Objective To carry out patients' participation in promoting health care workers(HCWs) to improve hand hygiene (HH) compliance in the outpatient transfusion room, obtain real data of HH, and further provide basis for performing the activity in the whole hospital.Methods HH compliance of nurses in outpatient transfusion room during four stages was observed by using the healthcare-associated infection control toolkit mobile phone APP.Intervention was not implemented at the first stage, HH promotion was implemented at the second stage, simulation of patients participated in promoting HCWs to improve HH compliance was performed at the third stage, and patients actually participated in promoting HCWs to improve HH compliance at the fourth stage.A questionnaire about patients' willingness to participate in the promotion of HCWs to improve HH compliance was developed and filled out by patients and nurses.Results HH compliance rates of nurses in transfusion room at four stages were 21.43%, 44.27%, 61.48%, and 82.88% respectively, differences was significant(χ2=110.35,P<0.01);HH correct rates at four stages were 44.44%, 74.14%, 81.33%, and 81.82% respectively, differences was significant(χ2=18.50,P<0.01).Conclusion Patients participating in promotion of HH can significantly improve HH compliance of HCWs, which is simple and effective, and worth to be popularized.

Objective To investigate the clinical effect and safety of linagliptin combined with insulin aspart 50 in the treatment of hepatogenous diabetes (HD).Methods A total of 57 patients with HD who visited The People's Hospital of Liaoning Province from October 2014 to February 2016 were enrolled and randomly divided into insulin aspart 50 group (group A,28 patients) and linagliptin combined with insulin aspart 50 group (group B,29 patients).The two groups were compared in terms of blood glucose,insulin,C-peptide,glucose disposition index (DI),glycosylated hemoglobin A1c (HbA1c),glucagon,and daily insulin dose at baseline and after 12 weeks of treatment.The adverse events including hypoglycemia were observed.The paired t-test was used for comparison of continuous data within one group,and the independent-samples t test was used for comparison of continuous data between groups;the chi-square test was used for comparison of categorical data between groups.Results After 12 weeks of treatment,both groups had significant reductions in blood glucose at four time points (t =5.357-21.380,all P ＜ 0.05) and significant increases in the insulin level at 30,60,and 120 minutes (t =2.222-6.491,all P ＜0.05).Compared with group A,group B had significantly lower levels of HbA1c and glucagon,daily insulin dose,and blood glucose and insulin levels at 30,60,and 120 minutes (t =3.136-15.096,all P ＜ 0.05),as well as significantly higher DI and levels of C-peptide at four time points (t =2.994-10.813,all P ＜ 0.05).Group A had a significantly higher incidence rate of hypoglycemia than group B (28.6％ vs 3.4％,x2 =5.005,P ＜ 0.05).Conclusion Linagliptin combined with insulin aspart 50 can effectively control blood glucose in patients with HD and has good safety.

OBJECTIVE:To observe the efficacy and safety of paroxetine combined with buspirone in the treatment of geriatric depression with anxiety. METHODS:78 patients with geriatric depression with anxiety were randomly divided into control group (39 cases) and observation group (39 cases). Control group received 20-40 mg Paroxetine hydrochloride tablet,within half an hour after breakfast. Observation group additionally received 5-10 mg Buspirone hydrochloride tablet for 3 times. The treatment course for both groups was 8 weeks. Clinical efficacy,HAMD,HAMA and TESS before and after 2,4 and 8 weeks of treatment in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,the difference was statistically significant(P<0.05). HAMD after 4 and 8 weeks,HAMA after 8 weeks in control group,HAMD and HAMA after 2,4 and 8 weeks in observation group were significantly lower than before,and it gradually decreased by time pro-longed,observation group was lower than control group,the differences were statistically significant (P<0.05 or P<0.01). And there was no significant difference in the TESS rating in 2 groups before and after treatment(P>0.05). CONCLUSIONS:The effi-cacy of buspirone combined with paroxetine is superior to paroxetine alone in the treatment of geriatric depression with anxiety, with better safety.

Objective To investigate the prevalence rates of healthcare-associated infection(HAI)and antimicrobial use in a maternal and child health hospital,so as to provide reference for preventing and controlling HAI.Methods A cross-sec-tional survey on HAI prevalence of all hospitalized patients from 2010 to 2014 was conducted by combination of bedside ex-amination and medical record review.Results The prevalence rates of HAI in 2010—2014 was 3.29%,5.20%,3.97%, 3.93% and 3.73% respectively.HAI mainly occurred in patients at department of pediatrics (9.09%-12.96%),the major infection site was upper respiratory tract (50.00%-69.56%).Antimicrobial usage rate was 50.19%,41.40%, 23.40%,25.47% and 23.92% respectively,which decreased year by year (χ2 = 133.40,P <0.001 );antimicrobial prophylactic usage rate was as high as 57.38%-75.47%;single usage rate were all>95%.Conclusion Antimicrobial a-gents used by hospitalized patients showed a overall downward trend from 2010 to 2014.,but antimicrobial prophylactic us-age rate is high,management of antimicrobial agents should be strengthened.

Objective:To construct the expression vectors of VH and VL from an anti -CD71 monoclonal antibody (line7579) , and express an anti-CD71 mouse/human chimeric antibody (D2C) in vitro.Methods:The variable regions of heavy and light chains from an anti -CD71 monoclonal antibody (line7579) cloned in the pGEM-T vectors were constructed respectively into the expression vectors,p?-Expr(including human IgG1 constant region) and p?-Expr(including human Ig? constant region).The expression plasmid vectors (Chi7579-p?-Expr and Chi7579- p?-Expr) ,confirmed by a clone-PCR and a further sequence analysis, were co-transfected by electroporation into the non-Ig-producing murine hybridomas SP2/0.Results:Screening for transfectomas secreting chimeric antibody was done by cross sandwich ELISA, which identified the transfectomas to secrete a chimeric antibody (D2C) with the human heavy constant region(C?) and light constant region(C?). FCM analysis of culture supernatants of the transfectomas demonstrated that the binding capacity of the chimeric Ab (D2C) to the antigen (CD71) was retained.Conclusion:The construction of the V H and V L expression vectors and the expression of an anti-CD71 mouse/human chimeric antibody (D2C) were accomplished successfully.

Objective:To investigate the expression of lysozyme in ampullary carcinoma, and its relation with invasion, metastasis and prognosis. Methods: 36 cases were analyzed with immunohistochemistry of lysozyme. Results: The lysozyme-positive rate in patients with lymph node metastasis (30%) was significantly lower than that in patients without metastasis (71%), while that in patients with advanced cancer invading the pancreas (35%), was significantly lower than that in patients with cancer without invasion of the pancreas. The Survival rate of lysozyme-positive patients (66.7%) was significantly higher than that of lysozyme-negative patients (14.3%). Conclusion: The expression of lysozyme in carcinoma of ampulla is associated with invasion, metastasis and prognosis. Lysozyme is important in typing of cancer of ampulla.

OBJECTIVETo evaluate the short-term and long-term effects on treatment of neck pain caused by cervical spondylosis with the combination of acupuncture and moxibustion with seed-size moxa cone.

METHODSOne hundred and forty-five patients of neck pain were randomly divided into an acupuncture-moxibustion group (49 cases), an acupuncture group (48 cases) and a moxibustion group (48 cases). Acupoints of Bailao (Extra), Dazhui (GV 14), Jianzhongshu (SI15) and Zhongzhu (TE 3) were adopted for all the 3 groups. Acupuncture was applied at all the acupoints with 20 min needling retention for the acupuncture group. Moxibustion with seed-size moxa cone was used with 5 cones on each point for the moxibustion group. And both acupuncture and moxibustion with seed-size moxa cone were adopted for the acupuncture-moxibustion group. The treatment was applied once every 3 days, and 10 treatments should be finished within 4 weeks. Follow-up should be carried out for 3 months. The short-term and long-term effects were evaluated with the scores of Northwick Park Pain Questionnaire (NPQ) and McGill Pain Questionnaire (MPQ) as the indices of therapeutic effect.

RESULTSThe NPQ score and MPQ score of all the 3 groups after the treating course and the 3-month follow-up were both decreased when compared with those before the treatment (all P<0. 05). The scores of NPQ and MPQ the acupuncture-moxibustion group were lower than that of the other two groups. And the difference had obvious significance (P<0. 05). High efficiency of pain relieving for cervical spondylosis could be found in all the 3 groups, which showed that short-term and long-term effects were good for all the 3 groups. And the highest curative effect could be found in acupuncture-moxibustion group.

CONCLUSIONCombination of acupuncture and moxibustion with seed-size moxa cone has reached a superior effect in short-term and long-term for neck pain caused by cervical spondylosis.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; instrumentation ; Neck Pain ; etiology ; therapy ; Spondylosis ; complications ; Treatment Outcome ; Young Adult

Objective To explore the role of CD4+CD25+CD127low/-regulatory T cells (Tregs) in the pathogenesis of psoriasis vulgaris(PV). Methods Flow cytometry analysis was used to detect the amount of Tregs in peripheral blood and ELISA to test the levels of IL-10 and TGF-β1 in blood serum; the suppressive function of Tregs on autologous CD4+CD25-T cells was determined by MTT method. Results No significant difference was found in the proportion of Tregs in PV patients and healthy controls(P>0.05). There was a diminished suppression of Tregs from patients on autologous CD4+CD25- responder T cell proliferation in PV patients when compared with that in controls (P < 0.01). The serum level of IL-10 in patients was lower than that in controls (P < 0.01) while that of TGF-β1 in PV patients was significantly higher than that in controls(P < 0.01). Conclusion Abnormal function of Tregs and low secretion of IL-10 in PV patients might be related to the pathogenesis of psoriasis.

Objective: To investigate the association between frailty and type 2 diabetes mellitus (T2DM) using a bidirectional two-sample Mendelian randomization (MR) analysis, so as to provide the evidence for the prevention and control of frailty and T2DM. Methods: Frailty status was assessed using the Fried Frailty Score (FFS), with aggregated data sourced from 386 565 European samples in the UK Biobank. The T2DM data were obtained from the summary results of genome-wide analysis published by the Diabetes Genetics Replication and Meta-analysis Consortium, excluding the UK Biobank data, including 455 313 European samples. Eligible single nucleotide polymorphism site were selected from the FFS and T2DM summary data as instrumental variables. The bidirectional MR analysis was performed using the inverse-variance weighted method. The heterogeneity was assessed using the modified Cochran Q test. The horizontal pleiotropy of instrumental variables was examined using MR-Egger regression. The robustness of the results was evaluated using the leave-one-out method. The bias was tested using funnel plot. Results: The forward MR analysis revealed a statistically significant association between increased FFS and an increased risk of T2DM (OR=2.280, 95%CI: 1.169-4.447). The reverse MR analysis showed a statistically significant association between T2DM and increased FFS (β=0.026, 95%CI: 0.012-0.041). Both bidirectional MR results were robust, with no horizontal pleiotropy of the instrumental variables was found (all P>0.5); and the funnel plots did not show significant basis. Conclusion The study found a bidirectional causal association between frailty and T2DM.

Objective To evaluate the safety and therapeutic effect of covered expandable metallic stent placement combined with interventional chemotherapy in treating malignant esophago-tracheal fistulae. Methods A total of 60 patients with esophago-tracheal fistula were enrolled in this study. The patients were randomly divided into control group (n=28) and study group (n=32). Patients of the control group were treated with covered stent implantation only, while patients of the study group were treated with combination use of covered stent implantation and interventional chemotherapy. All the patients were followed up regularly, the short-term and long-term results were determined, and the effect rate, median survival time and complications were statistically analyzed. Results Among the 60 patients, successful obstruction of the fistula was obtained in 58 with a success rate of 96.7%. The median survival time of the 58 patients was 5.8 months. The median survival time of the control group and the study group was 3.6 months and 8.7 months respectively, the difference between the two groups was statistically significant (P<0.05). The one-month, 3-month and 6-month effect rates were 78.1%, 68.8% and 62.5% respectively. The incidence of esophageal stent re-stenosis in the study group was much lower than that in the control group. Conclusion The combination use of covered stent implantation and interventional chemotherapy can effectively improve the median survival time of patients with malignant esophago-tracheal fistula, and reduce the occurrence of stent-related complications. Therefore, covered expandable metallic stent placement combined with interventional chemotherapy is an effective and safe treatment for malignant esophago-tracheal fistulae.