Objective To investigate the effect of radix paeoniae rubra (RPR) on expression of heme oxygenase (HO-1) and inducible nitric oxide synthase (iNOS) in lipopolysaccharide (LPS)-induced acute lung injury (ALI) and explore its protective mechanism. Methods Forty Wistar rats were randomly and equally divided into five groups, ie, control group, LPS group, RPR treatment group, RPR prevention group and Hemin group. Arterial blood was drawn for blood gas analysis. Models of endotoxin-induced ALI were used to observe the protein content, the ratio of neutrophiles in bronchoalveolar lavage fluid (BALF), the malondialdehyde (MDA) content in lung and the activities of serum NO. Expression of HO-1 and iNOS in rat lung tissue was detected by immunohistochemistry and morphometry computer image analysis. The histological change of lung were observed under light microscope. Results Compared with control group, expression of HO-1 and iNOS was markedly increased (P

Objective To investigate the clinical characteristics,distribution and drug sensitivity of pathogens causing intravenous catheter-related bloodstream infections (CRBSIs) in pediatric intensive care unit (PICU) so as to use antibiotics reasonably.Methods All patients with CRBSIs in PICU of Guangdong General Hospital from September 2009 to September 2014 were investigated and the drug resistance profiles of pathogens causing CRBSIs were also analyzed retrospectively.Results Between 2009 and 2014,there were totally 10 834 catheter days and 23 episodes of CRBSIs with an incidence of 2.1 infections per 1 000 catheter days.Catheter indwell time ＜ 7 days in 9 cases (39.1％),8 to 14 days in 10 cases (43.5％),14 to 21 days in 4 cases (17.4％).There were 13 strains (56.6％) of gram-positive bacteria,5 strains (21.7％) of gram-negative bacteria and 5 strains (21.7％) of fungi.The main pathogens causing CRBSIs were coagulase negative Staphylococci (7 strains,30.4％),Staphylococcus aureus (3 strains,13.0％),Candida albicans(3 strains,13.0％),Candida parapsilosis(2 strains,8.7％),and Enterobacter cloacae (2 strains,8.7 ％).The susceptibility to Vancomycin,Linezolid and Teicoplanin of coagulase negative Staphylococ cus such as S.epidermidis and to Imipenem,Piperacillin/Tazobactam,Cefoperazone/ Sulbactam and Amikacin of gram-positive bacteria arrived at 100.0％,respectively.The candida were 100％ susceptible to Amphotericin B,5-Flucytosine,Fluconazole and Voriconazole.Twenty-one cases (91.3％) received antibiotic treatment versus no antibiotic in 2 cases (8.7％).The average number of antibiotic kinds administered on the patients with fungal infection was 4.4,bacteria were 1.4.Ten cases (43.5％) treatment with 1 kind of antibiotic,4 cases (17.4％) with 2,4 cases (17.4％) with 3,5 cases (21.7％) with more than 3.Twenty-two cases (95.7％) cured and 1 case died (4.3％).Conclusions The major species of pathogen causing CRBSIs was coagulase negative staphylococci in PICU.It is critical for clinicians to guard against fungal infection because of prolonged catheter indwelling time and more antibiotics administered before indwelling catheter.It is effective way to prevent the CRBSIs by reasonably using antibiotics and shortening the time of catheter indwelling.Monitoring CRBSIs pathogenic bacteria distribution and drug susceptibility helps reasonable administration of antibiotics in the earlier time.

Objective: To describe the baseline characteristics of School-based Cardiovascular and Bone Health Promotion Program(SCVBH) in Beijing. Methods: Children and adolescents were selected in 30 schools (8 primary schools, 21 middle schools and one 12-year education school) from Dongcheng, Tongzhou, Fangshan and Miyun districts of Beijing by using a stratified cluster sampling method. 15 391 students in grade 1 to 4 from primary schools, grade 1 from junior and senior high schools were enrolled in the investigation with an exclusion of students who were not able to participate due to trauma or other uncomfortable physical conditions. The baseline survey including a questionnaire survey, physical examination and blood biochemical test was conducted from September 2017 to January 2018. Obesity, blood pressure, fasting blood glucose, lipid, bone density and grip were evaluated. Results: The prevalence of obesity, hypertension, hyperglycemia (impaired fasting glucose and diabetes), dyslipidemia, lower bone density were 22.3%(3 394), 14.8%(2 248), 10.4%(1 490), 20.3%(2 919) and 2.1%(316) in total respectively, and 27.2%(2 081), 16.3%(1 244), 12.8%(922), 22.2%(1 595) and 1.2%(94) for boys, 17.3%(1 313), 13.3% (1 004), 7.9%(568), 18.4%(1 324) and 2.9%(229) for girls. Boys had higher prevalence of obesity, hypertension, hyperglycemia, and dyslipidemia and lower prevalence of low bone density than girls (all P values <0.05) The mean of body mass index, systolic blood pressure, fasting plasma glucose and grip of boys were significantly higher than that of girls (all P values <0.05).The mean of body mass index, systolic blood pressure, fasting plasma glucose and grip of boys were significantly higher than that of girls (all P values <0.05), the mean of fat mass percentage, total cholesterol, triglyceride, high density lipoprotein-cholesterol and low density lipoprotein-cholesterol of boys were significantly lower than those of girls (all P values <0.05). Conclusion The prevalence of risk factors of chronic cardiovascular disease was high and the low bone density was appearing in children and adolescents in this study. The promotion of cardiovascular and bone health should be implemented in children and adolescents.

Three cases of flagellate shiitake mushroom dermatitis caused by Pleurotus ostreatus, Auricularia auricula, and Flammulina velutipes respectively were reported. Case 1, a 45-year-old male patient, developed multiple flagellate erythematous patches and papules on the trunk, axillae and abdomen without any subjective discomfort 8 hours after ingestion of a large amount of grilled Pleurotus ostreatus. Case 2, a 33-year-old female patient, developed multiple flagellate erythematous patches with mild swelling and itching on the back 1.5 days after consuming a fresh Auricularia auricula salad, and millet-sized papules were densely distributed on the erythematous patches. Case 3, a 54-year-old female patient, developed cord-like, flagellate edematous erythema and papules on the neck, trunk and proximal extremities 72 hours after consuming Flammulina velutipes. Histopathological examination of the dorsal lesions in case 3 showed epidermal spongiosis, intraepidermal blisters, papillary dermal edema, superficial dermal vasodilation, erythrocyte extravasation, inflammatory infiltration composed mainly of lymphocytes around dilated blood vessels, and a few scattered eosinophils. The 3 patients were all diagnosed with flagellate shiitake mushroom dermatitis. Case 1 received no treatment, while cases 2 and 3 were symptomatically treated with topical fluticasone propionate ointment, and achieved recovery of skin lesions after 1 week.

Objective: To estimate the dietary salt and potassium intake by two 24 hour urine salt and potassium excretion in primary and secondary school students. Methods: The boarders from Grade 5 to 6 in a rural primary school and Grade 1 to 3 in a rural middle school in Changde City, Hunan Province were recruited from October to December in 2017. Subjects who had 2 and more urinary incontinence episodes or a history of kidney disease or diarrhea and girls in menstruation were excluded. The final analysis included 284 subjects. Questionnaires on basic demographic information were collected, and height and weight were examined. Two inconsecutive 24-hour urine specimens were collected in weekdays. The differences and consistency between two 24-hour urine were tested and dietary salt and potassium intake were assessed by the average of two 24-hour urine collections. Results: A Total of 284 participants was (12.1±1.5) years old, of which 148 (52.1%) were boys and 36 (12.7%) were overweight. In the first 24-hour urine, the volume [P₅₀ (P₂₅, P₇₅)=670 (513, 868) ml], potassium concentration [P₅₀ (P₂₅, P₇₅)=29 (21, 39) mmol/L] and potassium excretion [P₅₀ (P₂₅, P₇₅)=0.7 (0.6, 1.0) g] were similar to those in the second 24-hour urine [P₅0 (P₂₅, P₇₅) values were 660 (490, 916) ml, 30 (21,40) mmol/L, and 0.8 (0.6, 1.0) g, respectively]. But the sodium and creatinine concentrations, salt excretion in the first 24-hour urine [P₅₀ (P₂₅, P₇₅) values were 175 (123, 219) mmol/L, 7.20 (5.15, 10.86) mmol/L and 6.6 (5.0, 8.7) g, respectively] were lower than those in the second 24-hour urine [P₅₀ (P₂₅, P₇₅) values were 188 (133, 248) mmol/L, 8.66 (5.99, 12.47) mmol/L and 7.3 (5.2, 9.2) g, respectively] (all P values<0.05). The intraclass correlation coefficients between salt and potassium excretions in the two 24-hour urine were 0.534 (95%CI: 0.412-0.631) and 0.478 (95%CI: 0.341-0.587) (P<0.001), respectively. The mean±SD of salt consumed was (7.3±2.5) g (range: 2.3 to 18.8 g) per day by all participants. Overweight children consumed more salt [(8.2±2.6) g/d] than those non-overweight [(7.2±2.4) g/d] (P<0.05). The mean±SD of potassium consumed was (1.1±0.3) g (range: 0.4 to 2.3 g) per day. Boys consumed more potassium [(1.1±0.3) g/d] than girls [(1.0±0.3) g/d] (P<0.05), and overweight children had higher potassium intake [(1.2±0.3) g/d] than those non-overweight [(1.0±0.3) g/d] (P<0.05). A total of 212 participants (74.6%) consumed more salt than the recommended level and all participants had inadequate potassium intake. Conclusion The problem of excessive salt intake and insufficient potassium intake of rural primary and middle school students was serious.

The ability of prevention, treatment and management of infectious diseases is a basic requirement for general practitioners. This article introduces our experience in the infectious disease rotation for general practice residency training, focusing on the rotation management at different stages of training to explore how to improve teaching quality and the ability of trainers in a short period of the rotation.

Objective To forecast the number of healthcare professionals at China′s primary medical institutions from 2016 to 2020 ,so as to provide the healthcare authorities with references for optimizing healthcare human resource allocation .Methods The Grey model was used to predict numbers of healthcare professionals in China from 2016 to 2020 on the base of health technicians data from 2010 to 2015 .Results The forecast results show that the number of healthcare professionals may be increased to about 600000 people a yearfrom 2015 to 2020 .The number of healthcare professionals at China′s primary medical institutions is expected to grow about 204000 people a year ,and general practitioner is increased to about 22000 people a year .The annual growth rates of medical(assistant) practitioners ,medical practitioners ,registered nurses ,pharmaceutical personnel and examiners in China are expected to be 3.20％ ,2.81％ ,6.88％ ,1.53％ and 2.16％ respectively. The annual average growth rates of postgraduates ,undergraduates and junior college graduates are expected to be 16.95％ ,12.08％ and 5.46％ respectively .Conclusions in the future ,the requirements for healthcare professionals at primary institutions will still be higher than demand in China ,with a gap to be filled and their professional makeup and academic title make to be optimized. Therefore greater efforts are required for their development to enhance their competence and professionalism ,with reasonable staffing of the human resources .

Enterotoxigenic Escherichia coli（ETEC）infection can induce watery diarrhea，leading to dehydration，electrolyte disturbance，and even death in severe cases. Recombinant B subunit/inactivated whole-cell cholera（rBS/WC）vaccine is effective in preventing ETEC infectious diarrhea. On the basis of the latest evidence on etiology and epidemiology of ETEC，as well as the effectiveness，safety，and health economics of rBS/WC vaccine，National Clinical Research Center for Child Health（The Children’s Hospital，Zhejiang University School of Medicine）and Zhejiang Provincial Center for Disease Control and Prevention invited experts to develop expert consensus on rBS/WC vaccine in prevention of ETEC infectious diarrhea. It aims to provide the clinicians and vaccination professionals with guidelines on using rBS/WC vaccine to reduce the incidence of ETEC infectious diarrhea.