Objective To explore the effect of personalized intervention on drug compliance in patients with multidrug-resistant pulmonary tuberculosis. Methods A total of 80 patients with multidrug-resistant pulmonary tuberculosis were selected from March 22, 2016 to March 22, 2017, and randomized groups were randomly divided into the observation group and the control group,40 cases in each groups . The observation group and the control group Intervention and routine care. Results Observation group of patients satisfaction score (97.92±1.24), compliance score (95.42±3.14), the incidence of adverse events (5.00%), reasonable nutrition rate (100.00%), prescribed medication rate (100.00%), don't do STH without authorization (100.00%), rate of quitting cigarettes, alcohol and drug withdrawal rate (95.00%), and regularly review rate (95.00%), the psychological function (97.53±1.22) and body function (96.18 ± 1.42) points (95.31±2.41), material life, social function (94.82± 3.42mm) were better than control group (P<0.05).Conclusion Individualized intervention in multidrug-resistant tuberculosis patients can improve drug compliance.

OBJECTIVETo evaluate the efficacy on hemiplegic spasticity after cerebral infarction treated with plum blossom needle tapping therapy at the key points and Bobath therapy.

METHODSEighty patients were collected, in compliance with the inclusive criteria of hemiplegic spasticity after cerebral infarction, and randomized into an observation group and a control group, 40 cases in each one. In the control group, Bobath manipulation therapy was adopted to relieve spasticity and the treatment of 8 weeks was required. In the observation group, on the basis of the treatment as the control group, the tapping therapy with plum blossom needle was applied to the key points, named Jianyu (LI 15), Jianliao (LI 14), Jianzhen (SI 9), Hegu (LI 4), Chengfu (BL 36), Zusanli (ST 36), Xiyangguan (GB 33), etc. The treatment was given for 15 min each time, once a day. Before treatment, after 4 and 8 weeks of treatment, the Fugl-Meyer assessment (FMA) and Barthel index (BI) were adopted to evaluate the motor function of the extremity and the activity of daily life in the patients of the two groups separately. The modified Ashworth scale was used to evaluate the effect of anti-spasticity.

RESULTSIn 4 and 8 weeks of treatment, FMA: scores and BI scores were all significantly increased as compared with those before treatment in the two groups: (both P<0. 05). The results in 8 weeks of treatment in the observation group were significantly better than those in the control group (all P<0. 05). In 4 and 8 weeks of treatment, the scores of spasticity state were improved as compared with those before treatment in the patients of the two groups (all P<0. 05). The result in 8 weeks of treatment in the observation group was significantly better than that in the control group (P<0. 05). In 8 weeks of treatment, the total effective rate of anti-spasticity was 90. 0% (36/40) in the observation group, better than 75. 0% (30/40) in the control group (P<0. 05).

CONCLUSIONThe tapping therapy with plum blossom needle at the key points combined with Bobath therapy effectively relieves hemiplegic spasticity in the patients of cerebral infarction and improves the motor function of extremity and the activity of daily life.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; Aged ; Cerebral Infarction ; complications ; physiopathology ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Muscle Spasticity ; etiology ; physiopathology ; rehabilitation ; therapy ; Treatment Outcome

OBJECTIVETo compare the effects between plum-blossom needle tapping at Jiaji (EX-B 2) combined with rehabilitation and simple rehabilitation for ataxia of cerebellar apoplexy.

METHODSSixty patients with ataxia of cerebellar apoplexy were randomly divided into an observation group,and a control group,30 cases in each one. Conventional rehabilitation training was applied in the control group. While based on the treatment as that of the control group, plum-blossom needle tapping at Jiaji (EX-B 2) was used in the observation group. All the treatment was given for 4 weeks. International cooperative ataxia rating scale (ICARS), Berg balance scale (BBS) and Barthel index (BD were observed before treatment,after 2-week treatment and 4-week treatment. Also, clinical effects After treating for 2 weeks and for 4 weeks, the results of ICARS,BBS and BI were obvi were compared.

RESULTSAfter treating for 2 weeksand for 4 weeks, the results of ICARS, BBS and BI were obviously better than those before treatment in the two groups (all P<0.05). After 2-week treatment,there was no sta tistical significance between the two groups (all P>0. 05). After 4-week treatment,all the scores of the observation group were apparently superior to those of the control group (all P<0. 05). The total effective rate was 96. 7% (29/30) in the observation group, better than 80. 0% (24/30) in the control group after 4-week treatment (P<0. 05). CCONCLUSION:Plum-blossom needle tapping at Jiaji(EX-B 2) combined with rehabilitation training markedly improve the coordination and balance functions and activities of daily life, which are better than simple rehabilitation.

Acupuncture Points ; Acupuncture Therapy ; methods ; Aged ; Ataxia ; etiology ; rehabilitation ; therapy ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Needles ; Stroke ; complications ; Treatment Outcome

Objective To investigate alterations of endothelial microparticles(EMPs) levels in patients with coronary heart dis‐ease(CHD) ,and to evaluate the relationship between EMPs and interleukin‐6(IL‐6) and C‐reactive protein(CRP) .Methods A to‐tal of 38 patients with CHD were divided into myocardial infarction(MI) group(13 cases) and unstable angina(UA) group(13 ca‐ses) and stable angina(SA) group(12 cases) ,and 12 healthy subjects were enrolled as control group .Levels of EMPs were meas‐ured by using flow cytometry technique .Concentration of IL‐6 and CRP were determined by using enzyme linked immunosorbent assay and special protein analysis respectively .Results Compared with SA group and control group ,levels of EMPs were signifi‐cantly increased in MI group and UA group(P<0 .05) .Levels of EMPs in patients with CHD were significantly correlated with IL‐6 and CRP ,with correlation coefficient of 0 .79 and 0 .50 respectively(P<0 .05) .Conclusion EMPs could contribute to monitoring and evaluating the degree of endothelial cells injury in patients with CHD as a laboratory indicator .EMPs might enhance the vascu‐lar inflammation in patients with CHD ,and further accelerate the development of CHD .

ObjectiveTo evaluate analytical performance of NT-proBNP on Electro-Chemiluminescence Immunoassay system.MethodsThe precision,accuracy,limit of blank ( LoB ),limit of detection (LoD),functional sensitivity (FS),analytical measure range (AMR),maximal dilution rate,clinical reportable range(CRR) and the analytical anti-interference ability of NT-proBNP were evaluated according to EP documents issued by CLSI and related references.The analytical performance data were compared to quality standards declared by the manusfacturers.According to CLSI C28-A2,80 healthy volunteers,aged from 18 to 74, were chosen and divided into 4 groups on average for biological reference intervals verification.Results The within-run CV and total CV were 1.1％ -2.2％and 1.5％ -2.9％ respectively.The deviations from controls distributed by National Center for Clinical Laboratory and affiliated calibrators were 2.7％ -5.9％ and 2.7％ -7.5％,respectively.The results of LoB,LoD and FS were 2.5,7.8 and 8.8 pg/ml,respectively.AMR was 8 -35 126 pg/ml,and the most suitable dilution rate was 1∶ 2,so the CRR was 9 -70 252 pg/ml.428 μmol/L bilirubin,2 g/L haematoglobin and 2 200 FIU chyle didn't interfere with the NT-proBNP assay.Moreover,almost all the data from different age groups were in the range of biological reference intervals declared by the manusfacturers, except one test data (167 pg/ml).Conclusions The analyticalperformance of NT-proBNP analyzed on Roche Cobas E601electrochemiluminescence immunoassay systemisconsistentwiththestandarlswhichmanufacturershas proclaimed.The establishment of LoD,FS,maximal dilution and CRR for NT-proBNP assay could provide the quality assurance for clinical use and the biological reference intervals declared by manusfacturers could meet the clinical needs.

ObjectiveTo discuss the correlation of the surgical risk score with the change of T cell subsets and the occurrence of postoperative complications. MethodsA total of 260 patients with hip fractures treated in our department were enrolled in this study and divided into high-risk group ( Group A) and low-risk group (Group B) based on the surgical risk score. The fasting peripheral venous blood was taken in the morning at one day before surgery and at days 1,3, 5, 7 and 14 after surgery for measuring CD3, CD4 and CD8 levels respectively in two groups.In the meantime, the correlation of level changes with risk score and postoperative complications was observed in two groups. ResultsThere were two patients with lung infection in the Group B, with no death. There were two patients with pulmonary infection, one with wound infection and two with deep vein thrombosis, with one death. The postoperative levels of CD3 and CD4 in the Group A and Group B were significantly lower than those in the control group (P ＜ 0.01 ), which reached the lowest level at day 1 after operation and recovered to normal at day 5 after operation. The postoperative levels of CD3 and CD4 in the Group A recovered near to normal at day 7 and to normal at day 14. While the postoperative levels of CD3 and CD4 in the Group B remained low level even at day 14. The level of CD8 decreased at days 1 and 5 in the Group A, then increased and remained relatively stable, while the level of CD8 increased in the Group B. The T cell subsets in both groups recovered from low to high trend at days 1-7 after surgery. The higher preoperative score had more obvious decrease and slower recovery of the T cell subsets. ConclusionsSurgical risk score has positive correlation with the change of T cell subsets and postoperative complications, which can more accurately predict the postoperative outcome of the old patients.

Objective To analyze clinicopathologic features and malignant transformation of spiradenoma (SA).Methods Clinicopathologic data on 25 cases of SA were retrospectively analyzed.An immunohistochemical study was conducted on 5 of the 25 patients.Clinicopathologic features of SA were summarized based on clinicopathologic data,immunohistochemical results and relevant literature.Results The average age of these patients was 40 years.Lesions were acquired and solitary in 24 cases (96％,24/25),and occurred most frequently in the extremities.The diameter of tumors was less than 2 cm in 20 cases (87％,20/23).Twenty-three cases were benign SA with various histological manifestations,including 15 cases (65％,15/23) of typical SA,8 cases (35％,8/23) of cylindroma.VarTing numbers of mitotic figures were observed in different cases.The immunohistochemical study showed epithelial and myoepithelial differentiation.Two cases of SA experienced malignant transformation into poorlydifferentiated basal cell adenocarcinoma and well-differentiated adenocarcinoma respectively.Lymphocytes decreased significantly in number or disappeared in the malignant area,and both the malignant tumors exceeded 2 cm in diameter.Conclusions SA is a kind of neoplasm with distinct histological characteristics and nonspecific clinical manifestations.Most SA cases have a benign clinical course,but malignant transformation should be considered in some cases with longterm clinical course and large size.

Objective To investigate the relationship of albumin levels with the prognosis and severity of illness in elderly sep-sis patients.Methods This was aretrospective study.108 elderly sepsis patients were enrolled from October 2014 to Decem-ber 2015.All patients were divided into survivors group (83 cases)and death group (25 cases)based on the 28-day progno-sis.The differences of clinical data and laboratory were compared between two groups.According to the albumin levels,all patients were divided into three groups,normal albumin group (≥35 g/L,24 cases),and mild hypoproteinemia group (28 g/L≤ALB<35 g/L,52 cases)and severe hypoproteinemia group (<28 g/L,32 cases),respectively.The mortality rate was compared in the groups.Spearman Correlation Coefficient was used to analyze ALB and other factors.Results In all 108 pa-tients,the 28-day mortality rate was 23.1%,and 77.8% of the patients with hypoproteinemia.ALB level [31.7 (28.3~35.7)g/L vs 25.8 (21.7~31.8)g/L,P<0.001]and Hb [128 (110~140)g/L vs 102 (84~132)g/L,P=0.015]in death group were significant lower than that in survival group.Meanwhile,APACHE II scores [20 (18~23)vs 22 (19~24),P=0.015]and SOFA score [6 (5~6)vs 6 (6~7),P<0.001]were higher than that in survival group.The mortality decreased with the increase of ALB level (43.8% vs 21.2% vs 0%,P<0.05).ALB had a negative correlation with APACHEⅡ score (r=-0.190,P=0.049)and coma (r=-0.311,P=0.001),and had a positive correlation with Hb (r=0.449,P<0.001).Conclusion The incidence of hypoproteinemia was high in elderly sepsis patients.ALB level was associated with prognosis and severity of illness among the patients.

Objective: To investigate the epidemiological characteristics of sexually transmitted diseases (STDs) in Zhejiang Province from 2018 to 2022, so as to provide insights into improving STDs prevention and control strategies. Methods: Data of syphilis, gonorrhea, condyloma acuminatum, genital herpes and genital Chlamydia trachomatis infections reported in Zhejiang Province from 2018 to 2022 were collected from the Infectious Disease Surveillance System of Chinese Disease Prevention and Control Information System. The temporal, spatial and population distribution of STDs were analyzed, and the trends in incidence of STDs were evaluated using annual percent change (APC). Results: A total of 386 770 STDs cases were reported in Zhejiang Province from 2018 to 2022, with mean annual reported incidence of 127.80/105. The mean annual reported incidence from high to low was syphilis (44.11/105), genital Chlamydia trachomatis infections (40.20/105), gonorrhea (24.92/105), condyloma acuminatum (13.32/105), and genital herpes (5.34/105). The incidence of STDs appeared a tendency towards a decline from 2018 to 2022 (APC=-9.332%, P<0.05), with an average annual growth rate of -9.41%. Syphilis (APC=-11.536%, P<0.05), condyloma acuminatum (APC=-7.509%, P<0.05), and genital Chlamydia trachomatis infections (APC=-9.009%, P<0.05) showed a appeared a tendency towards a decline. The top three highest reported incidence were reported in Hangzhou City (185.98/105), Taizhou City (133.85/105) and Lishui City (122.73/105), respectively. The mean annual reported incidence of females was higher than that of males (140.60/105 vs. 117.83/105; P<0.05). Most STDs cases were at ages of 20 to 49 years (265 314 cases, 68.60%). Farmers (118 096 cases, 30.53%), household and unemployed personnel (85 924 cases, 22.22%) were the predominant occupation. Conclusions The incidence of STDs appeared a tendency towards a decline in Zhejiang Province from 2018 to 2022, with regional differences in incidence. People at ages of 20 to 49 years, farmers, household and unemployed personnel are high-risk populations for STDs.

Objective: To assess the implementation of National Leprosy Control Plan (2011-2020) in Zhejiang Province, so as to provide insights into leprosy control. Methods: Leprosy control data were collected from the National Leprosy Management Information System of China, and health administrative sectors, centers for disease control and prevention and professional leprosy control institutions at each level in Zhejiang Province. According to the scheme for the final evaluation of National Leprosy Control Plan (2011-2020), the implementation of 12 indicators in Zhejiang Province in 2020 was investigated, including the current number of leprosy patients, prevalence of leprosy, proportion of training on leprosy control skills, proportion of regular leprosy treatment, proportion of treatment of adverse reactions, annual examination rate of close contacts, proportion of early case identification and awareness of leprosy control knowledge. Results: There were 50 registered leprosy cases in Zhejiang Province by the end of 2020, with a decrease of 50.98% relative to in 2010. The prevalence of leprosy was less than 1/105 in 93 counties (districts) of Zhejiang Province, and the rate of training on leprosy control skills, rate of regular leprosy treatment, rate of treatment of adverse reactions, annual examination rate of close contacts, rate of early case identification were all 100% in Zhejiang Province. There were no new confirmed cases with diagnosis of leprosy having grade 2 deformity or disability, or no new cases with deformity or disability within 2 years following anti-leprosy therapy. In addition, the awareness of leprosy control knowledge was 91.67% among the public and 98.12% among the close contacts. All of the 12 indicators reached the requirements of the National Leprosy Control Plan (2011-2020). Conclusions The implementation of the National Leprosy Control Plan (2011-2020) in Zhejiang Province had achieved the targets defined in the final evaluation of the plan. Intensifying multi-sectoral joint leprosy prevention and control and improving early identification and standardized therapy of leprosy cases are recommended for future leprosy control in Zhejiang Province.