Objective To investigate the distribution and drug resistance of Pseudomonas aeruginosa(PAE) in the hospital ,so as to provide the reference for the rational drug use and the infection control in clinical .Methods The infection distribution and drug resistance of 822 isolates of PAE were analyzed .The drug sensitivity test was proceeded by dilution method ,and the results were judged according to the relevant documents of the CLSI .The data was analyzed by WHONET 5 .6 software .Results 822 isolates of PAE were mainly distributed in intensive care unit ward ,general surgical department and respiration department .The sample was 82 .1% from sputum .The infection rate was the highest in autumn(30 .0% ) .The drug resistance rate of PAE to cefperazone/sul-bactam was the lowest(7 .6% ) ,and which to amikacin was 19 .1% .The resistance rates of PAE to other drugs were all higher than 20 .0% .Conclusion PAE is a common pathogen of respiratory tract infection ,which has a high resistance rate to the current clini-cal antibacterial agents ,and doctors should pay attention to the infection caused by PAE .

Objective To analyze the anatomy of the right colonic vessels in the laparoscopic right hemicolectomy.Methods The retrospective cross-sectional study was conducted.The clinical data of 60 patients who underwent laparoscopic right hemicolectomies in the Second Affiliated Hospital of Fujian Medical University from March 2013 to October 2016 were collected.All the patients used central approach.Patients intraoperatively underwent complete mesocolic excision (CME),and vascular anatomies of the right colon were precisely distinguished through postoperatively observing video.The starting position,formation and relative spatial location of vessels were counted and analyzed,and video screenshots were used as a comments during analysis.Observation indicators:(1) superior mesenteric artery (SMA) and superior mesenteric vein (SMV):occurrence rate and relative spatial location;(2) ileocolic artery and vein:occurrence rate and relative spatial location;(3) right colonic artery and vein:occurrence rate and relative spatial location of right colonic artery,occurrence rate and distribution of right colonic vein flowed into superior vein;(4) gastrocolic venous trunk:occurrence rate and composition of the branches;(5) middle colonic artery and vein:occurrence rate and relative spatial location of middle colonic artery,occurrence rate and distritution of middle colonic vein flowed into superior vein.Measurement data were represented as proportion and percentage.Results (1) SMA and SMV:all the 60 patients appeared SMA and SMV,with an occurrence rate of 100.0％(60/60).Of 60 patients,95.0％(57/60) and 5.0％(3/60) patients' SMAs respectively were located on the left side and right side of SMVs.(2) Ileocolic artery and vein:of 60 patients,the occurrence rates of ileocolic artery and vein were 96.7％ (58/60) and 100.0％ (60/60).Relative spatial location:of 58 patients with ileocolic artery,8.6％ (5/58),31.0％ (18/58),10.3％ (6/58),6.9％(4/58),32.9％(19/58) and 10.3％(6/58) patients' ileocolic arteries were respectively located on the right ahead,anterosuperior,inferoanterior,right behind,upper posterior and lower posterior of ileocolic veins;50.0％(29/58) patients' ileocolic arteries crossed from the front of SMV,and 50.0％ (29/58) patients' ileocolic arteries ran behind the SMV.(3) Right colonic artery and vein:① Right colonic artery:of 60 patients,occurrence rate was 55.0％(33/60),including 93.9％(31/33) with 1 right colonic artery and 6.1％(2/33) with 2 right colonic arteries.A trunk made of right colonic artery and middle colonic artery was detected in 24.2％ (8/33) patients,and flowed into SMA,including 2/8 patients with 2 right colonic arteries and 6/8 with 1 right colonic artery.Relative spatial location:of 33 patients,90.9％ (30/33) occurred right colonic artery crossed from the front of SMV;9.1％ (3/33) occurred SMA located on the right side of SMV that led to no relative spatial location between right colonic artery and SMV.② Right colonic vein:of 60 patients,occurrence rate was 93.3％ (56/60),including 87.5％(49/56) with 1 right colonic vein (7 were accompanied by right colonic artery) and 12.5％ (7/56) with 2 right colonic veins.Distribution of right colonic vein flowed into superior vein:of 49 patients with 1 right colonic vein,right colonic vein respectively flowed into gastrocolic venous trunk and SMV were detected in 73.5％ (36/49) and 26.5％ (13/49) patients.Of 7 patients with 2 right colonic veins,right colonic vein flowed into SMV and gastrocolic venous trunk were detected respectively in 6/7 patients and 1/7 patients.(4) Gastrocolic venous trunk:occurrence rate was 88.3％ (53/60);11.7％ (7/60) patients had absence of gastrocolic venous trunk,and right gastric epiploic vein directly flowed into SMV.Composition of the branches of gastrocolic venous trunk:of 53 patients,3-branch or 4-branch stomach-pancreas-colon venous trunk in 54.7％ (29/53) patients was made up of right gastric epiploic vein,pancreaticoduodenal vein,right colonic vein and middle colonic vein;2-branch or 3-branch gastrocolic venous trunk in 35.9％ (19/53) patients was made up of right gastric epiploic vein,right colonic vein and middle colonic vein;2-branch stomach-pancreas venous trunk in 9.4％ (5/53) patients was made up of right gastric epiploic vein and pancreaticoduodenal vein.(5) Middle colonic artery and vein:① Middle colonic artery:60 patients appeared middle colonic artery,with an occurrence rate of 100.0％ (60/60) and 1.7％ (1/60) appeared 2 middle colonic arteries.Of 60 patients,13.3％ (8/60) patients' middle colonic artery shared the same trunk together with right colonic artery that flowed into 1 middle colonic artery,and 85.0％(51/60) appeared 1 middle colonic artery.Middle colonic artery ≤ 1 cm,from 1 to 2 cm (excluding 1 cm) and ＞2 cm occurred branch at running out of neck of pancreas were detected in 15.7％ (8/51),66.7％ (34/51) and 66.7％ (34/51)patients,respectively.② Middle colonic vein:56 of 60 patients appeared middle colonic vein,with an occurrence rate of 93.3％(56/60),and 80.3％(45/56),16.1％(9/56) and 3.6％(2/56) patients appeared respectively 1,2 and 3 middle colonic veins.Distribution of middle colonic vein flowed into superior vein:45 patients appeared 1 middle colonic vein,55.6％ (25/45) and 44.4％ (20/45) middle colonic veins respectively flowed into SMV and gastrocolic venous trunk;9 patients appeared 2 middle colonic veins,7/9 middle colonic veins flowed into SMV and gastrocolic venous trunk and 2/9 middle colonic veins flowed into SMV;2 patients appeared 3 middle colonic veins,1 and 2 middle colonic veins respectively flowed into gastrocolic venous trunk and SMV.Conclusion Vascular anatomical variations of the right colon are complex in the laparoscopic right hemicolectomy,and anatomies of the surgical thunk and Helen trunk are difficult and core issue in operation.

Objective: To describe the confirmation process and long-term follow-up results of 1 case of HIV with long term progression. Methods: The subject was a HIV infected man aged 27 years old. The first HIV antibody positive was detected by ELISA in August 7^th, 2013. Close contacts were identified as 3 homosexual partners who had been contacted before infection and the first sexual partner had been unable to get in touch. Adopting the first epidemiological survey questionnaire of AIDS comprehensive prevention and control information system in China, the investigators conducted face-to-face surveys on the general demographic characteristics and behavioral characteristics of the subject. After the first ELISA test result was positive, 4 rapid detections of colloid selenium, ELISA, western-blot, CD4⁺T and viral load test were followed up (August 14^th, 21^st, 30^th and September 16^th, 2013). Long term follow-up was performed to detect CD4⁺T and viral load to observe the progress of the case after the diagnosis of infection. Results: The duration of sexual behavior was from 2011 to 2012 between the subject and his 1^st sexual partner. During the study, repeated HIV antibody ELISA test results were negative. Sexual behavior maintained from January to April 2013 between the subject and his 2^nd partner and the last one unprotected homosexual acts took place in April 2013. After the traceability survey, the 2^nd sexual partner was an AIDS patient who had antiretroviral therapy in the anti HIV treatment module of AIDS comprehensive prevention information system. The subject and his 3^rd partner maintained their sexual behavior from May to October 2013. The two ELISA tests of the 3^rd partner were negative. Because of the need for hospital operation in August 7, 2013, the subject was tested for HIV antibody by ELISA and the result was positive while western blot test showed that the HIV-1 antibody was not confirmed (band type was gp160/gp120/p24). In the subsequent follow-up, 4 rapid detections of colloid selenium, ELISA and western-blot were conducted and all the results were positive (western-blot band type was gp160/gp120/gp41/p24/p17). Results of continuous follow-up for 5 years showed that the first four CD4⁺T cell counts were as follows: 520, 616, 834, 879. The following 22 CD4⁺T counts sustained at a high level and the median was 895 cells/μl. A total of 5 follow-up visits were conducted to detect viral load exceeding 1 000 copies/ml and the remaining 19 test results were lower than 1 000 copies/ml except that no viral load was detected in 2 follow-up visits. The result of homology analysis showed that the HIV types of the case and its 2^nd sexual partner were all HIV-1 CRF_01AE. The similarity of gag region gene was 97.5%. So we inferred that the 2^nd sexual partner was its source of infection, and the case was infected at the end of April 2013 with the last unprotected homosexual behavior. Conclusion The infected person was found to be an early HIV infection. Continuous follow-up test results indicated that the case belonged to a HIV long-term nonprogressor.

OBJECTIVETo analyze survival time of AIDS death cases receiving Antiretroviral Therapy and related factors.

METHODSA retrospective cohort study was carried out to collect the data on death cases receiving Antiretroviral Therapy by the National HIV/AIDS Comprehensive Response Information Management System. Kaplan-Meier was used to calculate the median survival time, and compare survival time among different groups of age, sex, marriage status, infectious routes, WHO clinical stage, baseline CD4(+)T cell counts, and interval time from the start of ART to HIV confirmation. Life table and survival curve were applied to describe survival distribution. Cox proportional hazard model was used to determine the factors associated with the survival time.

RESULTSAmong 142 AIDS death cases, 125 (88.03%) were related with AIDS and 17(11.97%) were not. The total median survival time was 3.100 months (95%CI: 2.279-3.921). The cumulative survival rate was (52 ± 4)%, (33 ± 4)%, (26 ± 4)% in the first 3 months, 3-6 months, and 6-12 months. The median survival time of married or cohabitation group was 2.670 months (95%CI:1.470-3.870), and single (unmarried, divorced, separation, widowed) group was 5.870 months (95%CI: 2.617-9.123). The median survival time of WHO clinical stage I or II group was 5.870 months (95%CI: 3.989-7.751), and WHO clinical stage III or IV group was 1.700 months (95%CI: 0.885-2.515). The median survival time of baseline CD4(+)T cell counts ≤ 50 /µl group was 1.670 months (95%CI: 0.759-2.581), and 51-199 /µl group was 4.400 months (95%CI: 2.735-6.065), and ≥ 200/µl group was 7.100 months (95%CI: 0.000-14.542). The survival time was significantly different among different baseline marital status groups, different WHO clinical stage groups, and different CD4(+)T cell counts groups. The mortality risk of Single (unmarried, divorced, separation, widowed) group was 0.641 times of the risk in married or cohabitation group. The mortality risk of WHO clinical stage III or IV was 1.856 times of the risk in stage I or II. The mortality risk of baseline CD4(+)T cell counts 51-199 /µl group was 0.582 times of the risk in ≤ 50 /µl group, and ≥ 200 /µl group was 0.551 times of the risk in ≤ 50 /µl group.

CONCLUSIONThe total median survival time was relatively short. Most AIDS deaths happened in the first 3 months or 3-6 months after they received Antiretroviral Therapy, and the mortality trend slowed down in the following months. Married or cohabitation, low-baseline CD4(+)T cell counts, or WHO clinical stage III or IV were found to be the risk factors associated with AIDS death cases receiving Antiretroviral Therapy.

Acquired Immunodeficiency Syndrome ; Antiretroviral Therapy, Highly Active ; CD4 Lymphocyte Count ; Cohort Studies ; Disease Progression ; HIV Infections ; Humans ; Marital Status ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Survival Rate

Objective: To understand the consciousness of the cancer early detection among urban residents and identify the influencing factors from 2015 to 2017. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. Self-designed questionnaires were used to collect population, socioeconomic indicators, self-cancer risk assessment, regular participation in physical examination and other information. The multivariate logistic regression model was used to identify the factors of people who had not regularly participated in the regular physical examination in the past five years. Results: The self-assessment results of 32 357 residents showed that there were 27.54% (8 882) of total study population with self-reported cancer risk, 45.48% (14 671) without cancer risk and 26.98% (8 704) with unclear judgement on their own cancer risk. Among population with cancer risk, 79.84% (7 091) considered physical examination accounted. In the past five years, there were 21 105 (65.43%) residents participated in regular physical examination and 11 148 (34.56%) participated in non-scheduled one, respectively. The multivariate logistic regression analysis showed that compared with unmarried and western region residents, divorced, middle and eastern region residents had a stronger consciousness to participate in the regular physical examination (P<0.05). Compare with residents with annual household income less than 20 000 CNY in 2014, cancer risk assessment/screening intervention population, and self-assessment with cancer risk, residents with annual household income between 20 000 CNY and 59 000 CNY in 2014, occupational population, community residents, cancer patients, self-reported cancer-free risk, and self-assessment with unclear judgement of cancer risk were less likely to participate in the regular physical examination (all P values <0.05). Conclusion From 2015 to 2017, the Chinese urban residents had a acceptable consciousness of the cancer early detection. The marital status, annual household income, population group and self-assessment of cancer risk were related to the consciousness of the cancer early detection of people who had not participated in the regular physical examination in the past five years.

Objective: To understand the consciousness of the cancer early diagnosis among urban residents and identify the related factors from 2015 to 2017. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The general demographic characteristics, the consciousness of the cancer early diagnosis (whether people would have a willingness or encourage their relatives/friends to confirm the abnormal results once which were detected from the physical examination) and other information were collected by using the self-designed questionnaire. The non-conditional logistic regression model was used to identify the relateol factors related to the consciousness of the cancer early diagnosis. Results: As for residents with abnormal result from the physical examination, 89.29% (28 802) of residents would choose to seek medical treatment for further diagnosis. If their relatives/friends had abnormal results from the physical examination, 89.55% (28 886) of residents would encourage their relatives/friends to confirm the diagnosis in time. The non-conditional logistic regression model analysis showed that compared with the public institution staff/civil servants, annual household income less than 20 000 CNY, the western region and the cancer risk assessment/screening intervention population, the company staff, annual household income about 40 000 CNY and more, and the residents from the middle and eastern region had a stronger consciousness to seek further diagnosis; while the unemployed residents and community residents were less likely to seek further diagnosis (P<0.05). Conclusions From 2015 to 2017, the Chinese urban residents had a good consciousness of the cancer early diagnosis. Occupation, annual household income, residential region and population group were related to the consciousness of the cancer early diagnosis.

Objective: To investigate the demand and access to the cancer prevention and treatment knowledge and related factors among urban residents in China from 2015 to 2017. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The self-designed questionnaire was used to collect the information of general demographic characteristics, the demand and access to cancer prevention and treatment knowledge, and the influencing factors of the attitude. The Chi-square test was used to analyze the difference of the demand of the cancer prevention knowledge among different groups and the corresponding factors of the cancer prevention and treatment knowledge were analyzed by using the logistic regression model. Results: The proportion of residents who need the cancer prevention and treatment knowledge was 79.5%. The demand rate of the inducement, symptom and diagnosis methods of cancer in the occupational population was highest, about 66.8%, 71.0% and 20.8%, respectively. The demand rate of treatment methods and cost in current cancer patients was the highest, about the 45.9% and 21.9%, respectively. The top three sources to acquire the cancer prevention and treatment knowledge were "broadcast or television" (69.5%), "books, newspapers, posters or brochures" (44.7%) and "family and friends" (33.8%). The multivariate analysis showed that compared with public institution personnel/civil servants, unmarried/cohabiting/divorced/widowed and others, annual household income less than 20 000 CNY, from the eastern region, people without cancer diagnosis and people with self-assessment of cancer risk, the demand rate of cancer prevention and treatment knowledge was higher in enterprise personnel/workers, married, annual household income between 60 000 CNY and 150 000 CNY, from the central region, people with cancer and people with unclear cancer risk (all P values <0.05). Conclusion There was a high demand for the cancer prevention and treatment knowledge among urban residents in China from 2015 to 2017. The main access to the knowledge is from the radio or television. The occupation, marital status, annual household income, residential region, health status and risk of disease were the main factors of the demand of the cancer prevention and treatment knowledge.

Objective: To understand the health literacy and relevant factors of cancer prevention consciousness in Chinese urban residents from 2015 to 2017. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The self-designed questionnaire was used to collect the information of demographic characteristics and cancer prevention consciousness focusing on nine common risk factors, including smoking, alcohol, fiber food, food in hot temperature or pickled food, chewing betel nut, helicobacter pylori, moldy food, hepatitis B infection, estrogen, and exercise. The logistic regression model was adopted to identify the influencing factors. Results: The overall health literacy of the cancer prevention consciousness was 77.4% (24 980 participants), with 77.4% (12 018 participants), 79.9% (6 406 participants), 77.2% (1 766 participants) and 74.5% (4 709 participants) in each group (P<0.001). The correct response rates for nine risk factors ranged from 55.2% to 93.0%. The multivariate logistic regression analysis showed that compared with community residents, people with primary school level education or below, and the number of people living together in the family <3, the cancer risk assessment/screening intervention population, cancer patients, those with junior high school level educationor above and the number of people living in the family ≥3 had better health literacy of the cancer prevention consciousness (all P values <0.05). Compared with females, 39 years old and below, government-affiliated institutions or civil servants, from the eastern region, males, older than 40 years, company or enterprise employees, and from the middle or western region had worse health literacy of the cancer prevention consciousness (all P values <0.05). Conclusion The health literacy of the cancer prevention consciousness in Chinese urban residents should be improved. The cancer screening intervention, gender, age, education, occupation, the number of people co-living in the family, and residential region were associated with the health literacy of the cancer prevention consciousness.

Objective: To understand the consciousness of the cancer early treatment and its demographic and socioeconomic factors. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China (CanSPUC) from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The questionnaire collected personal information, the consciousness of the cancer early treatment and relevant factors. The Chi square test was used to compare the difference between the consciousness of the cancer early treatment and relevant factors among the four groups. The logistic regression model was used to analyze the influencing factors related to the consciousness of the cancer early treatment. Results: With the assumption of being diagnosed as precancer or cancer, 89.97% of community residents, 91.84% of cancer risk assessment/screening population, 93.00% of cancer patients and 91.52% of occupational population would accept active treatments (P<0.001). If the immediate family members were diagnosed as precancer or cancer, people who would encourage their family members to receive early treatment in the four groups accounted for 91.96%, 91.94%, 92.44% and 91.55%, respectively (P<0.001). The company employees, annual household income with 40 000 yuan and more and other three groups had a relatively better consciousness of the cancer early treatment (P<0.05). Male, widowed, unemployed and from the central and western regions had a relatively worse consciousness of the cancer early treatment (P<0.05). Conclusion Residents in urban China participants had a good consciousness of the cancer early treatment. The marital status, occupation, annual household income and residential regions were major factors related to the consciousness of the cancer early treatment.

Objective: To understand the health literacy of the cancer prevention and treatment among urban residents of China, and explore the related factors. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China (CanSPUC) from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The health literacy of the cancer prevention, early discovery, early diagnosis, early treatment and the demands of cancer prevention and treatment knowledge was analyzed. The level of health literacy among different groups were calculated and compared. The binary logistic regression model was used to analyze the influencing factors of the health literacy of the cancer prevention and treatment. Results: The level of health literacy of the cancer prevention and treatment was 56.97% among all study population; in each group it was 55.01% for community residents, 59.08% for cancer risk assessment/screening population, 61.99% for cancer patients and 57.31% for occupational population, respectively (P<0.001). The level of health literacy of the cancer prevention and treatment of residents aged 50 to 69 years old, other occupational groups, unmarried, the central and western region residents and the group with unclear self-assessment of cancer risk was significantly lower than that of residents younger than 40 years old, personnel of public institutions/civil servants, married, the eastern region residents and the group whose self-assessment without cancer risk (P<0.05) . The level of health literacy of cancer prevention and treatment of females, people who went to high school or over, cancer risk assessment/screening population, cancer patients and occupational population was significantly higher than that of males, people who had an education level of primary school or below and community residents (P<0.05) . Conclusion The health literacy of the cancer prevention and treatment of urban residents in China was relatively high, but there was still room for improvement. Gender, age, educational level, occupation, region, marital status, self-assessment of cancer risk, and type of respondents were the key influencing factors of the health literacy of the cancer prevention and treatment. Male, 50-69 years old, lower educational level, central and western regions, unclear cancer risk self-assessment, and without specific environmental exposure to cancer prevention and treatment knowledge or related risk factors were the characteristics of the key intervention group of the health literacy of the cancer prevention and treatment.