OBJECTIVE To investigate the genetic background and antibiotic resistance of continuously isolated P.aeruginosa strains in Shaoxing.METHODS Eighty six strains of P.aeruginosa were isolated from hospitalized patients,and drug-resistant genes,integrons and transposons were detected by PCR.RESULTS The positive rates of blaCARB,blaVIM,blaDHA,blaTEM,ant(2″)-Ⅰ,aac(6')-Ⅱ,aac(6')-Ⅰb and ant(3″)-Ⅰ were 30.2%,14.0%,3.5%,1.1%,27.9%,24.4%,15.1% and 4.7%.There were clone transmitted phenomenon.CONCLUSIONS There are very high positive percentages of blaCARB,blaVIM,ant(2″)-Ⅰ,aac(6')-Ⅱ,and aac(6')-Ⅰb genes in continuously isolated P.aeruginosa strains.P.aeruginosa can induce clone transmitted hospital infection and it has fulminant prevalence.

An introduction to the Basic service module featuring holistic,full flow and seamless connection built by the hospital.Authors described their experiences in achieving homogenous clinical nursing care,and pointed out that integrating medical humanistic care into the daily nursing process,can improve doctor-patient relationship and patients satisfaction,thus raising medical service quality and efficiency.

Objective? To explore the effects of Internet + home care platform on continued nursing care for peripherally inserted central catheterization (PICC) in cancer patients. Methods? Totally 173 cancer patients who were hospitalized and received PICC in Hu'nan People's Hospital between March and December 2017 were selected using convenient sampling and divided into the control group (n=92) and the home care group (n=81). Patients in the control group received conventional continued nursing care, while patients in the home care group received continued nursing care via the home care platform by following the WeChat account, including on-site catheter maintenance and personalized health education. The cases and frequency of catheter maintenance, patient's knowledge about daily PICC maintenance and the incidence of PICC-related complications from catheterization to catheter removal were compared between the two groups. Results? The incidence rate of complications was lower in the home care group than in the control group, the difference was statistically significant (χ2=5.210, P＜ 0.05); the number and frequency of missing catheter maintenance in the home care group were lower than that of the control group, while the knowledge levels about daily PICC maintenance at home in the home care group were higher than those of the control group, and the differences were all statistically significant (P＜ 0.05). Conclusions? Continued nursing care based on the Internet +home care platform for cancer patients receiving PICC is practical and feasible, and patients can enjoy safe, homogeneous and continued PICC nursing care at home. Therefore, it is worth promoting in clinical practice.

Medicinal materials may be contaminated with a broad variety of fungi, which are represented by Aspergillus spp, Penlicillium spp, Fusarium spp, Rhizopus spp, Mucor spp et al. This fact limits the utilization of medicinal materials, besides, medicinal materials may also be contaminated with mycotoxins produced by these fungi, and bring harm to human health. Several mycotoxins have been detected in medicinal materials, such as AFTs, OTA, FBs, et al. The contamination may originate from the conditions in which the medicinal plants are cultivated, stored and in the finished product manufacturing stages. Some methods have been used for detoxifcation and disinfection for medicinal materials, but they have limited effects. Taking into consideration the background situation, it is important for medicinal materials to be protected from contamination of fungi at every stage of production. The present study intends to give a review of contamination of medicinal materials by moulds and mycotoxins and discuss the factors influencing this situation, expecting to contribute to the knowledge for reducing the contamination.
Drug Contamination ; prevention & control ; Fungi ; isolation & purification ; Mycotoxins ; analysis

OBJECTIVE: To investigate the prognostic value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG), measured by preoperative ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT), in risk stratification of patients with endometrial carcinoma (EC). METHODS: The patients with pathological diagnosis of EC who underwent preoperative ¹⁸F-FDG PET/CT imaging were retrospectively selected for analysis of the prognostic values of PET parameters in risk classification and lymph node metastases (LNMs). Receiver-operating-characteristic analysis was used to analyze the correlation of PET parameters cutoff values with deep myometrial invasion (MI), lymphovascular space involvement and LNM for prognostic values in risk stratification. RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for detection of LNM are 83.3%, 99.7%, 90.9%, 99.5% and 99.2%, respectively. The MTV and TLG of primary lesion of EC in the patients with LNM are notably higher than those in patients without LNM, p<0.010. The MTV and TLG of the EC primary lesions in high-risk patients are significantly higher than those in low-risk patients (p<0.010), but the maximum standardized uptake value (SUVmax) is not. The MTV and TLG of primary lesions were superior to SUVmax for predicting of deep MI, LNM and high-risk of EC (p<0.005). CONCLUSION: MTV and TLG of primary lesions are more valuable in predicting risk stratification of EC patients. Preoperative ¹⁸F-FDG PET/CT imaging is useful in predicting the LNM of EC and may help guide pelvic lymphadenectomy to avoid unnecessary pelvic lymphadenectomy in EC patients with low-risk stratification.
Classification ; Diagnosis ; Electrons ; Endometrial Neoplasms ; Female ; Glycolysis ; Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Metabolism ; Neoplasm Metastasis ; Positron-Emission Tomography and Computed Tomography ; Retrospective Studies ; Risk Assessment ; Sensitivity and Specificity ; Tumor Burden

Objective To explore the value of energy spectrum CT based material imaging for quantitatively and qualitatively evaluating lumbar intervertebral disc degeneration.Methods Lumbar energy spectrum CT and MRI were collected from 82 patients with back and leg pain,and 74 keV CT,water(chondroitin sulfate[CS])and CS(water)material images were obtained.Intervertebral discs Pfirrmann grading(PG)was performed based on MRI.CT values,water(CS)and CS(water)concentration of nucleus pulposus(NP)and annulus fibrosus(AF)in lumbar intervertebral disc with different PG grades were compared,and the relations with PG grades were analyzed.Visual classification of lumbar intervertebral disc was performed based on water(CS)and CS(water)falsecolor map,while PG distribution of different visual classification were compared,and the relations with PG grades were observed.Results Totally 250 lumbar intervertebral discs were enrolled,including 22 of PG Ⅰ,49 of PG Ⅱ,83 of PG Ⅲ and 96 of PG Ⅳ.CT values,water(CS)and CS(water)concentration of anterior AF,NP and posterior AF of intervertebral disc with different PG grades were significantly different(all P＜0.001),and CT values were negatively correlated with PG grades(rs=-0.504,-0.399,-0.258,all P＜0.001),while water(CS)concentration was positively correlated(rs=0.476,0.753,0.324,all P＜0.001)but CS(water)concentration was negatively correlated with PG grades(rs=-0.486,-0.760,-0.329,all P＜0.001).Significant differences of PG grades were found among different water(CS)and CS(water)falsecolor images visual classification(all P＜0.001),while water(CS)and CS(water)falsecolor images visual classification were all positively correlated with PG grades(all rs≥0.700,all P＜0.001).Conclusion Energy spectrum CT based material imaging could be used for quantitatively and qualitatively evaluating lumbar intervertebral disc degeneration.

Objective To evaluate the diagnostic value of contrast-enhanced ultrasound in breast precancerous lesions . Methods Retrospectively analyzed the contrast-enhanced ultrasound model and angiographic predictive model of 465 cases of the A prospective multicenter study of breast nodules contrast-enhanced ultrasound" that led the Sichuan Provincial People′s Hospital from January 2016 to April 2017 ,which included 69 cases of breast precancerous lesions and 396 other types benign lesions ,and the sensitivity ,specificity and accuracy of the diagnosis of breast precancerous lesions were calculated . Results The sensitivity of ultrasound predictive model for the diagnosis of precancerous lesions was 60 .9％ and AUC was 0 .681 . Precancerous lesions mainly showed non-concentricity , increased homogeneity , and increased lesions;other types of benign lesions mainly showed non-centripetal ,high uniformity enhancement and lesion size unchanged . Conclusions Contrast-enhanced ultrasound shows a potential value in the differential diagnosis of precancerous lesions and other types of benign lesions ,that can help clinicians to take early intervention measures for breast precancerous lesions ,but there are still many problems to be solved .