Objective To understand the direct economic burden of healthcare-associated infection(HAI)due to multidrug-resistant organisms(MDROs).Methods Computer retrieval of CNKI,Wanfang,VIP,PubMed,Sci-enceDirect,and Cochrane databases on literatures about economic burden of MDRO HAI at home and abroad were performed,the retrieval time was from database establishment to December 2015,systematic evaluation of the liter-atures was obtained.Results According to the inclusion and exclusion criteria,as well as through Newcastle-Otta-wa Scale (NOS)for evaluating the literatures,19 literatures were included.In 12 studies about methicillin-resistant Staphylococcusaureus infection,the direct economic cost varied from $916.61 to $62908.00;in 4 studies about MDRO Acinetobacterbaumannii infection,the direct economic cost varied from$4644.00 to $98575.00.Direct economic cost due to extended-spectrumβ-lactamases-producing Enterobacteriaceae was $2824.14-$30093.00. Conclusion MDRO HAI will increase economic cost of both hospitals and patients,prevention and control measures should be taken .

Based on Moens-Korteweg model & hydrostatic principle, a simple calibration method by changing vertical distance between heart and radial artery is proposed in this paper. Using hydrostatic pressure to change arterial pressure and pulse wave transmit time, consequently obtain several sets of cardiovascular parameters and finally build up relationship between blood pressure and pulse wave transmit time. Clinical tests have been carried with different age and gender for long and short time monitoring. The comparison results with Sphygmomanometer OMRON EW3152 show its promising accuracy and coincidence feature in blood pressure measurement.
Blood Pressure Determination ; instrumentation ; methods ; Blood Pressure Monitors ; Calibration ; Equipment Design

Objective To investigate the expressions and the significance among the three markers TGF β1,Survivin and Caspase-3 in intrahepatic bile duct tissues in patients with intrahepatic bile duct stones.Method Total of 130 paraffin section of intrahepatic bile duct tissue were collected at Department of Pathology,The 904th Hospital of Joint Logistic Support Force of PLA from 2013 to 2018.Total of 50 patients with intrahepatic bile duct stones complicated with bile duct strictures (the stenosis group),40 patients with intrahepatic bile duct stones with chronic inflammation (the inflammation group),and 40 patients with normal liver tissues (the normal control group) were included in this study.The expressions of TGF β1,Survivin and Caspase-3 in liver tissues were detected by immunohistochemistry and compared among the 3 groups to find their correlations with the clinicopathological features of the disease of the patients.Results TGF β1 was expressed in 72.0％ of the patients in the stenosis group,37.5％ in the inflammatory group,and 15.0％ in the normal control group.The differences among the groups were significant (P ＜ 0.05);Survivin was expressed in 78.0％ of the patients in the stenosis group,47.5％ in the inflammatory group,and 25.0％ in the normal control group.The differences among the groups were significant (P ＜ 0.05);Caspase-3 was expressed in 10.0％ of the patients in the stenosis group,42.5％ in the inflammatory group,and 75.0％ in the normal control group.The differences among the groups were significant (P ＜ 0.05).Within the stenosis group,TGF β1 was negatively correlated with Caspase-3 (r =-0.882,P ＜ 0.05),and positively correlated with Survivin (r =0.889,P ＜ 0.05).Survivin and Caspase-3 were also negatively correlated (r=-0.923,P＜0.05).Conclusion Abnormal expressions of TGF β1,Survivin and Caspase-3 were involved in the formation of intrahepatic bile duct stones associated with bile duct strictures.

Objective To evaluate the surgical treatments of refractory sclerosing peritonitis related peritoneal dialysis.Methods Clinical data of 15 patients with refractory sclerosing peritonitis related to peritoneal dialysis treated in the General Surgery Department of the 900th Hospital of the Joint Logistics Support Force of the People's Liberation Army from June 30,2014 to May 30,2018.Among them,5 cases underwent"open abdomen peritoneal catheter removal+intestinal adhesiolysis+abdominal infection flushing and drainage with catheter",4 cases underwent"laparoscopic peritoneal catheter removal+intestinal adhesiolysis+abdominal infection flushing and drainage with catheter",3 cases underwent"laparoscopic peritoneal dialysis catheter removal+abdominal infection flushing and drainage with catheter",2 cases underwent"open abdomen peritoneal dialysis catheter removal+abdominal infection flushing and drainage with catheter",and 1 case underwent"laparoscopic examination combined with laparotomy exploration and removal of lower abdominal catheter+intestinal adhesiolysis+abdominal infection flushing and drainage with catheter".Age,gender,clinical symptoms,abdominal CT examination,peripheral blood routine,blood biochemistry,blood C-reactive protein(CRP),white blood cells,biochemistry,and aetiology of peritoneal dialysis fluid were collected and followed up,and the therapeutic effect was evaluated.Results 15 patients were transferred to the Department of Surgery after ineffective treatment in the Department of Internal Medicine.Preoperatively(after 5 days of antibiotic treatment)compared to before antibiotic treatment,there were no significant changes in blood WBC,blood NEUT％,CRP,and peritoneal fluid WBC(P＞0.05).Laparoscopic exploration or laparotomy exploration was performed,during which the peritoneal dialysis catheter was removed and the abdominal infection focus was cleared.A pelvic cavity washout drainage tube was left in place postoperatively.Fourteen patients had a good recovery after surgery,with effective control of peritonitis symptoms and no complications such as intestinal obstruction or enterocutaneous fistula.After the removal of the peritoneal dialysis catheter,all patients switched to hemodialysis.A comparison of inflammatory markers before and after surgery showed a significant decrease after surgery.Three days postoperatively compared to before surgery(after 5 days of antibiotic treatment),there were no significant changes in blood WBC,blood NEUT％,CRP,and peritoneal fluid WBC(P＞0.05).Seven days postoperatively compared to before surgery(after 5 days of antibiotic treatment),there was a significant decrease in blood WBC[(7.43±2.65)× 109/L VS(10.17±5.24)× 109/L],blood NEUT％[(88.23±9.02)％VS(85.07±11.57)％],and CRP[(152.88±113.01)mg/L VS(114.49±92.97)mg/L](P＜0.05);the peritoneal fluid WBC at 7 days postoperatively showed no significant change compared to before surgery(after 5 days of antibiotic treatment)(P＞0.05).The cases were followed up for at least 22 months,and 13 patients did not experience peritonitis or intestinal obstruction again.One patient died 39 days after surgery due to multiple organ failure,and one patient died from other causes after a 2-year follow-up.Conclusion For refractory sclerosing peritonitis related peritoneal dialysis that is ineffective in medical conservative treatment,On the basis of reasonable and effective antibiotics to control infection,surgical intervention should be actively carried out and surgical methods such as surgery should be used to control the progress of peritonitis,reduce mortality and improve the cure rate.

Objective To analyze the secondary metabolites of Abrus cantoniensis Hance based on plant metabolomics,and the quality marker(Q-marker)of Abrus cantoniensis Hance by multivariate statistics and network pharmacology prediction.Methods The chemical constituents of 11 batches of Abrus cantoniensis Hance were analyzed by UPLC-Q-TOF-MS methods established and their common components were confirmed.At the same time,cluster analysis(HCA),principal component analysis(PCA)and partial least squares discriminant analysis(OPLS-DA)were carried out to identify the main differential components that caused the classification of the multi-batch medicinal materials of Abrus cantoniensis Hance.Then,the network of"core components-core target-core pathway"was constructed through network pharmacology to screen and predict the potential Q-marker of Abrus cantoniensis Hance,and molecular docking verification was applied to further predict the activity.Results 39 common components were identified in 11 batches of Abrus cantoniensis Hance,mainly containing triterpenoid saponins,flavonoids,alkaloids,etc.HCA and PCA analysis showed that 11 batches of Abrus cantoniensis Hance were divided into 4 categories,and OPLS-DA analysis showed that 9 chemical components played an important role in the classification.The results of network pharmacology analysis showed that the above 9 components which acted on 166 targets were active components,and 29 core targets were obtained by protein interaction(PPI)screening.Among them,four chemical components,Abrine,Hypaphorine,SoyasaponinⅠ and Arginine,were highly correlated with the core targets.Combined with the concept of Q-marker and molecular docking results,it was preliminarily predicted that Abrine and Hypaphorine would be the Q-markers of Abrus cantoniensis Hance.Conclusion The Q-marker of Abrus cantoniensis Hance can be predicted and analyzed by plant metabolomics combined with multivariate statistics and network pharmacology.This study provided data reference for the quality control and evaluation of Abrus cantoniensis Hance and research ideas for further scientific development of Abrus cantoniensis Hance.