Objective:To discuss the accounting method for clinical usage efficiency of free medical consumable under information management system, and analyze these usage efficiency data.Methods: To adopt the medical material management system to collect usage quantity and amount of free medical consumables and chargeable medical consumable, respectively, from different department in every month, and then generalize usage quantity of different consumable; to apply hospital information system (HIS) to collect monthly patient data of different disease area or department; to gather statistics of monthly data proportion of usage ratio of free medical consumable as classified statistic principle by applying the consumption of them, patient quantity and usage proportion depend on data from two systems; and then got the line analysis charts of monthly usage efficiency and average usage efficiency of free medical consumable of each department in one year.Results: The data were evaluated through usage rate of free medical consumable of each department; the reference data from direct data and graph analysis depended on different classification and time interval, and they were provided for clinic practice in order to the free medical consumable can be more reasonable used in guiding clinical department.Conclusion: The purchase and used quantity of medical consumable can be grasped through information management system, which is scientific in management and usage for them, can avoid excessive waste and reduction of medical consumable, ensure them can be safety and efficiency used in clinical diagnosis and treatment. It make medical materials to be used in clinical diagnosis safely and effectively.

Objective:To establish a protein-protein interaction (PPI) network of 5 microRNA (miRNA) target genes differentially expressed in the plasma of coal-burning fluoride exposed population, and to screen genes and gene modules with important roles.Methods:Five miRNA (hsa-miRNA-3131, hsa-miRNA-4516, hsa-miRNA-6501-5p, hsa-miRNA-10b-5p, hsa-miRNA-4683) target genes differentially expressed in the plasma of coal-burning fluoride exposed population screened by our previous study were mapped to the STRING online database (https://string-db.org), and the PPI network was screened. The Cytoscape v3.6.0 software was used to visualize the PPI network, the topological attribute values degree and betweenness centrality were obtained by the NetworkAnalyzer plug-in, and the central node was filtered in the network (the node with the highest degree and the highest betweenness centrality). At the same time, the maximal clique centrality (MCC) analysis method in the CytoHubba plug-in was used to determine the important nodes in the PPI network. The cluster analysis was conducted by the MCODE plug-in, and the gene modules were screened in the PPI network. The protein names contained in the gene modules were submitted online to the KOBAS v3.0 database (http://kobas.cbi.pku.edu.cn/), and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis was performed on the gene modules selected by the MCODE plug-in.Results:The PPI network of target genes was consisted of 1 035 nodes and 4 346 edges. The degree (101) and betweenness centrality (0.010 723 89) of ubiquitin A-52 residue ribosomal protein fusion product 1 (UBA52) were the highest, which was the central node of the PPI network. According to MCC analysis, UBA52 was an important node in the PPI network. The top 5 gene modules were selected from the PPI network, and the highly enriched gene pathways in the KEGG pathway enrichment analysis of the 5 gene modules included ubiquitin mediated proteolysis, spliceosome, endocytosis, neuroactive ligand-receptor interaction and vesicular transport.Conclusion:The PPI network of 5 miRNA target genes differentially expressed in the plasma of people exposed to coal-burning pollution of fluoride is successfully established, and the UBA52 gene and the 5 main pathways of gene modules are selected.

Objective To determine the prevalence of and correlations between HIV infection and syphilis among men who have sex with men (MSM) in Beijing.Methods Totally,600 MSM collected from sentinel surveillance sites for AIDS in Beijing were recruited in this study,and underwent screening tests for HIV infection and syphilis.Enzyme-linked immunosorbent assay (ELISA) was used for the primary screening for HIV infection,and Western blot for its confirmation.Both nontreponemal test (rapid plasma regain (RPR) assay) and treponemal test (Treponema pallidum particle agglutination assay,TPPA) were performed to detect syphilis,and only those with a reactive TPPA result were defined as having syphilis (including past infection).Specimens confirmed as HIV-1 positive were further tested with BED-capture enzyme immunoassay (CEIA) to find recent HIV-1 infection,and the incidence of HIV infection was then calculated.The correlation between syphilis and HIV infection was statistically analyzed.Results Of the 600 MSM,49 (8.17％) had HIV infection,including 14 cases of recent infection,with the incidence rate of HIV infection being 4.68％; 51 were positive for both RPR and TPPA tests with the infection rate (including past infection) being 18.5％ (111/600).People without a Beijing household registration and those with high education levels accounted for a large proportion of HIV-infected MSM.Conclusions The prevalence and incidence of HIV infection as well as prevalence of syphilis maintain at a relatively high level in MSM in Beijing.HIV infection is markedly correlated with syphilis in MSM population.

Objective To analyze the clinical characteristics of community-acquired influenza virus pneumonia in hospitalized children and improve the clinicians' understanding level of this disease.Methods Data of 70 cases with community-acquired influenza virus pneumonia admitted to the Respiratory Department and Infectious Disease,Beijing Children's Hospital,Capital Medical University,from November 2009 to April 2018 were collected and the clinical characteristics were analyzed.Results Of the 70 cases,61 cases(89.7％) were discharged after improvement.The median age was 3.5 years old,and 50 cases(71.4％) were 0 to 5 years old.There were 29 cases with severe influenza pneumonia,41 cases with mild influenza pneumonia,3 cases died,and 19 cases (27.1％) had underlying diseases.Sixty-four cases (91.4％) were hospitalized in winter and spring.The first symptoms were mainly fever in 64 cases (91.4％) and cough in 65 cases (92.9％),and temperatures were mostly from 39.1 ℃ to 41.0 ℃.Lung auscultation was dominated by moist rales (30 cases,58.8％) and wheezing (8 cases,15.7％).There were many complications of influenza virus pneumonia,including 19 cases with myocardial injury,11 cases with liver function injury,4 cases with toxic encephalopathy,3 cases with electrolyte disturbance,2 cases with multiple organ failure,2 cases with hemophagocytic syndrome,and 1 case with septic shock.Chest radiographic results reveal bilateral inflammation in 40 children (57.1％),prodominatly in lower lobe lesions (39 cases).The common changes were patchy shadow,interstitial parenchymal lesion,ground glass shadow,and pleural effusion.Forty-seven children (67.1％) were infected by influenza A,and 23 children(32.9％) were co-infected.The percentage of severe cases with underlying diseases (68.4％) was significantly higher than that in children without chronic diseases (31.4％),the difference was statistically significant (x2 =7.830,P =0.005).The increase rate of C reaction protein (CRP) in severe cases (54.3％) was significantly higher than that in mild cases (28.6％),the difference was statistically significant (x2 =4.769,P =0.029).Conclusions Community-acquired influenza virus pneumonia in children mainly occurs in winter and spring.It is more common seen in children under 5 years of age.The main clinical manifestations of community-acquired influenza virus pneumonia are high fever and cough,extrapulmonary complications are more common.Most children have moist rales and showed bilateral inflammation and lower lobe lesions in chest radiography.Children with underlying diseases are more likely to develop severe influenza virus pneumonia.Elevated CRP is associated with severe influenza virus pneumonia.Most patients have a good prognosis,but there are still cases of death.

OBJECTIVETo analyze the proportion and associated factors of taking subsequent confirmation test among men who have sex with men (MSM) after being tested positive in oral fluid HIV antibody test.

METHODSBy using successive sampling, 1 003 MSM, who were tested positive in oral fluid HIV antibody test in China-Bill & Melinda Gates Foundation AIDS prevention Program (Extension program) in Beijing during May 1 to December 31, 2013, were recruited. The inclusion criteria included: the objects were men who reported having sex with men; the objects aged more than 18 years old; the objects were tested positive in oral fluid HIV antibody test; the objects had not been reported as HIV positives in China Information System for Disease Control and Prevention previously. According to the program strategy, MSM grassroots organizations transferred the respondents to seek subsequent confirmation tests in specific Center for Disease Control and Prevention (CDCs) or hospitals. The subsequent confirmation tests included: fingertip blood HIV antibody rapid test, venous blood Enzyme Linked Immunosorbent Assay (ELISA) HIV antibody test and venous blood Western Blot (WB) HIV antibody test. Chi-square test was adopted to compare the proportion of taking subsequent confirmation tests in different groups. Nonconditional multivaritae binarylogistic regression analysis was taken to identify the associated factors with whether taking subsequent confirmation tests and to calculate the OR (95% CI) values.

RESULTSThe 1 003 respondents were (30.9 ± 9.1) years old. Among all objects, 87.8% (881/1 003) of them took fingertip blood HIV antibody rapid tests and the positive rate was 85.4% (752/881). 98.0% (737/752) of those who were identified as positive in fingertip blood HIV rapid tests took ELISA and WB tests, and the positive rate was 94.4% (696/737). Comparing with those who were expected to seek subsequent confirmation tests in CDCs, the OR (95% CI) value of those who were expected to seek tests in hospitals was 5.10 (1.69-15.36). The OR (95% CI) values of those who used condom sometimes and those who never used condom in anal sex were 5.81 (2.14-15.77) and 3.45 (2.00-5.97) respectively, in comparison with those who reported not having anal sex or using condom consistently in anal sex during the past 6 months. Comparing with the respondents recruited from the internet, the OR (95% CI) values of those recruited in bathrooms, parks/toilets and bars were 0.17 (0.05-0.53), 0.10 (0.04-0.29) and 0.22 (0.06-0.79) respectively. The likelihood of taking subsequent confirmation test decreased with the increase of number of male sexual partners in the past 3 months, and the OR (95% CI) value was 0.92 (0.86-0.99).

CONCLUSIONThe potential HIV positive MSM in the bathroom, park/toilet and bars are less likely to take subsequent confirmation test. Those who do not use condom consistently during anal sex are more likely to seek subsequent confirmation test. Medical organization conducting subsequent confirmation tests is more likely to increase the confirmation test rate of potential HIV positive MSM. The number of male sexual partners has negative correlation with whether to accept the subsequent confirmation test.

Beijing ; Condoms ; HIV Antibodies ; analysis ; HIV Seropositivity ; diagnosis ; Homosexuality, Male ; Humans ; Male ; Mass Screening ; Patient Acceptance of Health Care ; Risk-Taking ; Sexual Behavior ; Sexual Partners ; Surveys and Questionnaires

Objective To evaluate the effect of anesthetic factors on perioperative inflammatory responses in bilateral lung transplantation.Methods Fifty-six American Society of Anesthesiologists physical status Ⅲ or Ⅳ patients,aged 18-64 yr,weighing 45-65 kg,undergoing elective bilateral lung transplantation,were divided into 2 groups (n=28 each) using a random number table:routine anesthesia group (group R) and dexmedetomidine-based anesthesia group (group D).In group D,dexmedetomidine was intravenously infused as a dose of 1.0 μg/kg for 10 min followed by an infusion of 0.5 μg · kg-1 · h-1,propofol 4-6 mg · kg-1 · h-1,cisatracurium besylate 0.05 mg · kg-1 · h-1 and remifentanil 0.1-0.3 μg · kg-1 · min-1 were intravenously infused and 1％-2％ sevoflurane was inhaled.In group R,the method for anesthesia maintenance was similar to that previously described in group D except dexmedetomidine.Before anesthesia induction,immediately after intubation,immediately after one-lung ventilation,at 30 and 60 min after one-lung ventilation,immediately after two-lung ventilation,at 30 and 60 min after twolung ventilation,at the end of surgery and at 12 and 24 h after surgery (T0-10),blood samples were collected from the radial artery for determination of serum tumor necrosis factor-alpha,interleukin-6 (IL-6) and IL-8 levels by enzyme-linked immunosorbent assay.The extubation time was recorded.Results The serum concentrations of tumor necrosis factor-alpha,IL-6 and IL-8 were significantly lower at T3-10,and the extubation time was shorter in group D than in group R (P＜0.05).Conclusion Dexmedetomidine-based anesthesia can decrease perioperative inflammatory responses and is helpful in improving prognesis in the patients undergoing bilateral lung transplantation.

Objective To evaluate the efficacy of dexmedetomidine mixed with sufentanil for patient-controlled intravenous analgesia (PCIA) after double lung transplantation.Methods Thirty-two patients of both sexes,aged 33-64 yr,of American Society of Anesthesiologists physical status Ⅲ or Ⅳ,with body mass index of 18-29 kg/m2,were divided into 2 groups (n=16 each) using a random number table:sufentanil group (group S) and dexmedetomidine mixed with sufentanil group (group DS).PCIA was performed after operation in both groups.The PCIA solution contained sufentainl 3.0 μg/kg and tropisetron 10 mg (diluted to 100 ml in normal saline) in group S and sufentainl 3.0 μg/kg,dexmedetomidine 1.0 μg/kg and tropisetron 10 mg (diluted to 100 ml in normal saline) in group DS.Visual analogue scale score was maintained less than or equal to 3 during postoperative analgesia period,and sufentainl 5 μg was intravenously injected when visual analogue scale score was more than or equal to 4.The requirement for rescue analgesics and development of adverse reactions were recorded.The pulmonary arterial pressure was recorded at the end of surgery (T0) and at 2,4,8,24 and 48 h after surgery (T1-5).Results Compared with group S,the requirement for rescue analgesics,incidence of nausea and vomiting and pulmonary arterial pressure at T1-5 were significantly decreased in group DS (P＜0.05).Conclusion Dexmedetomidine mixed with sufentanil produces better efficacy for PCIA with fewer adverse reactions and decreases the pulmonary arterial pressure after double lung transplantation.