In order to improve bilingual teaching in clinical epidemiology,a multidimensional teaching mode with flexible method was constructed.And it was proposed that based on the student-centered learning,the content of teaching should be adjusted,English should be used logically and clinical courses and practice should be closely connected.The new teaching method was proved successful.

Objective To investigate the effect of standardized usage of antibiotics and hand hygiene on carbapenem-re-sistant Enterobacteriaceae (CRE) infection in neonates. Methods According to the situation of standardized management of an-tibiotics in our hospital, the study period, from January 2011 to December 2013, was divided into pre-intervention, transition and post-intervention. Retrospective study was employed to analyze the antibiotics use density (AUD), the hand hygiene compliance rate among the medical staff, the positive rate of CRE and the nosocomial infection percentage of the neonatology department. Results From pre-intervention to post-intervention period, the AUD was decreased from 12.93 DDDs to 8.10 DDDs;hand hy-giene compliance rate of medical staff was increased from 53.49%to 83.33%;the detection rate of CRE was decreased from 3.71%to 2.27%. The differences were all signiifcant among different periods (P<0.01). The nosocomial infection percentage decreased from 0.22%to 0.17%and there was no signiifcant difference (P=0.441). Conclusions Standardized usage of antibiotics and hand hygiene can be served as economical yet effective approaches to controlling CRE infection in neonates.

Objective To investigate the causes of arterial reocclusion in diabetic feet patients after endovascular treatment and its remedial measures.Methods From January 2009 to October 2013,clinical data of 371 arterial reocclusion of diabetic feet patients after endovascular treatment in Tianjin First Central Hospital were reviewed retrospectively.We summarized the causes of reocclusion,treatment methods and the short term results.Results According to the Trans-Alantic Inter-Society Consensus (TASC) Ⅱ grading standards,the first time when the endovascular treatment started there were 37 cases of grade A,85 cases of grade B,143 cases of grade C,106 cases of grade D.Arterial re-occlusion developed from one day to 36 months,averaging at (21 ± 8) months.Causes of re-occlusion included intimal hyperplasia in 263 cases (70.9％),thrombosis in 65 cases (17.5％),dissection in 19 cases (5.1％),stent fracture in 17 cases (4.6％),vascular rupture in 7 cases (1.9％).Remedial therapy adopted for arterial reocclusion was repeated endovascular treatment in 327 cases (88.1％),arterial bypass surgery in 23 cases (6.2％),conservative treatment in 13 cases (3.5％),amputation (cut toe) in 4 cases (1.1％),4 cases (1.1％) died perioperatively.275 cases were followed up for 1 to 36 months,the average was (13 ± 8) months.patency rate was 82.9％,71.3％ and 63.0％ at 6 months,1 year and 2 years.Amputation rate was 1.1％,1.8％ and 2.5％ at 6 months,1 year and 2 years.Conclusions Intimal hyperplasia is to blame for arterial reocclusion after endovascular treatment of diabetic foot.In this case most patients still can benefit from second time endovascular treatment,with a satisfactory short term patency rate.

Objective To explore the clinical efficacy and satety of LFK-SLT30 semiconductor laser combined with polidocanol for the treatment of varicose veins of the lower extremities.Methods The clinical data of 105 patients treated by traditional surgery (surgery group) and 113 patients with endovascular laser treatment (EVLT) combined with polidocanol (combination group) were retrospectively analyzed from Apr 2013 to Apr 2015.Results The operative time [(50 ± 12) min vs.(70 ±10)min] and blood loss [(19 ± 6)ml vs.(41 ± 8)ml] between combination group and surgery group were significantly different (P ＜ 0.05).The rate of complications in surgery group was significantly higher than that in the combination group[15.2％ (16/105)vs.6.3％ (7/113),x2 =4.717,P =0.030].The overall 1',2' and 3 year follow-up rate was 85.3％ (186/218),76.6％ (167/218),and 60.6％ (132/218).The average follow up was (20 ± 13)months.No significant difference existed in the rate of recurrence [0 vs.3.5％(4/113),x2 =3.786,P=0.123] between the two groups.Conclusions EVLT combined with foam sclerotherapy is as effective as surgery,while resulting in less complications,less invasive,safer and more effective for the treatment of varicose veins of the lower extremities.

Objective: To study the influence of authraquinones derivative of nine fold processed Radix et Rhizoma Rhei on hyperlipema and hemorheology of animals. Methods: The blood TC and TG of experimental hyperlipemia rats before and after they were given drug and its improvement on hemorheology of rats were determired. Results: Anthraquinone derivative of nine fold processed Radix et Rhizoma Rhei could decrease levels of the blood TC and TG of experimental hyperlipemia rats and improve hemorheology of rats ( P

Abstract: Objective　To explore the spatial epidemiological characteristics of severe cases hand, foot and mouth disease (HFMD) in Guangxi, China, from 2014 to 2018, and to provide a basis for identifying the high-risk regions as well as the prevention and control of severe cases of HFMD in Guangxi. Methods　Spatial-temporal scanning analysis, global and local spatial autocorrelation analysis were used to analyze the spatial clustering of HFMD. The trend surface analysis was used to evaluate the spatial distribution trend of HFMD. Results　From 2014 to 2018, the incidence and severe case fatality rates of HFMD were 3.89/100 000 and 4.23%, respectively. Monte Carlo scanning analysis showed that the first cluster region was Cenxi City, the second cluster was mainly concentrated in northwest of Guangxi, and the aggregation time was mainly concentrated in April to May and August to October. The global spatial autocorrelation analysis showed that the severe HFMD was significant clustering distribution, and the Moran's I coefficients of the sever cases, severe morbidity and severe case fatality rate were 0.088, 0.118, 0.197, respectively (P<0.05). Local spatial autocorrelation analysis showed that hotspots of severe HFMD cases were concentrated in the southern Guangxi, mainly in Lingshan County. Anselin local Moran's I clustering and outlier analysis indicated that 5 high-high (H-H) clustering regions for fatality were Lingshan, Pubei, Zhongshan, Zhaoping and Pinggui County. There were 6 high-high (H-H) clustering regions for severe incidence rate, namely Lingshan, Qinnan, Lingyun, Youjiang, Bama Yao Autonomous and Pinggui County, and 1 high-low (H-L) clustering region, Cenxi County. The trend surface analysis showed that the overall number of severe cases of death decreased from east or west to the middle, and increased from north to middle, and then decreased to south. Conclusions　Severe HFMD cases in Guangxi have obvious spatial-temporal clustering, and the hop spots are mainly concentrated in southern Guangxi. The prevention and control of HFMD in areas with high incidence of severe cases should be strengthened to reduce the burden of HFMD cases.

This essay introduces a method of determining the dimethylacetamide concentration by gas chromatography in the dialyzer. The clinical dialysis process is simulated. The capillary chromingraphic method is used with the peak area and the external standard method, Optimizing testing conditions of gas chromatography. Therefore, This method shows good sensitivity and good repeatability.
Acetamides ; analysis ; Chromatography, Gas ; methods ; Dialysis ; Dialysis Solutions ; analysis ; Humans

Objective:To evaluate the efficacy and safety of excimer laser ablation (ELA) combined with drug-eluting balloon angioplasty in the treatment of arteriosclerosis obliterans of lower extremities.Methods:The clinical data of 17 patients who received ELA from May to Dec 2017 was retrospectively analyzed, including 12-month primary patency rate, technical success rate, surgical success rate, stent implantation rate, target vessel reintervention rate and major adverse events.Results:The length of lesions was (23.3±8.9) cm. The success rate of technique and operation was 100%.All cases were treated with combined DCB. Five cases underwent stent placement, and the patency rate at 12 months was 82.4%. The recurrence rate of target lesion was 5.9%.Conclusion:ELA combined with DCBA is safe and feasible in the treatment of lower extremity arterial occlusive disease.

OBJECTIVETo study the sequential changes of HIF-1alpha (hypoxia-inducible factor 1 alpha) in experimental spinal cord injury in rats and to analyze its potential effects in SCI.

METHODSA static compression model of SCI was employed in this study. Expressions of HIF-1alpha were measured with immunohistochemical staining, while flow cytometry was used to determine the apoptotic ratio and bcl-2 expressions.

RESULTSHIF-1alpha began to increase 1 day after injury, and reached the peak at 3-7 days. Two weeks later, it declined significantly. The sequential changes of HIF-1alpha coincided well with the alterations of apoptotic ratio and contents of bcl-2.

CONCLUSIONSHIF-1alpha possibly participates in the secondary ischemic and hypoxic procedures after spinal cord injury, and may mediate the traumatic apoptosis. Further understanding of HIF-1alpha may provide new therapeutic regimens for SCI.

Animals ; Apoptosis ; Biomarkers ; analysis ; DNA-Binding Proteins ; analysis ; metabolism ; Disease Models, Animal ; Female ; Flow Cytometry ; Hypoxia-Inducible Factor 1 ; Hypoxia-Inducible Factor 1, alpha Subunit ; Injury Severity Score ; Ischemia ; pathology ; Nuclear Proteins ; analysis ; metabolism ; Probability ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rats ; Rats, Sprague-Dawley ; Spinal Cord Injuries ; metabolism ; pathology ; Transcription Factors

OBJECTIVETo explore the mechanism of electroacupuncture therapy on Parkinson's disease (PD).

METHODSFifty Wistar rats were randomly divided into a normal group, a sham-operation group, a model group, a Fengfu-Taichong group and a Shuanggu Yitong group. PD model was duplicated by microinjection of 6-Hydroxyl-Dopamine into right corpora striata, and by microinjection of normal saline in sham-operation group. Rats in normal group, sham-operation group and model group were not treated. In Fengfu-Taichong group, the rats were treated by electroacupuncture at "Fengfu" (GV 16) and "Taichong" (LR 3) on the basis of the PD model, and by electroacupuncture at "Fengfu" (GV 16), "Taichong" (LR 3), "Guanyuan" (CV 4) and "Zusanli" (ST 36) in Shuanggu Yitong group, once daily for 2 weeks. GDNF and Ret expression were detected by immunohistochemistry and western blotting, respectively.

RESULTSThe number of GDNF positive cells and the content of Ret receptor increased significantly in the two electroacupuncture groups compared with those in the other groups (all P < 0.01), and the expression of GDNF increased significantly in Shuanggu Yitong group compared with that in Fengfu-Taichong group (P < 0.01).

CONCLUSIONElectroacupuncture can not only increase the expression of GDNF, but also enhance its effect. "Shuanggu Yitong" method is better than simple acupuncture at "Fengfu" (GV 16) and "Taichong" (LR 3) in increasing expression of GDNF.

Animals ; DNA-Binding Proteins ; genetics ; metabolism ; Disease Models, Animal ; Electroacupuncture ; Gene Expression ; Glial Cell Line-Derived Neurotrophic Factor ; genetics ; metabolism ; Humans ; Nuclear Proteins ; genetics ; metabolism ; Parkinson Disease ; genetics ; metabolism ; therapy ; Random Allocation ; Rats ; Rats, Wistar