Objective To investigate the effect of mixed-skin grafting with autologous microskin and allogenetic acellular dermal matrix microskin on wound healing in rats,and to make a further study on the related mechanism.Methods Wistar rats were served as a allogenetic acellular dermal matrix donor rats,and SD rats as acceptors with mould of full thickness skin defects on their back.The ninety SD rats were divided into 5 groups with 18 rats in each group.Group 1 was transplanted with autologous microskin,and group 2 with allogenetic acellular dermal matrix microskin.Groups 3,4 and 5 were grafted with mixed-skin ratio between autologous microskin and allogenetic acellular dermal matrix microskin 1 ∶ 1,1 ∶ 0.5 and 1 ∶ 0.25,repectively.The rate of wound healing was measured,wound samples collected,hematoxylin and eosin stain carried out,fibronectin (FN) and laminin (LN)detected,and intergroup comparison made,respectively,2,3 and 4 weeks after skin grafting.Results The wound healing rates and FN and LN expression of mixed-skin grafting groups were higher than those of the group with autologous microskin grafting.The group of 1 ∶ 0.25 obviously increased (P＜0.05 or P＜0.01).Conclusions The wound healing rate with mixed-skin grafting is higher than that with autologous microskin grafting.The best effect is achieved when the skin ratio between autologous microskin and allogenetic acellular dermal matrix microskin is 1 ∶ 0.25.It is possibly due to the increase of FN and LN on wound skin surface.

OBJECTIVE:To investigate the cognition of medical staff's cognition on clinical pharmaceutical care.METHODS:A total of 105 questionnaires collected from the doctors and nurses were subjected to an aggregate analysis in terms of their ultimate educational background,professional title,working lifetime,cognition on clinical pharmaceutical care etc.RESULTS & CONCLUSIONS:Doctors and nurses had positive attitude toward clinical pharmacy care and it is greatly demanded in drug use.Clinical pharmaceutical staff should keep improving their expertise level and strengthen cooperation with medical staff so as to facilitate the development of clinical pharmaceutical care.

Objective: To investigate the awareness of nutrition and health knowledge among adult residents in Hangzhou City, so as to provide insights into improving human nutrition and health. Methods: The permanent residents at ages of 18 to 64 years were sampled using a multi-stage stratified random sampling method from 13 counties (districts) of Hangzhou City from June to July, 2021. Participants' demographics and awareness of nutrition and health knowledge were collected using the Questionnaire on Nutrition and Health Knowledge among Chinese Adult Residents, and the awareness of nutrition and health knowledge was analyzed among participants with different demographic features. Results: A total of 5 106 questionnaires were allocated, and 4 920 valid questionnaires were recovered, with an effective recovery rate of 96.36%. The respondents included 2 575 men (52.34%) and 2 345 women (47.66%), and had a mean age of (39.89±12.85) years. The median score of nutrition and health knowledge was 67.50 (interquartile range, 16.50) points, and the awareness of nutrition and health knowledge was 24.49%, while the awareness of dietary recommendation, food characteristics, nutrition and disease, food choice and food safety was 15.89%, 16.77%, 54.17%, 26.36% and 60.69%, respectively. The awareness of nutrition and health knowledge was significantly lower among men than among women (21.01% vs. 28.32%, P<0.05), and among urban residents than among rural residents (22.94% vs. 27.34%, P<0.05). There were significant differences in the awareness of nutrition and health knowledge among residents in terms of age, occupation and educational level (P<0.05). Conclusions Age, gender, region, occupation and educational level may affect the awareness of nutrition and health knowledge among adult residents in Hangzhou City. Health education about nutrition and health knowledge requires to be reinforced with adaptations to characteristics of residents.

Objective To evaluate the advantages and disadvantages of different puncture positions in percutaneous nephrolithotomy. Methods Three hundred fifty-six patients who underwent PCNL were analyzed from March 2012 to October 2015. The passage caliber was 16F-20F. There were 217 cases in prone position and 139 cases in supine position. Results The successful operation in PCNL was 354 cases , while the remaining 2 cases were performed by open surgery. The primary stone clearance rate was 75.5%. The additional PCNLs were performed in 23 cases, and 63 cases of residual calculi were treated by ESWL. 11 patients were treated due to infection or bleeding by the additional PCNLs. There were 3 cases with massive hemorrhage which were treated by Interventional embolization therapy , 12 cases in postoperative fever , no renal resection , no intestinal injury, no deaths. There was no significant difference in stone clearance rate and complication rate between the two groups. Conclusion The puncture position of PCNL can be optional based on the stone size , stone location, degree of hydronephrosis ,and patient′s cardiopulmonary condition individually.

OBJECTIVE To observe the curative effect of Jieminqufeng decoction to the rats with allergic rhinitis. METHODS Fourty Wistar rats were randomly divided into 4 groups. There were Jieminqufeng decoction group (A),cetirizine group (B),model control group(C) and normal control group (D). The rats with allergic rhinitis were established with ovalbumin. The behavioral changes of the rats were observed. The histological and cellular morphological changes were studied with light microscope and transmission electron microscope. RESULTS The model control (C) group had typical symptoms of allergic rhinitis. By light microscope and transmission electron microscope,a lot of eosinophilic granulocytes were found in nasal mucosa. The mucosal cells were lost or destroyed. However,the histological and cellular morphological changes of nasal mucosa in Group A,B were similar to that in Group D. CONCLUSION The Jieminqufeng decoction is an effective drug to treatment of allergic rhinitis. It can decrease the aggregation and activation of eosinophilic granulocytes,lessen inflammatory reaction and block up the allergy.

Objective To understand the relationship between the dietary patterns and metabolic syndrome among elderly people in Zhejiang province,in order to provide scientific basis and reference for nutrition interventions.Methods Data were obtained from the 2010-2012 Chinese National Nutrition and Health Survey,and factor analysis was used to obtain food patterns among elderly people in Zhejiang province.The Logistic regression was used to explore the association of the food patterns with metabolic syndrome and its components.Results The intakes of bean products,nuts,fruits,eggs,and milk in elderly people were generally low,and the intakes of livestock and poultry meat,cooking oil and salt were relatively high.5 dietary patterns were derived by factor analysis:high-quality protein diet,mediterranean diet,condiments diet,traditional dietary pattern and western dietary pattern.The medical test results in 780 elderly people showed that the standardized prevalence of metabolic syndrome in the elderly was 28.8％,standardized central obesity rate was 41.2％,standardized hypertension rate was 50.3％ and standardized hyperglycemia rate was 39.5％.Logistic regression analysis showed that different dietary patterns had different effects on the metabolic syndrome and its components.Conclusions The prevalence rate of metabolic syndrome and the abnormal rates of its components are high in the elderly in Zhejiang.The intakes of fruits and milk are generally low,and intakes of livestock and poultry meat,cooking oil and salt are relatively high.The relationship between dietary patterns and MS or its components is complicated,so it is necessary to guide the elderly people to adopt reasonable diet by referring to the Diet Pagoda in order to reduce the risk of MS or its components.

ObjectiveTo investigate the trends and significant determinants of delayed HIV diagnosis （DHD） among newly reported HIV/AIDS cases in Xuhui District， Shanghai between 2018 and 2022. MethodsIn the newly reported HIV/AIDS cases， patients died within one year without accident， HIV/AIDS cases with CD₄ cell count <200 cells·μL^-1， and AIDS cases with a CD₄ cell count between 200 to 499 cells·μL^-1 were defined as delayed diagnosis. Univariate and multivariate logistic analysis were employed to explore the influencing factors of DHD. ResultsAmong the 862 newly reported HIV/AIDS cases， The DHD rate was 39.79% without statistically significant difference by year（χ²=4.508， P=0.342）. Patients with CD₄ cell count <200 cells·μL^-1 contributed the largest proportion of DHD. During 2018‒2022， the DHD rate declined among HIV/AIDS patients who were younger than 35 years old or 45‒65 years old， never married， original diagnosis from tertiary specialized hospitals. Patients who were 65 years or older， married or divorced， with heterosexual transmitted HIV/AIDS， and original diagnosis from other types of testing and tertiary metropolitan hospital， had sustainably higher DHD rates. The number of HIV screening and diagnosed from voluntary counseling and testing （VCT） decreased during the COVID-19 epidemic， while the DHD rate increased sharply. Multivariate logistic regression analysis suggested the DHD rates were higher among older age， other types of testing（OR=3.805， 95%CI： 2.260‒6.406）and pre-operative testing（OR=2.411， 95%CI： 1.424‒4.081）. Patients who received CD₄ test in 15 days had a higher DHD rate compared to the cases received CD₄ test exceeding 90 days （OR=0.336， 95%CI： 0.216‒0.522）. ConclusionThere is no significant decrease of delayed HIV diagnosis rate in Xuhui District in recent years， and the number of HIV tests has decreased in 2022. Monitoring of newly reported HIV/AIDS should be conducted continuously. Expansion of HIV antibody screening should be conducted in non-infectious departments and inpatient departments in healthcare institutions， particularly metropolitan hospitals. Assistance should be provided to clinicians and elderly patients for improving their ability to recognize and perceive the risk of HIV/AIDS， in order to enhance early diagnosis and subsequent treatment.

Objective The research aimed at evaluating whether non-invasive endolymphatic MR imaging could be used in aged patients(≥60 years)suffering from Meniere's disease.Methods Under guidance of nasal endoscopy,a diluted gadopentetate dimeglumine injection was administrated through eustachian tube into mid-ear cavity in four patients (≥60 years old) suffered from Meniere's disease.3D-FLAIR MRI scan was performed one day after the administration.Results The administration succeeded through eustachian tube into mid-ear cavity in those four patients.A rise of fluid level on tympanic membrane while administrating a diluted gadopentetated meglumine injection was observed.Imaging of inner ear endolymphatic spaces were visible in vestibule and cochlea in imaging of patient 1.As to patient 2,in cochlea the scala tympani of the first and second turns were enhanced while scala vestibule weren't;Vestibules couldn't be recognized.In images of patient 3,the scala tympani of the three turns in cochlea were enhanced while scala vestibule weren't;Vestibules couldn't be recognized.For Patient 4,in cochlea the scala tympani of the first turn were enhanced while scala vestibule weren't,and the second turn was partially enhanced;and endolymphatic space of vestibule could be distinguished from perilymphatic space.Conclusions This technique could be adopted in investigation of Meniere's disease in elderly patients.MR imaging of endolymphatic spaces in vestibule and cochlea can be visualized,which may partially provide data for diagnosis of Meniere's disease.

Objective To investigate the distribution and antibiotic resistance of the pathogens isolated from blood of the inpatients in hematology ward.Methods Antimicrobial susceptibility test was carried out using Kirby-Bauer method.The data were analyzed by WHONET 5.6 software.Results Of the 521 microbial isolates collected,gram-negative bacilli accounted for 47.2％,grampositive cocci 45.7％ and fungi (7.1％).The most frequently isolated microorganisms were coagulase negative Staphylococcus (154),E.coli (88),K.pneumoniae (51),P.aeruginosa (39) and Enterococcus spp (34).ESBLs were produced in about 40.4％ of the K.pneumoniae isolates and 63.4％ of the E.coli isolates.At least 90％ of the E.coli isolates were susceptible to imipenem and meropenem,and at least 70％ susceptible to piperacillin-tazobactam.At least 85％ of the K.pneumoniae strains were susceptible to imipenem and meropenem,and at least 70％ susceptible to levofloxacin,piperacillin-tazobactam and cefoperazone-sulbactam.The percentage of the P.aeruginosa susceptible to ciprofloxacin and tobramycin was at least 90％,and higher than 70％ to levofloxacin,meropenem,imipenem,piperacillin-tazobactam,cefepime,and cefoperazone-sulbactam.More than 90％ strains of the coagulase negative Staphylococcus and Enterococcus were susceptible to linezolid and teicoplanin.Overall,82.5％ of the coagulase negative Staphylococcus isolates were resistant to methicillin.Three E.coli isolates and 4 K.pneumoniae isolates were found resistant to carbapenems,and 14 Enterococcus isolates were resistant to vancomycin.Conclusions Gram-negative bacilli are the major pathogens from blood samples in hematology ward,which show high susceptibility to piperacillin-tazobactam and cefoperazone-sulbactam,imipenem and meropenem.The grampositive cocci show high susceptibility to linezolid and teicoplanin.These data are helpful for empirical antimicrobial therapy.

Objective To investigate the risk factors related to mortality in human avian influenza A (H7N9)cases in Hangzhou.Methods The clinical and epidemiological data of 61 H7N9 patients whose diagnoses were confirmed by laboratory tests between 1st March,2013 and 2nd March,2014 in Hangzhou were collected.Descriptive analysis and univariate analysis were used to analyze the demographic,clinical and epidemiological characteristics and treatment outcomes.Patients were classified into improvement group and death group according to treatment outcomes,and risk factors for death were explored.Chi square test and t test were used for statistical analysis.Results A total of 61 patients were included in this study,among which 20(32.8%)patients died.The ratio of men to women for death attributed to H7N9 infection was three to one.The mean age of patients in death group was (63.6 ±3.8)years,which was older than that in improvement group ([55 .4±2.2]years,t =1 .97,P =0.05 ).The univariate analysis showed that the risk factors of mortality included over 60 years (χ2 =5 .16,P =0.02;OR =3.65 ,95 %CI :1 .19-11 .13 ),low education level (χ2 = 5 .42,P =0.02;OR =4.20,95 %CI :1 .24 - 14.00 ), chronic diseases (χ2 =4.67,P =0.03;OR=3.81 ,95 %CI :1 .12-12.69),bad hand hygiene (χ2 =4.05 , P =0.04;OR=4.67,95 %CI :1 .04 -11 .56 ),C-reactive protein (CRP)≥120 mg/L (χ2 =4.04,P =0.04;OR=6.00,95 %CI :1 .04-35 .33),increased initial neutrophil count (χ2 =3.90,P =0.05 ;OR=4.58,95 %CI :1 .01 -34.22)and decreased initial lymphocyte count (χ2 =7.12,P =0.01 ;OR =7.53, 95 %CI :1 .63 - 24.51 ).Conclusion Over 60 years,low education level,chronic diseases,bad hand hygiene,CRP≥ 120 mg/L,increased initial neutrophil count and decreased initial lymphocyte count are identified as risk factors for death in H7N9 cases in Hangzhou.