration of myocytes in the pallium. CONCLUSION: G-CSF treatment protected the ischemic myocardium and it may be used to treat the acute myocardial infarction.

Objective To investigate the levels of antibody to pertussis toxin (PT) IgG in newborns in Shunyi Women and Children's Hospital of Beijing Children's Hospital in 2016.Methods A total of 419 newborns were enrolled in this study.Umbilical cord blood sample was collected from each subject and detected by enzyme-linked immunosorbent assay to measure the concentration of PT-IgG.Besides,all newborns were followed up to January 31,2017.Chi-square test was used for statistical analysis.Results The detectable rate of umbilical cord blood samples for PT-IgG accounted for 30.1％ (126/419).The median antibody level was ＜ 5 U/ml,and the 90th and the 95th percentile were 14.3 and 24.0 U/ml,respectively.No cases of pertussis occurred at the end of follow-up.Conclusions The newborns born in Shunyi Women and Children's Hospital of Beijing Children's Hospital are generally lack of protective PT antibody.

Objective:To construct a prognostic model for severe acute pancreatitis (SAP) based on CT scores and inflammatory factors, and to evaluate its efficacy.Methods:128 patients with SAP diagnosed admitted to the First Hospital Affiliated to Hebei North College from March 2019 to December 2021 were enrolled and given Ulinastatin combined with continuous blood purification therapy. The levels of C-reactive protein (CRP), procalcitonin (PCT), interleukins (IL-6, IL-8), tumor necrosis factor-α (TNF-α), and D-dimer were measured before and on the third day of treatment. An abdominal CT was performed on the third day of treatment to assess the modified CT severity index (MCTSI) and extra-pancreatic inflammatory CT score (EPIC). Patients were divided into the survival group ( n = 94) and the death group ( n = 34) according to the 28-day survival prognosis after admission. The risk factors for the SAP prognosis were analyzed using Logistic regression, which was then used to build nomogram regression models. The value of the model was evaluated using the concordance index (C-index), calibration curves and decision curve analysis (DCA). Results:Before treatment, the levels of CRP, PCT, IL-6, IL-8 and D-dimer in the death group were higher than those in the survival group. After treatment, the levels of IL-6, IL-8 and TNF-α in the death group were higher than those in the survival group. MCTSI and EPIC scores in the survival group were lower than those in the death group. Logistic regression analysis shows that, pre-treatment CRP > 140.70 mg/L, D-dimer > 2.00 mg/L, and post-treatment IL-6 > 31.28 ng/L, IL-8 > 31.04 ng/L, TNF-α > 31.04 ng/L, and MCTSI > 8 points were all independent risk factors for SAP prognosis [odds ratios ( OR) and 95% confidence intervals (95% CI) were 8.939 (1.792-44.575), 6.369 (1.368-29.640), 8.546 (1.664-43.896), 5.239 (1.108-24.769), 4.808 (1.126-20.525), 18.569 (3.931-87.725), all P < 0.05]. Model 1 (consisting of pre-treatment CRP, D-dimer, and post-treatment IL-6, IL-8 and TNF-α) had a lower C-index than that model 2 (consisting of pre-treatment CRP, D-dimer, and post-treatment IL-6, IL-8 and TNF-α, and MCTSI; 0.988 vs. 0.995). The mean absolute error (MAE) and mean square error (MSE) of model 1 (0.034, 0.003) were higher than those of model 2 (0.017, 0.001). When the threshold probability was in the range of 0-0.66 or 0.72-1.00, the net benefit of model 1 was lower than that of model 2. When the threshold probability was in the range of 0.66-0.72, the net benefit of model 1 was higher than that of model 2. In addition, model 2 had a higher C-index than acute physiology and chronic health evaluationⅡ (APACHE Ⅱ) and bedside index of acute pancreatitis severity (BISAP, 0.995 vs. 0.833, 0.751). Model 2 had a lower MAE (0.017) and MSE (0.001) than APACHEⅡ (0.041, 0.002). Model 2 had a lower MAE than BISAP (0.025). Model 2 had a higher net benefit than both APACHEⅡ and BISAP. Conclusion:The prognostic assessment model of SAP consisting of pre-treatment CRP, D-dimer, and post-treatment IL-6, IL-8 and TNF-α, and MCTSI has high discrimination, precision and clinical application value, and is superior to APACHEⅡ and BISAP.

WHO Guideline on Country Pharmaceutical Pricing Policies,published in 2020,outlines 10 commonly used pricing methods internationally.However,due to the unique composition of costs for traditional Chinese medicine(TCM),directly applying pricing methods designed for chemical and biological drugs may lead to discrepancies.Currently,in China,drug pricing primarily in-volves internal reference pricing,tender negotiation pricing,promoting the use of quality-assured generic and biosimilar drugs,and centralized procurement.It systematically analyzes various pricing methods and identifies their applicability and underlying reasons concerning the pricing of TCMwithin the medical insurance system.The method of value-based pricing and increasing price transparency has advantages for the pricing regulation of traditional Chinese medicine under medical insurance.