ObjectiveTo investigate the prevalence of 16S rRNA methylase genes, aminoglycoside modifying enzymes (AMEs) genes and small multidrug resistance efflux pump gene smr-2 in Klebsiella pneumoniae. MethodsTotally 138 Klebsiella pneumoniae isolates were collected in the First Affiliated Hospital, college of medicine, Zhejiang University from January 2007 to December 2009. Polymerase chain reaction (PCR) and DNA sequencing were performed to screen the presence of six 16S rRNA methylase genes ( rmtA, rmtB, rmtC, rmtD, armA and npmA), seven AMEs genes[aac ( 3 )- Ⅰ , aac ( 3 )- Ⅱ,aac(6′)- Ⅰ b, aac(6′)-Ⅱ, ant(2″)- Ⅰ , ant(3″)- Ⅰ , aph(3′)-Ⅵa]and small multidrug resistance efflux pumps gene (smr-2).Results Thirteen (9. 4％) isolates were found to carry rmtB gene, whereas 87 (63.0％) isolates were found to carry at least one kind of AMEs genes but no smr-2 was detected. The positive rates of aac(3)-Ⅱ, aac(6′)- Ⅰ b, ant (3″)- Ⅰ and ant(2″)- Ⅰ were 40.6％ (56/138), 31.9％ (44/138), 28.3％ (39/138) and 2.2％ (3/138), respectively. All strains harboring rmtB gene carried one to three AMEs genes. Among 44 aac(6′)- Ⅰ b positive strains, 37 (84. 1％ ) were confirmed to carryaac(6′)- Ⅰ b-cr. ConclusionFor Klebsiella pneumoniae, rmtB is the predominant subtype in 16S rRNA methylase genes, accompanying with several AMEs genes.

Objective:To evaluate in vitro antifungal activities of zhexinmycin against dermatophytes. Methods: The minimum in-hibitory concentration (MIC) and the minimum fungicidal concentration (MFC) of zhexinmycin against 7 strains of dermatophytes were determined by using broth microdilution method according to CLSI M-38A. Results:The MIC of zhexinmycin against dermatophytes was within the range of 0. 125-2. 000μg·ml-1 . The MFC was within the range of 0. 250-4. 000μg·ml-1 . Conclusion:Zhexinmycin shows strong in vitro antifungal effect on multiple fungi such as Epidermophyton floccosum, Trichophyton rubrum, Trichophyton violaceum, Mi-crosporum canis, Trichophyton mentagrophytes, Trichophyton tonsurans and Microsporum gypseum.

Objectives: To evaluate the efficacy, toxicity and side effects of CAP (cytoxan, adriamycin, cisplatin), NP(navelbine, cisplatin), GP(gemcitabine, cisplatin) in the treatment of patients with non small cell Lung cancer(NSCLC). Methods:146 patients with NSCLC diagnosed by pathology or cytology were treated with CAP, GP or GP regimen. Results:The overall response rate of the three groups (CAP, NP, GP)were 33.33%, 46.43% and 47.92% respectively. The major toxicity and side effects was bone marrow inhibition and the gastrointestinal reaction. Grade Ⅲ-Ⅳ side effects of CAP group were significant higher than the others. Conclusions:The regimen of navelbine and cisplatin or gemcitabine and cisplatin was more effective and less toxic than cytoxan, adriamycin, cisplatin and cisplatin.

Objective To explore the incidences of postpartum depression as well as the influencing factors in Guangzhou.Method Nine hundred and seventy women participated in the investigation with the Edinburgh postnatal depression scale(EPDS)to analyze the influenceing factors.Results The incidence rate was 38.87%(377/970). The influencing factors included age,feeding mode,delivery mode and education level.Conclusions The incidence of postpartum depression is at a higher level.The feeding mode,delivery mode and education level are the influencing factors.

ObjectiveTo investigate the anxiety and its interrelated factors of elderly outpatients. MethodsZung self-rating anxiety scale was used to evaluate 971 elderly outpatients, the scores between different sex, age, degree of education, etc. were compared. ResultsThe scores may become significantly different with the patients' sex, age, degree of education, satisfaction in regards to medical service and recognition of the disease(P<0.05).ConclusionFactors such as sex, age, degree of education, satisfaction of medical service, etc, deeply affect the anxiety in elderly outpatients.

Objective:To construct a multi-dimensional surgical equipment management and control platform based on artificial intelligence and Internet of Things(AIoT)to assist with the refinement and intelligent management medical equipment in hospital operating rooms.Methods:A multi-dimensional surgical equipment control platform based on AIoT was established by integrating the Internet of Things(IoT),big data analysis,indoor positioning technology,artificial intelligence(AI)technology and other technologies to collect real-time process data of surgical equipment such as endoscopy and electrosurgical,and to open up the relationships among information systems relating to surgical equipment,such as hospital information system(HIS),laboratory information system(LIS),radiology information system(RIS)and operation anesthesia management system(OAMS),so as to provide technical support for efficiency analysis,benefit analysis and assets management of surgical equipment.The platform was composed of 3 layers:data extraction layer,data engine layer and AI data analysis layer,including 4 functional modules:automatic data acquisition,deep data fusion,data mining and analysis and data visualization.Results:This platform was launched in Shanghai Municipal Hospital of Traditional Chinese Medicine in June 2022,and had realized achieving intelligent daily management such as indoor positioning of operating room equipment,one click inventory.A set of performance analysis method based on IoT and integrated with information systems was established to automatically count the utilization efficiency and cost-effectiveness of key surgical equipment to realize intelligent service,intelligent management,and digital operation.Conclusion:The construction and application of this platform improved the efficiency of medical equipment in operating rooms,reduced the cost and increased the efficiency,assisted in the refinement and intelligent management of hospital surgical equipment,and provided data support for scientific decision-making of hospital managers.

OBJECTIVE: To assess the clinical value of individualized pharmaceutical services for patients receiving vancomycin for severe infections and establish clinical monitoring procedures during vancomycin treatment. METHODS: Data were collected from patients with severe infections who received vancomycin treatment with individualized pharmacy services (test group, 144 cases) or without such services (control group, 884 cases) between January, 2017 and December, 2018. Using propensity score matching, the patients in the two groups with comparable baseline data were selected for inclusion in the study (62 in each group), and the efficacy, safety and economic indicators were compared between the two groups. RESULTS: The curative effects of the treatment did not differ significantly between the two groups, with the overall response rates of 95.16% in the test group and 91.94% in the control group ( CONCLUSIONS The participation of clinical pharmacists during the treatment can improve the clinical benefits of vancomycin in patients with severe infections.
Anti-Bacterial Agents/therapeutic use* ; Humans ; Infections/drug therapy* ; Pharmaceutical Services ; Retrospective Studies ; Vancomycin/therapeutic use*

BACKGROUND: Low-back pain (LBP) in nurses is a major health concern that affects their quality of life and ability to work, with consequences for their economic status. OBJECTIVE: This study evaluates the effect of low-level laser acupuncture combined with auricular acupressure (LAA) on pain intensity, pain interference and quality of life in nurses with LBP. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This randomized controlled trial recruited a convenience sample of hospital-based nurses from one teaching hospital in Taiwan, China. Participants were randomly assigned to the LAA group (n = 38) receiving low-level laser acupuncture and auricular acupressure for 4 weeks, and the control group (n = 38) receiving only sham laser acupuncture treatment without laser energy output. MAIN OUTCOME MEASURES: Data were collected for the primary pain outcome using the Short Form of the Brief Pain Inventory, while the secondary outcome, quality of life, was evaluated using the Roland-Morris Disability Questionnaire. Both primary and secondary outcomes were scored before the intervention, and after 2-week and 4-week intervention. The rate of LBP recurrence was evaluated at the 4th week and 8th week after the end of intervention. RESULTS: After controlling for prior pain, the result of linear mixed model analysis showed trends in significant between-group differences in the level of current pain occurring in week 4 (P < 0.001), worst pain in week 2 (P < 0.001) and week 4 (P < 0.001), least pain in week 2 (P = 0.032) and week 4 (P < 0.001), pain interference in week 2 (P = 0.009) and week 4 (P < 0.001), and in the life dysfunction in week 2 (P < 0.001) and week 4 (P < 0.001). Recurrence rates of LBP at the 4th and 8th weeks after the end of intervention were 0% and 36.89% in the LAA group, and 69.44% and 36.11% in the control group. CONCLUSION: This study shows that 4-week LAA intervention reduced pain intensity and pain interference, and improved quality of life for hospital-based nurses with LBP. These effects were maintained continuously for at least 4 weeks after the intervention. The nonpharmacological intervention, LAA, may be another efficacious, feasible, noninvasive, analgesic intervention for LBP. TRIAL REGISTRATION This study is registered at Clinicaltrials.gov (registration number NCT04423445).
Humans ; Acupressure ; Quality of Life ; Treatment Outcome ; Low Back Pain/therapy* ; Acupuncture Therapy ; Nurses

CRISPR-Associated Protein 9 ; Gene Editing ; CRISPR-Cas Systems/genetics*