With dwindling number of new antibiotics and inappropriate use of antibiotics, the emergence and spread of antibiotics resistance occurs commonly in healthcare institutions worldwide. In China, antibiotics are commonly overprescribed and misused. This study is to assess the effect of the nationwide special campaign on antibiotic stewardship program (ASP) at specialized hospitals in China by investigating prescription information from 2011 to 2012. Data on the hospital consumption and prescription of systemic antibiotics were obtained from four specialized hospitals, including maternity, children's, stomatological and cancer hospitals. Systematic random sampling was used to select outpatient prescriptions and inpatient cases. A total of 105 specialized hospitals in 2011 and 121 specialized hospitals in 2012 were analysed. The defined daily doses (DDDs) per 100 inpatient days, the percentage of antibiotic use in outpatient prescriptions, and the percentage of antibiotic use in inpatient cases were used as measurements of antibiotic use. The overall antibiotic use density in the selected hospitals decreased between 2011 and 2012 from 39.37 to 26.54 DDD/100 inpatient days (P<0.001). The percentage of antibiotic use in outpatient prescriptions (range: 24.12%-18.71%, P=0.109) and inpatient cases (64.85%-60.10%, P=0.006) also decreased within the two years. Significant changes were observed among regions and different hospitals within the two years. And antibiotic consumption was correlated with the type and size of specialized hospital in 2012, but not with the regions. This analysis of antibiotic consumption of specialized hospitals allows relevant comparisons for benchmarking and shows that national ASP has improved antibiotic rational use in China. The data will assist policymakers in formulating effective strategies to decrease antibiotic overuse and identify areas that require further work.

Objective To investigate the efficacy of double-“ U” embedding and pursestring suture and binding pancreaticojejunostomy for the prevention of pancreatic fistula.Methods The retrospective cohort study was adopted.The clinical data of 208 patients who underwent pancreaticojejunostomy at the Hunan Provincial People's Hospital from March 2011 to March 2015 were collected.Of 208 patients,106 patients undergoing double-“ U” embedding and pursestring suture and binding pancreaticojejunostomy were allocated into the double-“ U” group and 102 patients undergoing Child pancreaticojejunostomy were allocated into the Child group.Observation indicators included (1) surgical effects:anastomosis time,postoperative pancreatic leakage,duration of hospital stay,(2) follow-up situations.The follow-up using telephone interview and outpatient examination was performed to detect postoperative long-term complications and recovery of patients by abdominal ultrasound or computed tomography (CT) at every 6 months postoperatively up to September 2015.Measurement data with normal distribution were represented as x ± s and comparison between groups was analyzed by t test.Count data were analyzed using the chi-square test.Results (1) Surgical effects:208 patients underwent successful surgery without occurrence of death.The anastomosis time was (13.0 ± 1.5) minutes in the double-“ U” group and (20.0 ± 1.6) minutes in the Child group,with a statistically significant difference between the 2 groups (t =4.713,P ＜ 0.05).Two patients in the double-“ U” group were complicated with grade A of pancreatic leakage,including 1 of 36 patients with normal pancreatic remnant and 1 of 70 patients with fibrotic pancreatic remnant.Nine patients in the Child group were complicated with pancreatic leakage,including 6 in grade A,1 in grade B and 2 in grade C,and there were 6 of 33 patients (4 in grade A,1 in grade B,1 in grade C) with normal pancreatic remnant and 3 of 69 patients (2 in grade A,1 in grade C) with fibrotic pancreatic remnant.There were statistically significant differences in the pancreatic leakage between the 2 groups and among the patients with normal pancreatic remnant in the 2 groups (x2 =2.951,4.994,P ＜ 0.05).The duration of postoperative hospital stay was (13.5 ± 1.2)days in the double-“U” group and (15.7 ± 2.6)days in the Child group,with a statistically significant difference (t =1.011,P ＜ 0.05).No readmission in the 2 groups occurred.(2) Followup situations:91 of 106 patients in the double-“U” group were followed up for 6-54 months with a median time of 30 months.During the follow-up,8 patients were dead,12 patients didn't undergo reoperation due to multiple metastases in the liver,lung and greater omentum,4 and 4 patients were respectively complicated with relapsing pancreatitis and refluxing cholangitis,and other patients had good conditions without the occurrence of diabetes,diarrhea,indigestion and hypopancreatism.Eighty-eight of 102 patients in the Child group were followed up for 6-54 months with a median time of 25 months.During the follow-up,10 patients were dead,11 patients didn't undergo reoperation due to multiple metastases in the liver,lung and greater omentum,6 and 6 patients were respectively complicated with relapsing pancreatitis and refluxing cholangitis,and other patients had good conditions without the occurrence of diabetes,diarrhea,indigestion and hypopancreatism.Conclusion Double“U” embedding and pursestring suture and binding pancreaticojejunostomy for the prevention of pancreatic fistula can reduce the suture time,incidence of pancreatic leakage and duration of postoperative hospital stay,and it is especially suitable for the patients with normal pancreatic remnant.

Objective To investigate the risk factors of postoperative hemorrhage after pancreatoduodenectomy (PD).Methods The retrospective case-control study was adopted.The clinical data of 857 patients with pancreatic diseases who were admitted to the First Affiliated Hospital of Hunan Normal University from January 2007 to December 2014 were collected.All the 857 patients underwent PD and digestive tract reconstruction using the Child method.The number of patients with postoperative hemorrhage,classification,bleeding sites,source and time of bleeding and method and effect of treatment after PD were observed.The correlations among the gender,age,concomitant diseases (diabetes and hypertension),malignancy degree of tumor,the preoperative levels of serum alanine transaminase (ALT),total bilirubin (TBil),albumin (Alb) and prothrombin time (PT),international normalized ratio (INR),operation time,volume of intraoperative blood loss,method of pancreatic and jejunal anastomosis and postoperative hemorrhage after PD were analyzed.The follow-up of outpatient examination and telephone interview was performed to observe postoperative recovery of patients for 2 months till February 2015.Univariate analysis and multivariate analysis were done using the chisquare test and Logistic regression model,respectively.Results Of 72 patients with postoperative hemorrhage,grade A,B and C hemorrhage were detected in 3,41 and 28 patients,respectively,and 41,29 and 2 patients had respectively enteral hemorrhage,parenteral hemorrhage and enteral and parenteral hemorrhage.After PD,38 patients had hemorrhage located at the gastrointestinal tract,9 at the common hepatic artery,proper hepatic artery and gastroduodenal artery (5 due to pseudoaneurysm),5 at the pancreatic section,3 at the jejunal mesenteric vessels,2 at the middle colic arterial branches,1 at the superior mesenteric artery,1 at the superior mesenteric vein and 13 at the ambiguous bleeding sites.The early and late stage hemorrhages (within postoperative hour 24 and after postoperative hour 24) were detected in 20 and 52 patients,respectively.Of 44 patients with grade A and B of hemorrhages,17 underwent conservative treatment,16 underwent reoperation,8 underwent hemostatic therapy under gastroscopy,3 underwent interventional treatment.All the 44 patients had good hemostasis effect.Of 28 patients with grade C of hemorrhage,interventional treatment,reoperation,hemostatic therapy under gastroscopy,conservative treatment,interventional treatment + reoperation and gastroscopy + interventional treatment were applied to 10,7,4,3,3 and 1 patients,respectively.Ten of 28 patients died and 18 had successful hemostasis.The gender and preoperative levels of ALT and TBil were related factors affecting postoperative hemorrhage after PD in the univariate analysis (x2 =4.516,7.585,7.209,P ＜ 0.05).Male,preoperative ALT ≥ 172 U/L and preoperative TBil ≥ 159 μmol/L were the independent risk factors affecting postoperative hemorrhage after PD in the multivariate analysis (HR =2.033,1.860,1.872,95％ confidence interval:1.237-3.341,1.135-3.047,1.060-3.307,P ＜ 0.05).Fifty of 62 patients were followed up for a median time of 2 months with a follow-up rate of 80.6％ (50/62),and no rehemorrhage was occurred.Conclusion Male,preoperative ALT≥172 U/L and preoperative TBil≥≥ 159 μmol/L are the independent risk factors affecting postoperative hemorrhage after PD.

Objective To investigate the prevalence and attitude of smoking and its influencing factors among residents in Hongkou District of Shanghai,so as to provide evidence for tobacco control. Methods Nine hundred and sixty residents in Hongkou District of Shanghai aged 15 to 69 years were selected by multi-level random sampling,among whom 958 completed the investigations on smoking status. Results The smoking rate and standardized smoking rate were 20.04% and 18.73%,respectively.The smoking rate and standardized smoking rate of males were 41.05% and 30.07%,and those of females were 0.80% and 1.70%,respectively.The smoking rate of males was higher than that of females(RR=0.02,95%CI: 0.01-0.03).The smoking rates of age groups of 25 years old and over were higher than those of 15 to 24 years old,and the smoking rate of subjects with or above junior college education was lower than that of subjects with or below middle school education(RR=0.45,95%CI: 0.25-0.79).Subjects who drank alcohol smoked more than those did not(RR=2.68,95%CI: 1.76-4.09).Lower annual per capita income and higher knowledge on smoking hazard led to more tendance to object to smoking and agree with anti-smoking. Conclusion The prevalence of smoking of residents aged 15 to 69 years in Hongkou District of Shanghai was relatively lower.Age,gender,education status and alcohol drinking were influencing factors of smoking.Education on tobacco control among subjects aged more than 35 years should be strengthened,and more attention should be paid to those with lower education.Besides,education on alcohol control should be managed together with tobacco control.

Toll-like receptors (TLRs) family may play important roles in inflammatory bowel disease. This study examined the expression of TLR2, TLR4 and TLR9 in the colonic tissues of patients with ulcerative colitis (UC) and explored their roles in the pathogenesis of UC. Colonic biopsies were taken from the colon of 30 patients with mild or moderate UC (at active phase) and 10 healthy controls during colonoscopy. TLR2, TLR4 and TLR9 protein expression levels were immunohistochemically detected. The mRNA expression levels of TLR2, TLR4 and TLR9 were assessed by reverse transcription polymerase chain reaction (RT-PCR). The disease activity index (DAI), colonoscopic and histologic grades and fecal microbial flora were determined. Histological examination showed that the intestinal mucous membrane of UC patients underwent acute inflammation changes. Immunohistochemistry exhibited that the expression levels of TLR2, TLR4 and TLR9 in colon epithelia and inflammatory cells were higher in UC patients than in control group (P<0.01). The mRNA expression levels of TLR2, TLR4 and TLR9 were increased in UC patients but were not detected in the normal controls. Expression levels of TLR2, TLR4 and TLR9 were positively correlated, and bore close correlation with DAI, colonoscopic and histologic grades and fecal microbial flora. An important mechanism of UC might be that abnormal activation of mucosal immunity by intestinal dysbacteriosis caused dysregulation of TLRS that mediates innate immunity.

Trichosanthes kirilowii has been widely cultivated as its medicinal use, health care and food value. Drought resistance of seedlings is an important feature in breeding. Seeds of two T. kirilowii strains were used to research the difference of surface ultrastructure characteristic and drought resistance. Scanning electron microscope was used to identify the surface ultrastructure characteristic of seeds and PEG was used to simulate drought stress. The seeds germination rate, MDA content, chlorophyll content and the antioxidant enzymes activity were measured under the drought stress. The results showed that the seed surface colour of KXY-001 was lighter than that of KXY-005. The testa cobwebbing of KXY-001 was more intensive than that of KXY-005. The germination rate of KXY-001 was higher than that of KXY-005 under drought stress. The MDA content was increased and the chlorophyll content was decreased with the increasing of drought degree. The SOD activity of KXY-001 was higher than that of KXY-005, while the activity of POD and CAT was also increased firstly and decreased later. Surface reticulate of seeds and hilar traits can be used as identification points to identify the investigated strains. SOD and POD are activated to resist drought in T. kirilowii seedlings and the drought resistance of KXY-001 is superior than that of KXY-005.
Adaptation, Physiological ; drug effects ; Catalase ; metabolism ; Chlorophyll ; metabolism ; Droughts ; Germination ; Malondialdehyde ; metabolism ; Microscopy, Electron, Scanning ; Peroxidase ; metabolism ; Polyethylene Glycols ; pharmacology ; Seedlings ; metabolism ; Seeds ; growth & development ; metabolism ; ultrastructure ; Species Specificity ; Superoxide Dismutase ; metabolism ; Trichosanthes ; classification ; growth & development ; metabolism

To study the effect of plant-derived smoke water on the accumulation of biomass and active substance of Salvia miltiorrhiza f. alba, seedlings of S. miltiorrhiza were treated with different concentrations of smoke water (1:500, 1: 1 000, 1: 2 000). The fresh weight and dry weight of underground part, the number of split-root, maximum root diameter, average root diameter, average root length, the content of lipophilic components and water-soluble components were measured. Results showed that fresh weight and dry weight of underground part were respectively improved by 98.01%, 44.32% and 85.71%, 28.57% with significant difference by smoke water treatment with concentration of 1: 500 and 1: 1 000. Maximum root diameter and dry weight of underground part were respectively enhanced by 58.44% and 85.71% by smoke water with concentration of 1:500. The content of tanshinone I and tanshinone II(A) were improved by smoke water treatment, however there were no significantly difference on the content of cryptotanshinone and dihydrotan shinone. This study indicates that smoke water treatment could be used to improve the accumulation of biomass and active substance content of S. miltiorrhiza f. alba, which could provide new ideas for its green cultivating.
Agriculture ; methods ; Biomass ; Drugs, Chinese Herbal ; analysis ; metabolism ; Salvia miltiorrhiza ; chemistry ; growth & development ; metabolism ; Smoke ; analysis ; Water ; chemistry ; metabolism

Abstract: Objective　To understand the distribution and drug resistance of bacteria in clinical blood culture specimens in Ningxia in recent years, and to provide a basis for the prevention and treatment of bloodstream infection diseases. 　　　Methods　The blood culture isolation bacteria and drug resistance of Ningxia bacterial resistance monitoring network hospitals from 2018 to 2020 were statistically analyzed by WHONET5.6 software. Results　In the past three years, a total of 6 757 strains of bacteria were isolated from blood samples, including 3 697 strains (54.7%) of gram-negative bacteria and 3 060 (45.3%) of gram-positive bacteria. Among the gram-negative bacteria, Escherichia coli (2 074 strains,30.7%), Klebsiella pneumoniae (696 strains), Pseudomonas aeruginosa (139 strains), and Acinetobacter baumannii (121 strains). Among the gram-positive bacteria, coagulase-negative Staphylococcus (1 691 strains,25.0%), Staphylococcus aureus (442 strains), Streptococcus spp. (431 strains), Enterococcus spp. (379 strains). Resistance to Escherichia coli and Klebsiella pneumoniae was 56.6% and 22.6% against third-generation cephalosporins, and resistance to carbapenems was 1.0% and 3.7%, respectively. Pseudomonas aeruginosa and Acinetobacter baumannii were resistant to carbapenems at 9.0%（12/139） and 80.7%（71/121）. Methicillin-resistant Staphylococcus aureus (MRSA) was detected at 26.8%, methicillin-resistant coagulase-negative Staphylococcus was detected at 70%, and no Staphylococcus bacteria resistant to vancomycin and linezolid were found. For three years, only 1 strain of vancomycin-resistant Enterococcus faecalis was detected, and no linezolid-resistant Staphylococcus and Enterococcus were detected. Conclusions　Ningxia clinical blood specimen isolates of Escherichia coli, coagulase-negative Staphylococcus, and Klebsiella pneumoniae are more common. Among them, the resistance rate of Escherichia coli and Klebsiella pneumoniae to the third generation of cephalosporins is relatively stable, and the resistance rate to carbapenems is low. Acinetobacter baumannii is highly resistant to carbapenems, and methicillin-resistant Staphylococcus aureus detection rates are on the rise and should be closely monitored.

OBJECTIVETo observe therapeutic effect of acupoint embedding thread therapy on ulcerative colitis and to study the mechanism.

METHODSThe rat model of ulcerative colitis was developed with 2,4-dinitrochlorobenzene method. The 20th day after the end of model development, they were randomly divided into a model group, a salicylazosulfapyridine (SASP) treatment group and an acupoint embedding thread therapy group. The SASP treatment group were treated with intragastrical perfusion of 4.5% SASP suspension, and the acupoint embedding thread therapy group were treated with embedding thread at "Zusanli" (ST 36) and "Shangjuxu" (ST 37). Anti-neutrophil cytoplasmic antibody (ANCA) was detected with indirect immunofluorescence, and the pathological changes were investigated with pathological tissue section technique.

RESULTSThe positive rate of ANCA reached to 62.5% in the rat with ulcerative colitis with significant differences among the 3 groups. After treatment, the positive rate of ANCA was decreased in the two treatment groups (P < 0.05, P < 0.01).

CONCLUSIONAcupoint embedding thread therapy has definite therapeutic effect on ulcerative colitis and the mechanism is possibly related with the decrease of ANCA.

Objective To investigate the effect of microRNA-223-3p (miR-223-3p) on megakaryocytic differentiation and maturation, and explore the potential mechanism .Methods The endogenous expression of miR-223-3p during megakaryocyte ( MK) differentiation was detected by real-time PCR.Flow cytometry further indicated that alteration of miR-223-3p in human cell lines exerted effects on MK differentiation and maturation .By performing integrative bioinformatic analysis, the potential miR-223-3p target gene, MYH10,was identified.Real-time PCR, luciferase reporter assay and flow cytometry revealed that MYH10 was a direct target of miR-223-3p.Results Endogenous expression of miR-223-3p was in-creased with the differentiation and maturation of MK .The expression of megakaryocytic surface markers CD41 and CD61 and the ploidy were significantly increased in K562 and Meg-01 cells after transfection with miR-223-3p mimics.The expression of MYH10 decreased with the increase in miR-223-3p.Using a luciferase reporter assay ,we demonstrated that MYH10 was a direct target of MiR-223-3p.Furthermore, direct downregulation of MYH10 promoted MK polyploidization . Conclusion MiR-223-3p might regulate the polyploidization of MK by targeting MYH10.