Objective To compare whether there is a difference in medical cost of intensive care unit(ICU)pa-tients with catheter-associated infection (CAI)between before and after targeted intervention.Methods CAI in ICU patients in 2010(pre-intervention group)and 2013 (post-intervention group)were investigated by retrospective survey,hospitalization cost of two groups of patients before and after intervention was compared.Results The morbidity and mortality in patients with CAI both decreased significantly after intervention,morbidity of healthcare-associated infection(HAI)decreased from 13.47% in 2010 to 4.41 % in 2013,mortality decreased from 10.36% in 2010 to 2.2% in 2103.Total hospitalization cost,blood transfusion cost,and cost of special material before and af-ter the implementation of targeted intervention all significantly different (all P <0.05),the difference of procalcito-nin and antimicrobial agents cost were also significant(all P <0.05).Conclusion Medical cost in ICU patients with CAI decreased after intervention.

Objective: To explore aspirin resistance (AR) phenomenon in patients with coronary artery disease (CAD) for secondary prevention and to study the relationships between AR and COX1, COX2, TBXA2R gene polymorphisms. Methods: A total of 2881 CAD patients taken aspirin (100 mg/day) in 7 consecutive days were enrolled. Among them, 2 groups were established as AR group, n=166 and Control group, n=200 aspirin sensitive patients. Platelet aggregation function was induced by arachidonic acid (AA), COX1, COX2 and TBXA2R gene polymorphisms were examined by polymerase chain reaction-restricted fragment length polymorphisms (PCR-RFLP) method. Results: The occurrence rate of AR was 5.76% (166/2881). There were 8 tagSNPs locus in 3 genes as in COX1:(rs3842788), (rs4273915), (rs7866582); in: COX2 (rs3218625); in TBXA2R: (rs2238630), (rs2238631), (rs2238633), (rs3786989). The frequencies of wild type, heterozygous genotype and homozygous genotype were similar between 2 groups. Conclusion: The incidence rate of AR is not high in CHD patients with regular aspirin medication; single nucleotide gene polymorphisms of COX1, COX2 and TBXA2R have no obvious correlation to AR.

Purpose To assess the clinical application of non-contrast-enhanced MR angiography (NCE-MRA) using flow sensitive dephasing (FSD) prepared steady-state free precession (SSFP) for displaying hand arteries of patients with rheumatoid arthritis. Materials and Methods Twenty-two patients with rheumatoid arthritis were recruited in this study. All the patients undertook hand NCE-MRA and three-dimensional dynamic CE-MRA on a 1.5T MR scanner. The informed consent was obtained from each subject. Image quality was assessed independently by two experienced radiologists at three arterial segments (wrist arteries, palm arteries, andfinger arteries) with a four-point scale. Signal to noise ratio (SNR), contrast to noise ratio (CNR), and vessel sharpness were evaluated by a magnetic resonance physicist. The results and image quality were statistically compared between the two MRA techniques.Results Twenty-two patients of 24 hands successfully underwent NCE-MRA and CE-MRA scan. Among 72 vascular segments, 69 segments of NCE-MRA were diagnostic, which was higher than that of CE-MRA (96% vs 83%,P<0.05). Otherwise, the image quality, SNR, CNR and vessel sharpness of NCE-MRA were all superior to those of CE-MRA (P<0.05).Conclusion NCE-MRA using FSD-prepared SSFP allows clear depiction of the hand arterial tree, and the image quality is superior to that of dynamic CE-MRA. It is a potential tool for evaluating the disease of hand arteries.

Eighty-two newly-diagnosed type 2 diabetic patients with poor glycemic control were treated by mitiglinide calcium for 16 weeks.Plasma fibroblast growth factor-21 ( FGF-21 ) level were evaluated.The relationship of plasma FGF-21 levels with body mass index,body fat,waist-to-hip ratio,lipid,blood glucose,HbA1c,and free fatty-acid were analyzed.Plasma FGF-21 was decreased significantly by treatment with mitiglinide calcium in type 2 diabetic patients,and it may play a role in the pathogenesis of type 2 diabetes mellitus.

Objective To evaluate the knowledge,attitude and practice(KAP)related with AIDS of local floating population.Methods A total of 1 942 floating persons were sampled by multistage cluster sampling and interviewed with questionnaire in the agricultural markets,construction sites,and their habitats within 3 communities in Hongkou District.Results 82.9% of the interviewees were 20 ～49 years old.The average score was 34.77 ±3.52 (maximum score is 44)for knowledge,12.11 ±2.32(maximum score is 19)for attitude,5.50 ±0.95(maximum score is 7)for practice,respectively.The scores increased with educational level significantly.The scores of knowledge were 33.26 ±3.54,34.63 ±3.23,36.56 ±3.39 among the subjects with educational levels of primary school and below,junior high school,senior high school and above.The scores of attitude were 13.77 ±2.27,14.79 ±2.39,15.62 ±2.38,respectively.And the score of practice was 5.40 ±0.90,5.51 ±0.93,5.58 ±1.03,respectively.Conclusion In the present,the KAP relating AIDS of local floating population is poor in Hongkou District.A variety of intervention methods and operational patterns should be developed for the floating population with different educational levels and jobs.

The risk factors of high trait anger of juvenile offenders were explored through question naire study in a youth correctional facility of Hubei province,China.A total of 1090 juvenile offenders in Hubei province were investigated by self-compiled social-demographic questionnaire,Childhood Trauma Questionnaire (CTQ),and State-Trait Anger Expression Inventory-Ⅱ (STAXI-Ⅱ).The risk factors were analyzed by chi-square tests,correlation analysis,and binary logistic regression analysis with SPSS 19.0.A total of 1082 copies of valid questionnaires were collected.High trait anger group (n=316) was defined as those who scored in the upper 27th percentile of STAXI-Ⅱ trait anger scale (TAS),and the rest were defined as low trait anger group (n=766).The risk factors associated with high level of trait anger included:childhood emotional abuse,childhood sexual abuse,step family,frequent drug abuse,and frequent internet using (P＜0.05 or P＜0.01).Birth sequence,number of sibling,ranking in the family,identity of the main care-taker,the education level of care-taker,educational style of care-taker,family income,relationship between parents,social atmosphere of local area,frequent drinking,and frequent smoking did not predict to high level of trait anger (P＞0.05).It was suggested that traumatic experience in childhood and unhealthy life style may significantly increase the level of trait anger in adulthood.The risk factors of high trait anger and their effects should be taken into consideration seriously.

Objective To analyze the mechanism of the influencing factors of myopia for junior high school students in China. Methods Based on the follow-up to 7 119 students in the 3 waves of questionnaire survey of the Chinese Education Panel Survey in junior high school stage, and the variables on students’ myopia status, myopia influencing factors, and two kinds of risk behaviors of myopia including near visual activities and outdoor activities, the mediation effects of the myopia risk behaviors were tested by Logistic regression model. Results The myopia prevalence of 9th graders before junior high school graduation was 66.36%. Time on writing homework significantly increased the risk of myopia，the odds ratio (OR) was 1.17，the 95% confidence interval (CI) was 1.13-1.21, and the time on outdoor sports significantly decreased the risk of myopia (OR=0.80，95% CI:0.75-0.86). Before and after including the risk behaviors into the model, the myopia risk OR(95% CI) of female centralized from 1.84(1.66-2.04) to 1.69(1.51-1.88), the myopia risk OR(95% CI) of urban students’centralized from 1.19(1.03-1.37) to 1.16(1.00-1.34), the myopia risk OR(95% CI) of only children’centralized from 1.20(1.06-1.36) to 1.18(1.04-1.33). With reference to not myopic for both parents, the myopia risk OR(95% CI) of students having one myopic parent centralized from 2.47(2.12-2.88) to 2.44(2.09-2.85), the myopia risk OR(95% CI) of students having parent without myopic centralized from 4.25(3.09-5.86) to 4.13(3.00-5.69). Conclusions Gender, urban and rural, only child, and myopic parents are influencing factors of myopia. These factors have effects on myopia via two kinds of risk behaviors including outdoor activities and near visual activities.

OBJECTIVETo study the progression of myopia in school-age children over the past 12 years and factors influencing myopia progression.

METHODSA total of 4569 cases of 5 to 12-year-old children who had refractive examinations in the Third Xiangya Hospital, Central South University between January 2000 and December 2011 were enrolled in this study. The children had no family history of congenital high myopia or other eye diseases. Myopia progression was evaluated when the children were re-examined. The refractive state of each child was measured with cyclopiegic retinoscopy.

RESULTSThe mean spherical equivalent (SE) myopia was-2.0±1.7 D between January 2000 and December 2011. There was no statistical difference in yearly myopia progression between different years. The average age of the myopic children decreased from 10.1 in 2000 to 8.9 years old in 2011 (P<0.05). Mean myopia progression was -0.6±0.7 D per year from 2000 to 2011. Myopia progression reduced gradually in 5 to 8-year-olds (P<0.05), however, it accelerated between ages 9 and 11 years. Myopia progression in 10- and 11-year-olds was significantly greater than in 7- and 8-year-olds (P<0.01). The multiple linear regression analysis demonstrated that age and baseline myopic refraction were positively related to myopia progression.

CONCLUSIONSThere was no obvious change in the yearly myopia progression of the children over the past 12 years. The mean age of myopia occurrence became younger with time. More preventive measures are needed to ward off high myopia in children with moderate myopia, especially those aged over 10 years.

Adolescent ; Child ; Child, Preschool ; Disease Progression ; Female ; Humans ; Linear Models ; Male ; Myopia ; etiology ; Retrospective Studies

Objective:To investigate the sensitivity of newborn screening for neonatal intrahepatic cholestasis caused by Citrin deficiency (NICCD) based on tandem mass spectrometry and the carrying rate of known pathogenic variants of SLC25A13 in Guangzhou population. Methods:A total of 124 250 neonates born in Guangzhou from January 1, 2015 to December 31, 2018 were performed newborn screening for NICCD by tandem mass spectrometry technology. SLC25 A13 gene mutation analysis was performed to diagnose patients with suspected NICCD.The carrying rate of known pathogenic variants of the SLC25 A13 gene in the whole exon sequencing results of 2 395 healthy children in Guangzhou was retrospective analyzed. Results:Among the 124 250 screened neonates, 31 cases were screened positive for NICCD and one of them was confirmed.Three false negative patients with NICCD were found in this cohort.NICCD screening sensitivity was 25%(1/4 cases). All of the four patients were homozygous for c. 851_854del of SLC25A13.Among 2 395 controls, 60 cases were detected heterozygous variant of SLC25A13, including 8 kinds of reported pathogenic variants.The carrying rate of pathogenic alleles was 1/40 (60/2 395 cases). The estimated prevalence of citrin deficiency was about 1/6 400.The most common variant was c. 851_854del (56.7%, 34/60 cases), and the second was c. 790G>A (23.3%, 14/60 cases). The controversial variant c. 2T>C was detected in 113 children with heterozygous and 2 cases with homozygous and the carrying rate of c. 2T>C was 1/20(117/2 395 cases). Conclusions:The carrying rate of pathogenic variants of SLC25A13 and the estimated prevalence of Citrin deficiency in Guangzhou population are high.The sensitivity of newborn screening for NICCD by tandem mass spectrometry is limited.Even if the negative results for screening of multiple genetic and metabolic diseases by tandem mass spectrometry, it is recommended to recheck blood for newborns or infants with delayed jaundice to avoid missed diagnosis.

Objective To evaluate the health related quality of life (HRQoL) and to explore the influencing factors related to the prevalence of the essential hypertension,diabetes,coronary heart disease (CHD) and stroke in middle-aged and elderly people from rural communities.Methods A total of 5345 individuals were chosen from a 2010 Health Survey in Fangshan,Beijing.Self-designed questionnaire was applied to collect the information on general health-related behaviors,chronic conditions,self-rated health,blood pressure and HRQoL with the EuroQoL questionnaire (EQ-5D) were measured.Probit regression model was used to identify the influencing factors on HRQoL,adjusting age,marriage status,education level,smoking,alcohol intake,physical activity and control of blood pressure.Population Attributable Risk Proportion (PARP) for estimating the influence of chronic disease on HRQoL was also calculated.Results The average EQ-5D index was 0.923 ±0.145,with 72.1％ of the overall respondents in the status of having chronic diseases.Participants with chronic diseases had significantly lower EQ-5D index (0.907 ± 0.155 ) than those without (0.963 ±0.105 ) (t =15.082,P＜ 0.001 ).Significant relations were found between a lower HRQoL and chronic diseases.Relative risk (RR) and 95％ confidence interval (95％ CI) of poor HRQoL in populations with hypertension,diabetes,CHD and stroke were 1.686 (95％CI: 1.519-1.871),1.725 (95％CI:1.502-1.981 ),1.869 (95％CI: 1.663-2.099),and 1.759 (95％CI: 1.474-2.089) respectively.The most influential disease appeared to be stroke in male (RR=1.929,95％CI: 1.462-2.546),whereas CHD in female individuals (RR=1.926,95％CI: 1.671-2.220).Rates of PARP (PAR％) for poor HRQoL in chronic disease subgroups were as follow: hypertension 31.05％,CHD 23.39％,diabetes 4.84％ and stroke 4.44％,respectively.Conclusion This study suggested that stroke,at individual level,was the major influential factor to HRQoL.However,hypertension remained the leading preventable influential factor to HRQoL at the population level.