OBJECTIVE:To compare different prescription strategies of antibiotics in the management of acute upper respiratory tract infection(AURTI).METHODS:A total of 984 patients with AURTI were divided into three groups:antibiotic group(treated with antibiotics throughout the course),delayed group(delayed use of antibiotics),and none-antibiotic group(receiving no antibiotics).The course of diseases,rate of return visits,incidence of adverse drug reactions(ADR)and total trea-tment costs were analyzed statistically.RESULTS:Course of diseases was the longest in the antibiotic group(P

Objective To investigate the clinical value of individualization of transrectal ultrasound guided prostate biopsy strategies for prostate cancer detection.Methods Ninety-seven patients who were considered having prostate cancer underwent individualization prostate biopsy strategies as individualization group.Fifty-two patients who were considered having prostate cancer underwent systemic 6-core prostate biopsy as control group.The detection rate of prostate cancer and rate of complications were compared between two groups.Results The detection rate of prostate cancer in individualization group was 43.3 ％(42/97),there was no significant difference in age and prostate volume between the prostate cancer patients and the non-prostate cancer patients(P＞0.05),but the prostate specific antigen(PSA)level of the prostate cancer patients was significantly higher than that of the non-prostate cancer patients[(26.4±2.9)μ g/L vs.(11.2±3.1)μ g/L,P=0.0000].The detection rate of prostate cancer in control group was 23.1％(12/52),the detection rate of prostate cancer in individualization group was significantly higher than that in control group(P=0.014).There was no significant difference in the rate of complications between two groups(P＞0.05).Conclusions The first detection rate of prostate cancer in individualization of transrectal ultrasound guided prostate biopsy strategies is higher than that by systemic 6-core prostate biopsy,and the rate of complications is not increased.The individualization of transrectal ultrasound guided prostate biopsy strategies for prostate cancer is good,safety,deserve clinical expansion.

Objective To investigate the effect of Clopidogrel on the plasma endothelin(ET)and calcitonin gene related peptide(CGRP)in patients with unstable angina pectoris(UAP).Methods Patients with UAP were divided into two groups,the regular treated group(n =50)was treated with Isoket and the Dansben group(n =50)was treated with combined Isoket and Clopidogrel.The plasma ET and CGRP were measured before and after treatment by radioimmunoreactive assay.Data were compared between the two groups and also compared with those measured in 20healthy subjects for control.Results ET level was significantly higher and CGRP level was lower in UAP patients than that in healthy subjects(P ＜ 0.05).After Clopidogrel treatment,ET was significantly decreased(P ＜ 0.01)and CGRP increased(P ＜0.05)in combined treatment group compared with patients received lsoket only.Conclusion Clopidogrel was an effective drug for UAP treatment,which could efficiently regulate the ET and CGRP metabolism.

Objective To study on the anti-hepatic fibrosis effects of salvianolic acid A injection (SAA), and further to provide the theoretical basis for the clinical application .Methods Using CCl4 induced hepatocyte injury in vitro, the hepatocyte viability , the levels of ALT , AST and LDH in cell culture supernatants and the levels of SOD and MDA in cell lysates were detected .In addition , the hepatic fibrosis rat model was made by subcutaneous injection of CCl 4 , the serum LN, HA, SOD and MDA levels were detected and the pathological changes in liver tissue were also observed . Results Compared with model group , the hepatocyte viability in SAA high or low dose group and Vit E group were significantly increased (P <0.01), and the activities of ALT, AST and LDH in SAA high dose group were significantly lowed ( P <0.01 ) .The activity of SOD in SAA high dose group and Vit E group was significantly increased ( P <0.05), while MDA content was decreased (P <0.05).Vivo test showed that the levels of serum LN and HA in SAAhigh dose group were significant lower than those of hepatic fibrosis rat model group (P <0.05).Moreover, the activity of SOD in SAA high or low dose group was significantly increased (P <0.05, P <0.01), while MDA content was lowed (P <0.05, P <0.01), and can improve the pathological of liver tissues .Conclusions SAA injection can anti-lipid peroxidation and thereby protect hepatocyte and reduce hepatic fibrosis .

Objective To observe the effect of Guanxinning Tablet (GXNT) on myocardial infarction and cardiac autonomic nervous function in rats with myocardial ischemia reperfusion injury (MI/RI).Methods Seventy SD rats were divided into 7 groups randomly (n=10);the sham group, the MI/RI group, 75 mg/kg, 150 mg/kg, 300 mg/kg and 600 mg/kg GXNT groups and 300 mg/kg Compound Danshen Tablets (DST) group.All rats were administered orally for 7 days, and then the MI/RI model was made by ligating the left anterior descending branch of coronary artery in rats.The changes of electrocardiogram were recorded and the electrocardiogram of J points and heart rate variability (HRV) parameters were analyzed.At the end of reperfusion, the myocardial infarct size was measured by using Evans blue and tetrazolium chloride (TTC) double staining, and pathological changes of myocardium were observed by HE staining.The changes of serum lactate dehydrogenase (LDH), creatine kinase (CK), malondialdehyde (MDA) and nitric oxide (NO) levels were also detected.Results Compared with MI/RI group, GXNT and DST groups were significantly reduced myocardial infarct size and inhibited the rising of serum LDH and CK activities (P < 0.05, P < 0.01), and also reduced the total or average value of J point during reperfusion (P < 0.05, P < 0.01).Meanwhile, GXNT and DST groups were markedly increased HRV and serum NO level as well as decreased serum MDA content (P < 0.05, P < 0.01), and improved myocardial tissue pathology.Conclusions GXNT can reduce the myocardial infarction in rats with MI/RI, and also improve the cardiac autonomic nervous function.

Objective: To explore the effectiveness of Balint group on compassion fatigue among oncology nurses. Methods: From January to December 2016, 35 oncology nurses from one general hospital were enrolled. 18 cases were allocated in the observation group and 17 cases in the control group by computer randomization. Nurses in the observation group were received a total of 8 times Balint Group activities, with 2 times a month and 1.5 hours each time, which is aiming to discuss difficult cases encountered in the clinic to help nurses have a deeper experience and a better understanding of the emotions and behaviors, fantasies and needs between nurse-patient interaction. Nurses in the control group without intervention. All the Participants were requested to complete the survey of the Professional Quality of Life (ProQOL) , the Jefferson Scale of Empathy-Health Professionals (JSE-HP) , and the General Health Questionnaire (GHQ) at pre and post intervention. Results: Before intervention, two group of nurses in age, working years, marriage, and education were not statistically significant (P>0.05). There was no difference in the scores of empathy, compassion satisfaction, secondary traumatic stress, and General health (P>0.05). After intervention, the scores of JSE-HP and its three dimensions of perspective taking, emotional care, and trans-positional consideration in the observation group had significantly higher than the control group (P<0.05). The level of compassion satisfaction in the observation group was higher, and the general health status was lower (P<0.05). There was no statistically difference in the level of burnout and secondary traumatic stress between two groups (P>0.05) . Conclusion Balint group has a positive role in promoting nurses’empathetic skills, compassion satisfaction and mental health.

OBJECTIVETo study the severe acute respiratory syndrome (SARS)-associated coronavirus genotype and its characteristics.

METHODSA SARS-associated coronavirus isolate named ZJ01 was obtained from throat swab samples taken from a patient in Hangzhou, Zhejing province. The complete genome sequence of ZJ01 consisted of 29,715 bp (GenBank accession: AY297028, version: gi: 30910859). Seventeen SARS-associated coronavirus genome sequences in GenBank were compared to analyze the common sequence variations and the probability of co-occurrence of multiple polymorphisms or mutations. Phylogenetic analysis of those sequences was done.

RESULTSBy bioinformatics processing and analysis, the 5 loci nucleotides at ZJ01 genome were found being T, T, G, T and T, respectively. Compared with other SARS-associated coronavirus genomes in the GenBank database, an A/G mutation was detected besides the other 4 mutation loci (C:G:C:C/T:T:T:T) involved in this genetic signature. Therefore a new definition was put forward according to the 5 mutation loci. SARS-associated coronavirus strains would be grouped into two genotypes (C:G:A:C:C/T:T:G:T:T), and abbreviated as SARS coronavirus C genotype and T genotype. On the basis of this new definition, the ZJ01 isolate belongs to SARS-associated coronavirus T genotype, first discovered and reported in mainland China. Phylogenetic analysis of the spike protein gene fragments of these SARS-associated coronavirus strains showed that the GZ01 isolate was phylogenetically distinct from other isolates, and compared with groups F1 and F2 of the T genotype, the isolates of BJ01 and CUHK-W1 were more closely related to the GZ01 isolate. It was interesting to find that two (A/G and C/T) of the five mutation loci occurred in the spike protein gene, which caused changes of Asp to Gly and Thr to Ile in the protein, respectively.

CONCLUSIONAttention should be paid to whether these genotype and mutation patterns are related to the virus's biological activities,epidemic characteristics and host clinical symptoms.

Objective:To study the distribution and antibiotics resistance of the main pathogens of neonatal purulent meningitis in different regions of China.Methods:A retrospective descriptive clinical epidemiological study was conducted in children with neonatal purulent meningitis which admitted to 18 tertiary hospitals in different regions of China between January 2015 to December 2019. The test results of blood and cerebrospinal fluid, and drug sensitivity test results of the main pathogens were collected. The distributions of pathogenic bacteria in children with neonatal purulent meningitis in preterm and term infants, early and late onset infants, in Zhejiang Province and other regions outside Zhejiang Province, and in Wenzhou region and other regions of Zhejiang Province were analyzed. The chi-square test was used for statistical analysis.Results:A total of 210 neonatal purulent meningitis cases were collected. The common pathogens were Escherichia coli ( E. coli)(41.4%(87/210)) and Streptococcus agalactiae ( S. agalactiae)(27.1%(57/210)). The proportion of Gram-negative bacteria in preterm infants (77.6%(45/58)) with neonatal purulent meningitis was higher than that in term infants (47.4%(72/152)), and the difference was statistically significant ( χ2=15.54, P=0.001). There were no significant differences in the constituent ratios of E. coli (36.5%(31/85) vs 44.8%(56/125)) and S. agalactiae (24.7%(21/85) vs 28.8%(36/125)) between early onset and late onset cases (both P>0.05). The most common pathogen was E. coli in different regions, with 46.7%(64/137) in Zhejiang Province and 31.5%(23/73) in other regions outside Zhejiang Province. In Zhejiang Province, S. agalactiae was detected in 49 out of 137 cases (35.8%), which was significantly higher than other regions outside Zhejiang Province (11.0%(8/73)). The proportions of Klebsiella pneumoniae, and coagulase-negative Staphylococcus in other regions outside Zhejiang Province (17.8%(13/73) and 16.4%(12/73)) were both higher than those in Zhejiang Province (2.9%(4/137) and 5.1%(7/137)). The differences were all statistically significant ( χ2=14.82, 12.26 and 7.43, respectively, all P<0.05). The proportion of Gram-positive bacteria in Wenzhou City (60.8%(31/51)) was higher than that in other regions in Zhejiang Province (38.4%(33/86)), and the difference was statistically significant ( χ2=6.46, P=0.011). E. coli was sensitive to meropenem (0/45), and 74.4%(32/43) of them were resistant to ampicillin. E. coli had different degrees of resistance to other common cephalosporins, among which, cefotaxime had the highest resistance rate of 41.8%(23/55), followed by ceftriaxone (32.4%(23/71)). S. agalactiae was sensitive to penicillin, vancomycin and linezolid. Conclusions:The composition ratios of pathogenic bacteria of neonatal purulent meningitis are different in different regions of China. The most common pathogen is E. coli, which is sensitive to meropenem, while it has different degrees of resistance to other common cephalosporins, especially to cefotaxime.