Objective To explore the effect of comprehensive intervention measure on antimicrobial use and incidence of healthcare-associated infection(HAI)in patients in sports medicine department.Methods Antimicrobial use and incidence of HAI in hospitalized patients in the surgical departments (sports medicine department and other surgical departments)of a hospital between January 2006 and December 2010 were analyzed retrospectively(before intervention),from January 2011, comprehensive intervention based on clinical-centered multi-department cooperation was adopted by sports medicine depart-ment,the other surgical departments over the same period were not comprehensively intervened;antimicrobial use and inci-dence of HAI in patients in surgical departments between January 2012 and December 2013 were monitored prospectively (after intervention ),effectiveness of intervention was evaluated.Results Antimicrobial use and incidence of HAI in pa-tients in sports medicine department after intervention were both lower than before intervention (55.75% vs 95.26%,χ2=753.42;0.10% vs 0.32% ,χ2 =15.13,both P <0.01).Antimicrobial use in patients in other surgical departments after intervention was lower than that before intervention(65.63% vs 73.79% ,χ2 =251.57,P <0.01 );incidence of HAI was higher than that before intervention(0.55% vs 0.42% ,χ2 =19.04,P <0.01).Conclusion Comprehensive in-tervention measure based on clinical-centered multi-department cooperation is safe and effective,it can reduce antimicrobial use and incidence of HAI in patients in sports medicine department.

Objective To study the risk factors for surgical site infections (SSIs)in patients with hepatobiliary and pancreatic surgery.Methods Sixty patients who received hepatobiliary and pancreatic surgery and suffered SSIs from January 2006 to January 2010 were selected as infections group,119 patients who also received hepatobiliary and pancreatic surgery but didn’t develop infection were as control group,retrospective investigation was per-formed.Results Univariate analysis revealed the associated factors for post-operative SSIs were age,history of car-diocerebrovascular disease,history of abdominal surgery,history of smoking,preoperative anemia,abnormal pre-operative coagulation and blood sugar,pre-operative infection,use of laparoscope,incision type,duration of opera-tion,ASA score,post-operative drainage and dressing chang within 24 hours of post-operation(all P<0.05).Mult-ivariate analysis revealed that abdominal surgery history (OR95%CI:3.09 [1.21 -7.91 ]),high NISS score (OR95%CI:6.18[2.41-15.85])were risk factors of SSIs in patients with hepatobiliary and pancreatic surgery, and dressing chang within 48 hours of post-surgery were protective factor (OR95%CI:3.81 [1.56-9.34]). Conclusion History of abdominal surgery and high score of NISS are major risk factors for SSIs in patients with hepatobiliary and pancreatic surgery.To reduce the risk of SSIs,blood glucose should be actively adj usted,anemia and coagulation abnormalities should be treated;duration of operation should be shortened as far as possible,wound should be kept clean and dressing should be changed timely after surgery.

We have developed a rapid and high throughput lipase-ANS (8-Anilino-l-naphthalenesulfonic acid) assay to evaluate the thermo-stability of lipases based on the ANS fluorescence signal's increasing and shifting when this small fluorescence probes binds to lipase. The testing lipase samples were incubated at a temperature range of 25 degrees C to 65 degrees C for 30 min before mixed with ANS solution (0.20 mg/mL lipase and 0.05 mmol/L ANS in the buffer of 20 mmol/L Tris-HCl, 100 mmol/L NaCl, pH 7.2) in a cuvette or microplate. Fluorescence signals of the samples were measured at EX 378 nm, EM 465 nm with a fluorescence photometer or a plate reader, and Tm was calculated with the software of GraphPad Prism5.0. The Tm values of several mutants of Penicillium expansum lipase (PEL) were measured with this ANS assay and conventional method simultaneously and the results show that Tm values are comparative and consistent between these methods, suggesting that the lipase-ANS assay is a reliable, rapid and high throughput method for lipase thermo-stability measurement.
Anilino Naphthalenesulfonates ; chemistry ; Enzyme Stability ; High-Throughput Screening Assays ; methods ; Hot Temperature ; Lipase ; metabolism ; Spectrometry, Fluorescence

Objective To evaluate the efficacy of the thoracic approach to thoracic paravertebral blockade ( PVB) performed via video-assisted thoracoscope on postoperative analgesia in patients undergoing lobectomy. Methods A total of 84 patients of both sexes, aged 44-64 yr, with body mass index of 19. 7-24. 9 kg∕m2 , of American Society of Anesthesiologists physical statusⅡorⅢ, scheduled for elective vide-o-assisted thoracoscopic unilateral lobectomy, were divided into 2 groups ( n=42 each) using a random number table method: thoracic PVB group (TP group) and control group (C group). In TP group, the thoracic approach to thoracic PVB was performed on the affected side via video-assisted thoracoscope before closing the chest, and 0. 375％ ropivacaine hydrochloride 20 ml was injected. Then patient-controlled intra-venous analgesia ( PCIA) was performed in both groups. PCIA solution contained dezocine 0. 6 mg∕kg, flurbiprofen axetil 200 mg, palonosetron 0. 5 mg and dexamethasone 10 mg in 120 ml of normal saline. The PCA pump was set up with a 0. 5 ml bolus dose, a 15 min lockout interval and background infusion at a rate of 2 ml∕h after a loading dose of 5 ml. Duration of operation was recorded. The peak expiratory flow rate ( PEFR) was recorded before surgery and at 6, 24 and 48 h after surgery. The amount of dezocine and pressing times of PCA were recorded at 24 and 48 h after surgery. The occurrence of drowsiness, dizziness, nausea and vomiting was recorded after surgery. Tramadol 2 mg∕kg was intravenously injected as rescue an-algesic when visual analog scale score≥4 points. Results Compared with group C, the amount of dezo-cine and pressing times of PCA were significantly reduced at 24 and 48 h after surgery, the requirement for rescue analgesia and incidence of nausea and vomiting were decreased, and the PEFR was increased at 6 h after operation in group TP ( P<0. 05) . Conclusion The thoracic approach to PVB performed via video-assisted thoracoscope can enhance the efficacy of postoperative analgesia in patients undergoing lobectomy.

Objective:To explore the experience and learning curve of single-line suspension suction rod-assisted hybrid cavity-building thyroid surgery via the oral vestibular approach.Methods:Clinical data of 138 patients undergoing single-line suspension suction rod-assisted hybrid cavity-building thyroid surgery via oral vestibular approach from Sep. 2019 to Dec. 2021 in the Department of Thyroid and Breast Surgery of Affiliated Hospital of North Sichuan Medical College were retrospectively analyzed. The cumulative sum (CUSUM) method and best-fit curve analysis were used to compare the differences in each index such as operative time, intraoperative bleeding, number of lymph nodes cleared in the central region and postoperative related complications at various stages of the learning curve.Results:All 138 patients underwent single-line suspension rod-assisted hybrid cavity-building thyroid surgery via the oral vestibular approach, and one patient was converted to open surgery due to large intraoperative bleeding in the mass. There were 14 males and 124 females, mean age (36.07±8.49) years (20-55 years), thyroid tumor size (7.74±6.49) mm (2.4-50mm), 5 cases underwent Subtotal thyroidectomy, 129 cases underwent Unilateral lobectomy + lymph node dissection in the middle region, and 4 cases total thyroidectomy + central zone lymph node dissection. The number of surgical cases corresponding to the apex of the CUSUM learning curve was 45, and the learning curve was divided into two stages: the learning improvement stage (1-45 cases) and the mastery stage (46-138 cases). The operative time, intraoperative bleeding, postoperative hospital stay, and chin numbness were all lower in the proficiency period than in the learning and training period ( P<0.05), and the number of lymph nodes cleared in the central region was larger than that in the learning and improvement stage ( P<0.05), while the differences in other indexes between the two stages were not statistically significant ( P>0.05) . Conclusion:The single-line suspension suction rod-assisted hybrid cavity-building thyroid surgery via the oral vestibular approach has clinical application value and is worth promoting, and the number of surgical cases to be accumulated to master this technique is 45.

Objective:To analyze the changing trend of the incidence and mortality rates of liver cancer in the Chinese population from 1990 to 2019, and predict the future development trend of liver cancer.Methods:The descriptive epidemiologic method was conducted. Based on the Global Burden of Disease data from the Institute for Health Metrics and Evaluation at the University of Washington, the crude incidence rate and total number, crude mortality rate and total number, age- and sex-specific incidence rate and number, age- and sex-specific mortality rate and number of liver cancer in the Chinese population from 1990 to 2019 were collected. The age-standardized rate was calculated using the year 2000 China's standard population. Observation indicators: (1) the incidence and mortality of liver cancer in the Chinese population from 1990 to 2019; (2) changing trend of the age-standardized incidence and mortality rates of liver cancer in the Chinese population from 1990 to 2019; (3) prediction of the incidence and mortality of liver cancer in the Chinese population during 2020-2044. Count data were described as absolute numbers, percentages and ratios. The Joinpoint V.4.9.0.0 software was used to calculate the annual percent change (APC), average annual percent change (AAPC) and its 95% confidence interval ( CI) of age-standardized incidence and mortality rates of liver cancer in different time periods. The age-period-cohort model in the Nordpred package of R software (V.4.1.1) was used to predict the incidence and mortality of liver cancer in the Chinese population during 2020-2044. Results:(1) The incidence and mortality of liver cancer in the Chinese population from 1990 to 2019: the crude incidence rate and the age-standardized incidence rate of liver cancer in the Chinese population decreased from 20.01/100,000 and 24.31/100,000 in 1990 to 14.80/100,000 and 9.71/100,000 in 2019, respectively. The crude incidence rate and the age-standardized incidence rate of liver cancer in the Chinese male popula-tion decreased from 27.88/100,000 and 34.76/100,000 in 1990 to 22.05/100,000 and 15.22/100,000 in 2019, respectively. The crude incidence rate and the age-standardized incidence rate of liver cancer in the Chinese female population decreased from 11.63/100,000 and 13.51/100,000 in 1990 to 7.26/100,000 and 4.29/100,000 in 2019, respectively. The crude mortality rate and the age-standardized mortality rate of liver cancer in the Chinese population decreased from 19.64/100,000 and 23.97/100,000 in 1990 to 13.20/100,000 and 8.44/100,000 in 2019, respectively. The crude mortality rate and the age-standardized mortality rate of liver cancer in the Chinese male population decreased from 27.03/100,000 and 34.10/100,000 in 1990 to 19.18/100,000 and 13.03/100,000 in 2019, respectively. The crude mortality rate and the age-standardized mortality rate of liver cancer in the Chinese female population decreased from 11.78/100,000 and 13.64/100,000 in 1990 to 6.98/100,000 and 3.97/100,000 in 2019, respectively. (2) Changing trend of the age-standardized incidence and mortality rates of liver cancer in the Chinese population from 1990 to 2019: the trend of age-standardized incidence rate of liver cancer in the Chinese population could be divided into 5 periods, namely year 1990 to 1996, year 1996 to 2001, year 2001 to 2005, year 2005 to 2010 and year 2010 to 2019. In these 5 periods, the APC of age-standardized incidence rate changed from 1.27%(95% CI as 0.81% to 1.73%, P<0.001) to 1.12%(95% CI as 0.91% to 1.33%, P<0.001) of the total Chinese population, from 1.68%(95% CI as 1.19% to 2.17%, P<0.001) to 1.65%(95% CI as 1.42% to 1.87%, P<0.001) of the Chinese male population and from 0.21%(95% CI as -0.32 % to 0.75%, P=0.406) to -0.14%(95% CI as -0.40% to 0.11%, P=0.241) of the Chinese female population, respectively. The trend of age-standardized mortality rate of liver cancer in the Chinese population could be divided into 5 periods, namely year 1990 to 1996, year 1996 to 2000, year 2000 to 2005, year 2005 to 2012 and year 2012 to 2019. In these 5 periods, the APC of age-standardized mortality rate changed from 1.47%(95% CI as 0.74% to 2.20%, P=0.001) to 1.34%(95% CI as 0.78% to 1.90%, P<0.001) of the total Chinese population, from 1.96%(95% CI as 1.18% to 2.75%, P<0.001) to 1.79%(95% CI as 1.18% to 2.41%, P<0.001) of the Chinese male population and from 0.14%(95% CI as -0.54% to 0.82%, P=0.670 ) to 0.48%(95% CI as 0.02% to 0.93%, P=0.041) of the Chinese female population, respectively. From 1990 to 2019, the AAPC of age-standardized incidence and age-standardized mortality rates of liver cancer were -3.22%(95% CI as -3.41% to -3.03%) and -3.51%(95% CI as -3.82% to -3.19%) in the Chinese population, -2.90%(95% CI as -3.10% to -2.71%) and -3.22%(95% CI as -3.57% to -2.88%) in the Chinese male population, -3.96%(95% CI as -4.17% to -3.76%) and -4.13%(95% CI as -4.43% to -3.82%) in the Chinese female population, respectively. (3) Prediction of the incidence and mortality of liver cancer in the Chinese population during 2020-2044: the age-standardized incidence rate of liver cancer would decrease from 9.51/100,000 in 2015-2019 to 5.78/100,000 in 2040-2044 in the Chinese population, from 14.84/100,000 in 2015-2019 to 9.75/100,000 in 2040-2044 in the Chinese male population and from 4.28/100,000 in 2015-2019 to 1.88/100,000 in 2040-2044 in the Chinese female population, respectively. The age-standardized mortality rate of liver cancer would decrease from 8.40/100,000 in 2015-2019 to 4.62/100,000 in 2040-2044 in the Chinese population, from 12.91/100,000 in 2015-2019 to 7.59/100,000 in 2040-2044 in the Chinese male population and from 4.01/100,000 in 2015-2019 to 1.70/100,000 in 2040-2044 in the Chinese female population, respectively. The incidence number and mortality number of liver cancer from 2020 to 2044 would remain stable at around 160,000 per year and 140,000 per year in the Chinese population, 128,500 per year and 109,000 per year in the Chinese male population, 36,000 per year and 34,900 per year in the Chinese female population, respectively. Conclusion:The incidence and mortality rates of liver cancer in the Chinese popula-tion show a significant downward trend from 1990 to 2019, and the incidence number and mortality number of liver cancer in the Chinese population will remain stable above 100,000 during 2020-2044.

¹⁷⁷Lu- prostate specific membrane antigen (PSMA) radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China. Based on domestic clinical practice and experimental data and referred to international experience and viewpoints, the expert group forms a consensus on the clinical application of ¹⁷⁷Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.