Objective:To establish a method for the determination of chloramphenicol and hydrocortisone in chloramphenicol hy-drocortisone ear drop. Methods:An HPLC method was used with a Shiseido SPOLAR C18 column (250 mm ′4. 6 mm, 5 mm). The mobile phase was 0. 01 mol·L-1 sodium heptane sulfonate buffer solution (6. 8 g potassium dihydrogen phosphate was dissolved in 0. 01 mol · L-1 heptane sodium sulfonate buffer solution and diluted to 1000 ml, 5 ml triethylamine was added and mixed, and then the pH was adjusted to 2. 5 by phosphoric acid)-methanol (40︰60). The column temperature was 30℃ and the flow rate was 1. 0 ml · min-1 . The detection wavelength was 245 nm and the injection volume was 10 μl. Results: Chloramphenicol and hydrocortisone had a good linear relationship within the range of 50. 26-753. 84 μg · ml-1 ( r =0. 9996 ) and 10. 93-163. 92 μg · ml-1 ( r =1. 0000), respectively. The average recovery of chloramphenicol was 100. 21% and RSD was 0. 48%(n=9). The average recovery of hydrocortisone was 100. 82% and RSD was 0. 37% (n=9). Conclusion:The method has the advantages of high specificity, good reproducibility and high precision, and can be used as a method for the determination of chloramphenicol and hydrocortisone in chlor-amphenicol hydrocortisone ear drop.

Objective To explore the empathy deficits of adolescents with different types of conduct disorder. Methods The participants included 65 adolescents ( who met the DSM-Ⅳ criteria for conduct disorder)ranging from 13 ～ 18 in age,and 195 normal adolescents ranging from 13 ～ 18 in age. All participants were assessed by revised Basic Empathy Scale. 65 patients were divided into 4 subgroups according to symptoms: destructive-nondestructive subgroups and overt-covert subgroups. Results (1) Scores of cognitive empathy were lower in patients than normal controls ( (29.86 ± 4.72) vs ( 32.09 ± 4.94), P ＜ 0. 01 ). (2) There were significant differences in the levels of cognitive empathy between patients and controls (P＜0. 01 ). Scores of cognitive empathy were lower in destructive subgroup than controls ( (29.76 ± 4.46) vs ( 32.09 ± 4.94) , P ＜ 0.01 ). (3) There were significant differences in the levels of two dimensions and total scores of empathy between patients and controls (F=3.10 ～5.36, P ＜ 0.05 ). Scores of cognitive empathy were lower in overt subgroup ( 29.22 ± 3.77 ) and covert subgroup (30.21 ± 5.17 ) than controls (32.09 ± 4.94) (P＜ 0.05, P＜0.01 );and scores of affective empathy were lower in overt subgroup than covert subgroup ( (26.13 ±5.05) vs (29.50 ±4.16), P＜0.05 ). Total scores of empathy were lower in overt subgroup (55.35 ±7.09) than covert subgroup (59.71 ±7.58) and controls (60.04 ±8.50 ) (P＜0.05). (4) Logistic regression analysis showed that cognitive empathy was a protective factor for conduct disorders( OR = 0.43 ). Conclusion The cognitive empathy level of patients is significantly lower than normal students;and boys with different types of conduct disorder possess different empathic abilities when compared with healthy controls;and cognitive empathy is a protective factor for conduct disorder.

Objective To evaluate the effect of sevoflurane on cognitive function of mice with Alzheimer's disease.Methods Twenty male mice carrying mnutations in amyloid precusor protein (APP) and presenilin 1 genes,weighing 30-40 g,aged 7 months,were divided into either sevoflurane group (group Sev) or control group (group C),with 20 mice in each group.Mice inhaled 3％ sevoflurane for 4 h in group Sev,and mice inhaled 30％ oxygen for 4 h in group C.At 1 month after inhaling sevoflurane or oxygen,the mice underwent continuous multiple-trail inhibitory avoidance training.The mice were then sacrificed and hippocampi were isolated for determination of the number of Aβ plaques (by immunohistochemistry) and expression of APP and Tau (S396) phosphorylation (by Western blot).Results Compared with group C,the memory lateucy was significantly shortened,the number of Aβ plaques was increased,the phosphorylation of Tau (S396) was increased,and the expression of APP was up-regulated in group Sev (P＜0.05).Conclusion Sevoflurane can decrease the cognitive function of mice with Alzheimer's disease.

Shanghai East Hospital has built a general practice residency training information system based on "Internet +" technology since 2017. This training system effectively promoted the training quality, improved the clinical and research ability of general practitioners, and strengthened the supervision of the training. It has improved the training satisfaction, increased passing rate of national medical licensing examination and graduation comprehensive examination of trainees. This training system can largely break the time and space limitations, and has strong replicability. It may provide reference to optimize the general practice standardized residency training for other institutions.

Objective:To explore the clinical significance of patient for patient safety strategy in inpatients with traumatic fracture.Methods:Convenience sampling method was used to randomly select 120 patients with traumatic fracture from September to December 2019 in the Department of Orthopaedics and Traumatology of a third-class hospital of Zibo city. Sixty patients with traumatic fracture treated from September to October 2019 were the control group, and 60 patients with traumatic fracture treated from November to December 2019 were the intervention group. The control group implemented routine safety management, and the intervention group implemented patient for patient safety strategy on the basis of routine safety management. The general information questionnaire, Hamilton Anxiety Scale (HAMA), patient for patient safety attitude questionnaire, incidence of adverse events during hospitalization and inpatient satisfaction scale were used to evaluate the effect after application.Results:HAMA score was 17.6±3.4,11.5±2.7 3 days after operation and at discharge in the intervention group, whcih were significantly lower than 23.3±4.3, 14.3±3.2 in the control group ( t values were 7.919, 6.912, P<0.001). The score of patients for patient safety attitude questionnaire was significantly higher in the intervention group at discharge compared with one day after operation ( t values were 3.246-6.558, P<0.001), as well as compared with those in the control group ( t values were 2.251-6.445, P<0.05). The total incidence rate of adverse events during hospitalization and satisfaction degree was 6.7%(4/60) and 95.0% (57/60) in the intervention,better than 13.3%(8/60), 90.0% (54/60) in the control group ( χ2 values were 7.260,16.008, P<0.001). Conclusions:The patient for patient safety strategy can effectively alleviate patients' negative psychological emotions, enhance patients' attitude to participate in safety behaviors, increase their enthusiasm to participate in safety behaviors, reduce the occurrence of adverse events during hospitalization, and improve patients' satisfaction with hospitalization.

Objective To explore the effects of vascular risk factors on cognitive function among the elderly in community. Methods A cross-sectional study was conducted in 1 269 elderly people ( aged 65 and over) who were randomly selected from three communities. Through face-to-face interview, cognitive function was assessed by mini-mental state examination(MMSE),and blood samples were collected for labo-ratory examination. Logistic regression analysis was used to analyze the vascular risk factors affecting cogni-tive function. Results Age (( 73. 1 ± 6. 6), ( 71. 3 ± 4. 9),t=4. 603,P<0. 05),education level ( χ2=12. 727,P<0. 05),hypertension (χ2=9. 106,P<0. 05) and LDL-C (χ2=5. 157,P<0. 05) were significantly different in the elderly with or without mild cognitive impairment(MCI). After controlling age,gender and ed-ucation,the logistic regression analysis showed that hypertension(β=0. 378,P=0. 006,OR(95%CI)=1. 44 (1. 10-1. 91)),systolic blood pressure ≥140 mmHg( β=0. 350,P=0. 011,OR( 95% CI)= 1. 42( 1. 08-1. 86),1 mmHg=0. 133 kPa),and high LDL-C( β=0. 355,P=0. 014,OR(95%CI)=1. 43( 1. 08-1. 89)) were the risk factors of MCI in the elderly in the community. Hypertension alone or high LDL-C (β=0. 365, P=0. 029,OR(95%CI)=1. 44(1. 04-2. 00)) alone was risk factor for mild cognitive impairment in the eld-erly in the community. The risk of mild cognitive impairment in the elderly with hypertension and high LDL- C was 2. 00 times higher than that in the healthy elderly ( β=0. 696,P<0. 05,OR( 95%CI)= 2. 00( 1. 36-2. 97)). Conclusion Mild cognitive impairment in the elderly is closely related to hypertension and elevat-ed LDL-C levels. Multiple vascular risk factors can further increase the risk of cognitive impairment.

Objective:To investigate the risk factors of post-stroke depression (PSD) in patients with first acute stroke 6 months after onset.Methods:Three hundred and sixty-seven patients with acute stroke who were treated for the first time in the Affiliated Hospital of Xuzhou Medical University were selected retrospectively. After onset for 6 months, the patients were followed up and divided into PSD group and non-PSD group. The clinical data, blood index, imaging data, degree of nerve damage and the patient's stigma level were compared between the two groups.Results:Totally 182 and 185 cases were included in the PSD and non-PSD groups, respectively. The incidence of PSD at 6 months post-stroke was 49.6% (182/367). The results of univariate analysis showed that diseased region, drinking history, monthly income, standard of culture, serum cortisol, total cholesterol (TC), high sensitivity C-reactive protein (hs-CRP), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), Stigma Scale for Chronic Illness-8 Chronic Disease Stigma Scale-8(SSCI-8) scores, National Institute of Health Stroke Scale (NIHSS) scores and subtype of stroke were risk factors for PSD ( P<0.05). Binary Logistic regression analysis showed that diseased region at frontal lobe ( OR = 3.245, P = 0.011), basal ganglia region ( OR = 2.820, P = 0.007), cerebellar hemisphere ( OR = 4.594, P = 0.010) and serum cortisol ( OR = 1.174, P<0.001), hs-CRP ( OR = 1.057, P<0.001), SSCI-8 scores ( OR = 1.674, P<0.001), NIHSS scores ( OR = 1.283, P<0.001) were independent risk factors for PSD. Conclusions:PSD is a common complication in patients with stroke. Diseased region (at frontal lobe, basal ganglia region, cerebellar hemispheres), hs-CRP, serum cortisol, level of morbidity stigma and degree of neurological impairment are development risk factors for the PSD at 6 months of acute stroke.

Continuing medical education for general practitioners is an important measure to upgrade the quality of primary health care services in China, which is still facing various challenges and need to be further developed and improved. This article analyzes the status quo and existing problems of continuing medical education for general practitioners in China, and proposes suggestions based on the concept of people centered and integrated health care (PCIC), including faculty development, training contents, assessment methods, and experience learning, to provide references for the improvement of continuing medical education for general practitioners.

Objective: To explore the effects of vascular risk factors on cognitive function among the elderly in community. Methods: A cross-sectional study was conducted in 1 269 elderly people (aged 65 and over) who were randomly selected from three communities.Through face-to-face interview, cognitive function was assessed by mini-mental state examination(MMSE), and blood samples were collected for laboratory examination.Logistic regression analysis was used to analyze the vascular risk factors affecting cognitive function. Results: Age ((73.1±6.6), (71.3±4.9), t=4.603, P<0.05), education level (χ²=12.727, P<0.05), hypertension (χ²=9.106, P<0.05) and LDL-C (χ²=5.157, P<0.05) were significantly different in the elderly with or without mild cognitive impairment(MCI). After controlling age, gender and education, the logistic regression analysis showed that hypertension(β=0.378, P=0.006, OR(95%CI)=1.44(1.10-1.91)), systolic blood pressure ≥140 mmHg(β=0.350, P=0.011, OR(95%CI)=1.42(1.08-1.86), 1 mmHg=0.133 kPa), and high LDL-C(β=0.355, P=0.014, OR(95%CI)=1.43(1.08-1.89)) were the risk factors of MCI in the elderly in the community.Hypertension alone or high LDL-C (β=0.365, P=0.029, OR(95%CI)=1.44(1.04-2.00)) alone was risk factor for mild cognitive impairment in the elderly in the community.The risk of mild cognitive impairment in the elderly with hypertension and high LDL-C was 2.00 times higher than that in the healthy elderly (β=0.696, P<0.05, OR(95%CI)=2.00(1.36-2.97)). Conclusion Mild cognitive impairment in the elderly is closely related to hypertension and elevated LDL-C levels.Multiple vascular risk factors can further increase the risk of cognitive impairment.

Objective:To investigate the bacterial composition and antimicrobial resistance profile of clinical isolates from bloodstream infections in China.Methods:The clinical bacterial strains isolated from blood culture were collected during January 2020 to December 2020 in member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS). Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical Laboratory Standards Institute(CLSI, USA). WHONET 5.6 was used to analyze data.Results:During the study period, 10 043 bacterial strains were collected from 54 hospitals, of which 2 664 (26.5%) were Gram-positive bacteria and 7 379 (73.5%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (38.6%), Klebsiella pneumoniae (18.4%), Staphylococcus aureus (9.9%), coagulase-negative Staphylococci (7.5%), Pseudomonas aeruginosa (3.9%), Enterococcus faecium (3.3%), Enterobacter cloacae (2.8%), Enterococcus faecalis (2.6%), Acinetobacter baumannii (2.4%) and Klebsiella spp (1.8%). The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus aureus were 27.6% and 74.4%, respectively. No glycopeptide- and daptomycin-resistant Staphylococci were detected. More than 95% of Staphylococcus aureus were sensitive to rifampicin and SMZco. No vancomycin-resistant Enterococci strains were detected. Extended spectrum β-lactamase (ESBL) producing Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis were 48.4%, 23.6% and 36.1%, respectively. The prevalence rates of carbapenem-resistance in Escherichia coli and Klebsiella pneumoniae were 2.3% and 16.1%, respectively; 9.6% of carbapenem-resistant Klebsiella pneumoniae strains were resistant to ceftazidime/avibactam combination. The prevalence rate of carbapenem-resistance in Acinetobacter baumannii was 60.0%, while polymyxin and tigecycline showed good activity against Acinetobacter baumannii. The prevalence rate of carbapenem-resistance of Pseudomonas aeruginosa was 23.2%. Conclusions:The surveillance results in 2020 showed that the main pathogens of bloodstream infection in China were gram-negative bacteria, while Escherichia coli was the most common pathogen, and ESBL-producing strains declined while carbapenem-resistant Klebsiella pneumoniae kept on high level. The proportion and the prevalence of carbapenem-resistant Pseudomonas aeruginosa were on the rise slowly. On the other side, the MRSA incidence got lower in China, while the overall prevalence of vancomycin-resistant Enterococci was low.