Objective To investigate the factors affecting the door-to-needle (DTN) time for intravenous thrombolytic therapy in patients with acute ischemic stroke. Methods Patients with acute ischemic stroke treated with intravenous thrombolysis were enrolled prospectively. The demography, vascular risk factors, and other clinical data were collected. According to DTN time 60 min as a standard, the patients were divided into either a non-delay group or a delay group. The factors affecting DTN delay were analyzed. Results A total of 78 patients with acute ischemic stroke treated with intravenous thrombolysis were enrolled, 46 (59.0%) were males with an average age of 64.24 ± 10.06 years. The average National Institutes of Health Stroke Scale(NIHSS)score was 12.13 ± 3.17.The average DTN time was 79.77 ± 20.51 min, and the DTN time in 55 patients (70.51%) was >60 min. The age (66.3 ± 9.7 years vs. 59.3 ± 9.4 years; t=2.939, P=0.004), door-to-CT initiation time (32.7 ± 11.3 min vs. 24.6 ± 7.1 min; t= 3.183, P= 0.002), door-to-CT interpretation time (50.8 ± 16.8 min vs. 35.5 ± 8.8 min; t= 4.383, P< 0.001), and door-to-biochemistry result time (62.6 ± 11.0 min vs. 44.8 ± 5.6 min;t=7.377, P<0.001) in the delay group were all significantly higher or longer than those in the non-delay group.The proportions of patients with hypertension(58.2% vs. 26.1%;χ2=6.687,P=0.010) and using antihypertensive drugs before onset (41.8% vs. 13.0%; χ2=6.043, P=0.014) in the delay group were also higher than those in the non-delay group. Multivariate logistic regression analysis showed that the door-to-biochemistry result time (odds ratio 1.725, 95% confidence interval 1.058-2.814; P=0.029)was an independent influencing factor for DTN delay.Conclusions The delay of door-to-biochemistry result time is an independent factor for DTN time delay in patients with acute ischemic stroke treated with intravenous thrombolytic therapy.

This paper focused on the research progress of the assessment methods of carers′ fall concern for the elderly. The content of this review included the definition of carers′ fall concern, and the advantages and disadvantages of various assessment method of carers′ fall concern for the caregivers to the elderly, such as qualitative interviews, questionnaires, and scales. Through this review, the authors hoped to provide a reference for selecting or developing a localized carers′ fall concern assessment tool.

OBJECTIVETo elucidate the epidemic condition and molecular subtyping of ciprofloxacin and cefotaxime co-resistant Salmonella Indiana (S. Indiana) isolated from retail chicken carcasses in six provinces of China.

METHODSA total of 2 647 Salmonella strains isolated from retail chicken carcasses collected from six provinces of China were subjected to antimicrobial susceptibility testing. All Salmonella isolates co-resistant to ciprofloxacin and cefotaxime were further characterized by serotyping, extended-spectrum beta-lactamases (ESBLs) producing strains screening and pulsed field gel electrophoresis (PFGE) typing.

RESULTSAmong 2 629 Salmonella isolates tested, 227 (8.52%) isolates were co-resistant to ciprofloxacin and ceftazidime/cefotaxime (Beijing: 11.67% (99/874), Jilin: 8.20% (60/726), Guangdong: 1.39% (7/502), Jiangsu: 15.61% (42/260), Shaanxi: 8.56% (16/186), Inner Mongolia: 0 (0/81)), and 224 of them were identified as S. Indiana. 213 (95.10%) isolates of S. Indiana were ESBLs producing strains. All ciprofloxacin and cefotaxime co-resistant S. Indiana isolates developed a multi-drug resistant profile and 17.86% (40/224) of them were resistant to all antibiotics tested except carbapenems, and 50.89% (114/224) of them resistant to 9 antibiotics, additionally, 25.45% (57/224) of them showed multi-drug resistance to 8 antibiotics. All ciprofloxacin and cefotaxime co-resistant S. Indiana isolates were divided into 32 PFGE clusters and 150 PFGE patterns. Strains of S. Indiana from same or different sampling site and time seemed to either share the same PFGE patterns or be differential to each other in different regions.

CONCLUSIONThe results indicated that chicken carcasses collected from parts of China were heavily contaminated by ciprofloxacin and cefotaxime co-resistant S. Indiana and could serve as an important reservoir of ciprofloxacin and cefotaxime co-resistant Salmonella. Molecular subtyping results indicated that cross contamination or common pollution source might be in these strains.

Animals ; Anti-Bacterial Agents ; pharmacology ; Cefotaxime ; pharmacology ; Chickens ; microbiology ; China ; Ciprofloxacin ; pharmacology ; Drug Resistance, Multiple, Bacterial ; Electrophoresis, Gel, Pulsed-Field ; Food Contamination ; Food Microbiology ; Meat ; microbiology ; Salmonella ; classification ; isolation & purification ; Serotyping ; beta-Lactamases

Objective By analyzing the incidence, prevalence, mortality, Disability Adjusted of Life Years (DALY) situations and trends of AIDS in China from 1990 to 2019, this paper provides scientific basis for the preventions and controls of AIDS in China. Methods The incidence, prevalence, mortality and DALY rate of AIDS from 1990 to 2019 are obtained from GBD 2019 data. The standardardized rate of four indicators are used to compare and analyze the AIDS changes in China, the United States, Japan and the global with the development of years. Results The four indicators of AIDS in China present increasing trends, with male higher than female. The incidence rate increased from 0.82/100 000 in 1990 to 2.24/100 000 in 2019, the prevalence increased from 5.63/100 000 to 38.77/100 000, and the mortality increased from 0.23/100 000 to 2.23/100 000. The DALY rate increased from 13.18/100 000 to 98.15/100 000. Compared with the global and the United States, the standardized rate of four indicators of AIDS in China in 2019 showed a trend of low level, but it was higher than that in Japan. Conclusion In recent years, some progress has been made in AIDS preventions and controls in China, but the disease burden of AIDS is still on the rise. The situation of AIDS preventions and controls is still serious and unremitting efforts should be made to reduce the burden of AIDS.

Three cases of dermatomyositis presenting with inverse Gottron's papules were reported.Of the 3 patients,there were 2 males and 1 female aged 43,41 and 46 years respectively,whose disease durations were 1,6,7 months respectively.Inverse Gottron's papules manifested as papules overlying the palmar aspect of the metacarpal and interphalangeal joints,which were arranged in a linear pattern in 2 cases.Of the 3 cases,1 presented with interstitial pneumonia,3 with myositis,and 2 showed negative anti-nuclear antibody test.Histopathological examination of inverse Gottron's papules in 1 case revealed focal liquefaction degeneration of basal cells and perivascular infiltration with inflammatory cells,especially lymphocytes,in the superficial dermis.The 3 patients received oral glucocorticoids and immunosuppressive agents in the early period of treatment.After 3-month treatment,clinical symptoms including muscle weakness and muscle pain were improved evidently,but no obvious improvement in inverse Gottron's papules was observed.After 1-year treatment,these papules on the palmar aspect were markedly relieved in 1 case.

Objective: To analyze the clinicopathological characteristics of papillary thyroid microcarcinoma (PTMC) and risk factors for central lymph node metastasis(CLNM) in PTMC. Methods: The data of 900 patients with PTMC initially treated in our hospital from January 2004 to December 2015 were retrospectively analyzed. Chi-square test and Logistic regression analysis were performed to determine the risk factors for CLNM. Results: CLNM affected 162 (22.9%) of 707 patients treated with central lymph node dissection. Age, maximum tumor size, multifocality, bilaterality, and extracapsular spread (ECS) were significantly correlated with CLNM (all P<0.01). Age<45 years, maximum tumor size>5 mm, multifocality, bilaterality, and extracapsular spread were independently correlated with CLNM. Conclusion A prophylactic central lymph node dissection should be considered in PTMC patients with age<45 years, maximum tumor size>5 mm, multifocality, bilaterality, and extracapsular spread.