0.05).The usage rate of antimicrobial agents in inpatients and outpatients was 74.65% and 45.52% respectively,with a significant difference(P

Objective To explore the viral etiology of acute respiratory tract infections in Nanping area .Methods A total of 3 572 patients ,suffered from acute respiratory tract infections from December 2012 to December 2014 were enrolled in the study .Sev‐en common respiratory viruses were detected by direct immunofluorescence assay ,including influenza A virus(IA) ,influenza B virus (IB) ,adenovirus (ADV) ,respiratory syncytial virus (RSV) ,arainfluenza type Ⅰ (P1) ,arainfluenza type Ⅱ (P2) ,arainfluenza typeⅢ (P3) .Results In total 3 572 samples ,509 samples were virus positive (14 .25% ) .Among them ,507 positive samples were single virus infections and 7 positive samples were double virus infections .RSV infection(9 .38% ) ,P3 infection(2 .32% ) and IA infection (1 .09% ) rates were the top three .Conclusion RSV was the main viral pathogen among 7 common respiratory viruses with obvious seasonal periodicity .Children′s immunity is low and need to prevent respiratory viral infections .

In recent ten years, general practitioner (GP) training and practice develops rapidly in China. It has established a relatively complete GP training system, including medical college education and standardized residency training. However, the path of continuing professional development and clinical skills improvement for GP after standardized residency training is still unclear. The concept of GP with special interest (GPSI) has been proposed these days, and it has put forward a new development direction for the career path of GP. In this article, on the basis of understanding the current status of GPSI in China, we try to discuss its advantages and problems, and then propose our suggestions for its future development.

Objective To better promote the health education and health promotion among patients with chronic disease, general practitioners (GPs) in the community should master the knowledge of non-communicable diseases (NCDs). This paper aimed to describe the current situation of GPs' knowledge about prevention and treatment of NCDs. Methods Self-designed questionnaires were issued to 1 077 GPs in community health service centers, and all GPs finished the questionnaire without assistance. The content of questionnaire includes the general information of GPs and six questions focusing on NCDs. Results Overall, 1 076 GPs completed the questionnaire, and the response rate was 99.9% (1 076/1 077). With regard to the six questions about NCDs, 90.4% (973/1 076) of GPs were well aware of the diagnosis of hypertension. Apart from that, the knowledge of diabetes mellitus (60.9%, 655/1 076), factors related to NCDs (70.2%, 755/1 076), the concepts of mental illness (52.0%, 560/1 076) and the clinical significance of tumor markers (87.9%, 946/1 076) among GPs were adequate, while more than half of the GPs did not know a lot about home oxygen therapy. Conclusion The mastering level of knowledge about prevention and treatment of NCDs among GPs varies that they need further improvement.

Objective To investigate the value for the level mensuration of von Willebrand factor antigen (vWF:Ag) in stroke risk assessment in the patients with non-valvular atrial fibrillation (AF).Methods 180 non-valvular AF patients were selected from the Tianjin medical university general hospital from the 2009 to 2011 for retrospective cohort study,112 males and 68 females in the group,age 61-87 years.Using the IL ACL-9000 blood coagulation instrument assay the level of vWF:Ag.Using ROC curve to analyze the diagnosis performance of vWF:Ag,using Cox regression analysis model to evaluate the of vWF:Ag effect on prognosis,using x2 test to analyze the relevance between vWF:Ag and clinical pathological factors.Compared the patients group with CHADS2 score with the patients group with CHA2DS2VASc score date using t test.Results vWF:Ag levels were control group (112 ± 34)％,paroxysmal AF group (119 ±31)％,the persistent AF group (179 ± 47)％,permanent AF group (217 ± 56)％,atrial fibrillation associated with stroke group (235 ± 104)％ respectively.There was no difference between the paroxysmal AF group and control group (q =1.75,P ＞ 0.05) ; vWF:Ag level was higher in persistent atrial fibrillation group than in paroxysmal AF group (q =10.10,P ＜ 0.01); permanent atrial fibrillation group was higher than that of the persistent AF group (q =5.21,P ＜ 0.01).The optimum cut-off point with vWF:Ag for stroke diagnosis was 188.5％,the area under ROC curve =O.843 (95％ confidence interval:0.785-0.901).In Cox regression multianalysis,the vWF:Ag (HR =0.405; 95％ CI =0.268-0.716; P =0.026),the congestive heart failure(HR =2.901 ; 95％ CI =1.837-3.951 ; P =0.001),stroke/transienl ischemic attack (HR =4.665 ; 95 ％ CI =2.837-7.291 ; P =0.000),age (HR =0.474 ; 95 ％ CI =0.211-0.765; P =0.039),the Cox analysis showed that vWF:Ag was the independent prognosis factor for stroke in AF patients.Inx2 analysis,there was the relationship between the level of the vWF:Ag and the congestive heart failure/LVdysfunction (x2 =8.227,P ＜ 0.01),hypertension (x2 =3.305,P ＜ 0.05),age (x2 =7.581,P ＜ 0.01),diabetes mellitus (x2 =6.730,P ＜ 0.01),stroke/ transient ischemic attack/thromboembolism (x2 =4.825,P ＜ 0.05),vascular disease (x2 =4.126,P ＜ 0.05).Compared the subjects with CHADS2 (score =1) with the CHA2DS2VASc(score =1),the level of the vWF:Ag was higher in patients with CHADS2 score =1 (t =4.283,P ＜ 0.01).Conclusion There was relationship between the level of vWF:Ag and main pathologic factors in patients with AF,and changed with the condition,high vWF:Ag level was an independent predictor of stroke risk,and had superior reference value for in assessment of stroke in patients with atrial fibrillation.

Animals ; Antineoplastic Agents ; therapeutic use ; Gene Silencing ; Genetic Therapy ; methods ; Humans ; MicroRNAs ; antagonists & inhibitors ; therapeutic use ; Neoplasms ; genetics ; therapy ; RNA Interference ; physiology ; RNA, Small Interfering ; antagonists & inhibitors ; therapeutic use ; RNA-Induced Silencing Complex ; metabolism

Objective To evaluate the effect of operation associated with uterine arerial chemotherapy and embolization preoperation.Methods 31 patients with pathologically confirmed cervical carcinoma were treated with interventional therapy,followed by uterectomyandpelvic lymphadenectomy.Results Curative effect was obvious.The lymph metastasis of Ⅱ and Ⅲ stage was 12% and 66.67%respectively.27 patients followedup for 3 years,23 were survived(85.19%).Conclusion For cervical carcinoma,before operation,the interventional therapy can reduce the size of tumor and the metastasis of lymph,improve the ectomy by operation and the survival rate.

Objective\ To investigate the effect and safety of LMWH on treatment of nephrotic syndrome(NS).Methods\ We randomized 43 patients with primary NS into 2 groups.Steroid and cyclophosphamide were given in control group.LMWH with the dosage of 3200～5000IU twice per day was added in the treated group.Results\ After 4 to 6 weeks of treatment,a significant increase in AT-Ⅲ,anti-Xa activity and serum albumin and decrease in fibrinogen and proteinuria were observed in LMWH.Conclusion\ LMWH should be recommended as a useful treatment of NS.

Objectives To investigate the incidence of deep vein thrombosis (DVT) of lower limbs and pulmonary embolism (PE) caused by hypercoagubility in patients with nephrotic syndrome and to estimate the indication and clinical effect of anticoagulation therapy. Methods 54 patients with nephrotis syndrome(thirty-one males and twenty-three females with mean age: 44 13?15 88, 24 hours proteinuria:8 43?5 64g, albuminemia: 20 48?5 41g/L) were enrolled in this study.DVT of lower limbs and PE were confirmed by radionuclide imaging (RNV) with 99mTc-MAA and the clinical effect of subcutaneous injection of low molecular weight heparin (LMWH) and oral antiplatelet coagulation therapy were evaluated as well. Results 41 out of 54 cases (76%) had DVT of lower limbs, 14 8% of which had clinical manifestations. 32 out of 54 cases (59 25%) had PE, 7 4% of which had symptoms. 70 7% of PE were caused by DVT of lower limbs. No patient died of PE after the LMWH treatment.Conclusions DVT is one of the most important complications of NS. RNV can be used to make early diagnosis of DVT of lower limbs and PE. Early anticoagulation therapy might ameliorate the prognosis of NS and lower the mortality of PE.

Objective To analyze the radiographical and histological features of implanted composites of decalcified bone matrix(DBM) impregnated with calcium phosphate cement(CPC) and recombinant human bone morphogenetic protein-2(rhBMP-2) in bone defect,and evaluate its biodegradation properties.Methods By prefabricating the rabbit DBM,the CPC/DBM/rhBMP-2 composites were prepared in a DBM/CPC ratio of 2∶8 and the rhBMP-2 content of about 1.2mg/cm3.Twenty-four rabbits were divided into groups A and B(12 each).Animals in group A were implanted with the composites in the bone defects at femoral condyle and femoral muscle,and the rabbits in group B CPC was implunted in the same place.Animals were sacrificed at 6,12 and 24 weeks after operation(4 each),and the implants were examined radiographically and histologically.Results It was shown by radiography that,in group A,the margin of implants in femoral condyle defects became irregular 6 weeks after operation;the appearance of the implants appeared hazy and shrunken in size 12 weeks after operation;and most of the implant was absorbed and the medullary cavity became partly rediotransparent 24 weeks after operation.The density of the implants in muscles beoame less dense gradually during 6 to 24 weeks after operation.While in group B,the appearance and density of the implants in femoral condyle defects and muscles were not obviously changed during 6-24 weeks after operation.Histological observation showed that,in group A,the interface between the implants in the bone defects was filled with newly formed bone grown into the composites 6 weeks after operation.New bone formed inside the composites 12 weeks after operation,and the bone defect was repaired,and most of the implants were replaced by new bones,with a little portion of it remained 24 weeks after operation.Fibrous tissue was seen to grow into the composites in muscles during 6-12 weeks after operation,and only a little of the composites remained 24 weeks after operation.In group B,no fibrous tissues or new bones grew into composites implanted in femoral condyle defects or muscles 6-12 weeks after operation,and the bone defects was still filled with materials of CPC,and no new bone or fibrous tissue was found inside CPC 24 weeks after operation.Conclusion Compare with CPC,the DBM with an optimal formula is are easy biodegradable and can be replaced by autologous bone.