The new round of medical and health system reform proposed the need to explore effective ways to gradually reform the mechanism of “using medicine costs to supply medical care”, through the implementation of “medical separation”, solve patients’ problem of “difficult and expensive”. While implementing the mode of the “medical separation”, according to exploring and practicing the actual situation of the region, it describes on the main mode of “medical separation”, analyzes the advantages and disadvantages, and proposes policy recommendations of “medical separeation” according to analysis of different modes.

Objective To evaluate the sensitivity and specificity of DNA micro-array in early detection of infectious pathogens on burn wounds,including 9 species of potential infectious pathogens namely Staphylococcus aureus,Escherichia coli and Pseudomonas aeruginosa,etc.Methods Serial dilutions of each targeted bacteria in saline were examined with VITEK automated microbial test systems(routine methods) as well as by DNA micro-array to compare the sensitivity between these two methods.Sixty-two strains of infectious pathogens collected from burn wounds,were identified by routine methods,and they were also subjected to DNA micro-array examination to determine coincidence.One hundred and three examinations of smear specimens collected from fresh burn wounds were performed with both methods synchronously.The difference in positive result of identification of bacteria between routine method and micro-array technology in sensitivity and specificity was compared.Results The identification of bacteria by micro-array was more convenient and rapid than that by routine method.A 10 to 100 fold higher sensitivity was found in bacterial identification by DNA micro-array than by routine methods.The positive and negative coincidence of bacterial identification was 100% between these two methods.All the strains found by the routine methods were successfully identified by DNA micro-array.In a few instances,more strains of bacteria were detected with micro-anay method than rowtine method.Conclusion The extremely high coincidence and sensitivity of micro-array method with the routine method was confirmed.The detection of bacteria from burn wounds and other contaminated or infected wounds using micro-array method has a bright prospect though some improvements are still necessary.

Objective To investigate the relationship between antibiotic administration and the changes in constituent ratios of preponderant pathogens in infection of burn wounds in our burn unit. Methods The consumption of different kinds of antibiotics [expressed as the number of defined daily doses (DDD)/100 patient-day], as well as the constituent ratio of Staphylococcus aureus and Pseudomonas aeruginosa, and percentage of methicillin-resistant S. aureus (MRSA) among all positive cultures of S. aureus were calculated from 1995 to 2004, and their correlation was analyzed. Results Within this period, it was found that the consumption of first and second-generation cephalosporins and aminoglycosides, including cefazolin and amikacin, was decreased remarkably, while the consumption of antibiotics combined with lactamase inhibitor, third-generation cephalosporins, quinolones, including ceftazidime, levofloxacin and fosfomycin, was increased significantly. At the same time, the constituent ratio of P. aeruginosa declined to certain extent, while the constituent ratio of S. aureus gradually rase, but no increase was found in percentage of MRSA in S. aureus. The constituent ratios of S. aureus and P. aeruginosa were correlated to consumption of more than ten kinds of antibiotics or antimicrobial agents. Conclusions The results suggested that more cefazolin or amikacin and less antibiotics with lactamase inhibitor or third generation cephalosporins were used in the treatment of burn infection might help decrease the infection caused by S. aureus, and that when more carbopenem or cefoperazone/sulbactam were used there might be a tendency of declination of P. aeruginosa infection.

Burns ; complications ; diagnosis ; prevention & control ; Humans ; Sepsis ; diagnosis ; etiology ; prevention & control

No abstract available.
Biopsy* ; Neoplasm Metastasis* ; Prostate* ; Prostatic Neoplasms*

Objective To study the efficacy of tourniquet to block the distal of radial styloid on success rate of radial artery catheterization.Methods One hundred and forty ASA Ⅰ-Ⅲ patients, aged 22-88 years,undergoing general anesthesia and requiring radial artery catheterization were in-cluded in this study and were randomly allocated into touch positioning group (group A)or tourni-quet-assisted group (group B).Radial artery catheterization was conducted after induction of general anesthesia in two groups.The invasive systolic blood pressure (ISBP ), invasive diastolic blood pressure(IDBP)and HR of patients were recorded in group B at 1 min before ischemia (T1 ),using pressure pulse blocking after 1 min (T2 ),2 min (T3 ),5 min (T4 )and the complete release of tour-niquet after 1 min (T5 ),5 min (T6 )and 10 min (T7 ).The first and total success rate of radial artery puncture,puncture times,puncture duration and complications were recorded.Results The radial ar-tery diameter was not statistically significant in group B between before and after blocking radial artery .ISBP at T2-T4 in group B was significantly higher than that at T1 (P <0.05).The first time puncture success rate and overall success rate in group B was significantly higher than that of group A,The number of puncture in group B was significantly less than that of group A,and puncture time was significantly shorter in group A (P <0.05).Conclusion Tourniquet-assisted radial artery cathe-terization could improve success rate,decrease puncture times and shorten puncture duration.

Objective To evaluate the implementation effect of Malaria Elimination Project supported by the Global Fund in Shaanxi Province so as to provide the evidence for the scientific implementation of Malaria Elimination Action Plan and the exami-nation and evaluation work. Methods The data of malaria prevention and control work were collected and analyzed statistically in 27 counties from 2010 to 2012 in order to evaluate the measures and effects of malaria control. Results There were 64 reported cases in the project areas from 2010 to 2012,and the average annual incidence rate was 0.15/10 million with a declining trend. The infected area sources of patients were mainly imported overseas accounting for 79.69%of the total cases. The blood completion rate of febrile patients was 94.14%,and the scope of the blood smears testing work had expanded to 88 counties(including 61 third-class counties). The training coverage rate of malaria prevention knowledge and skills had achieved to 100%. The awareness rates of malaria prevention and control were 91.68%and 89.44%in the students and local residentsrespectively. The case reporting with-in 24 h after diagnosed,epidemiological case study and outbreak disposal,laboratory testing and confirming and the other case management capabilities had also improved significantly. Conclusions The implementation of the Global Fund Malaria Project in Shaanxi Province has accelerated the process of Malaria Elimination work and improved significantly the malaria control ability in the project areas.

Objective To investigate effect of the mild CYP3A4 inhibitor aprepitant on the pharmacokinetics of orally administered controlled-release ( CR) oxycodone.Methods This study designed was an single-sequence with two phases in cancer patients with pain who continued to be administered orally with multiple doses of CR oxycodone every 8 or 12 hours.Plasma concentration of oxycodone and its metabolites were measured up to 8 hours after administration as follows: on day 1, CR oxycodone was administered alone; on day 2, CR oxycodone was administered with aprepitant (125 mg, at the same time of oxycodone dosing in the morning).The steady-state trough concentrations ( Css) were measured from day 1 to day 3.Results Aprepitant increased the area under the plasma concentration-time curve (AUC0-8) of oxycodone by 25%(P<0.001) and of oxymorphone by 34% (P<0.001), as well as decreased the AUC0-8 of noroxycodone by 14% (P<0.001).Moreover, aprepitant increased Css of oxycodone by 57%(P=0.001) and of oxymorphone by 36% (P <0.001) and decreased Css of noroxycodone by 24% (P =0.02) at day 3 compared to day 1.Conclusion The clinical use of aprepitant in patients receiving multiple doses of CR oxycodone for cancer pain significantly altered plasma concentration levels, but would not appear to need modification of the CR oxycodone dose.

Objective To observe the external morphology of Lepidoglyphus destructor hypopus under an optical microscope. Methods The samples were collected in a store of Chinese medicinal herbs in Huainan City in September,2016,the L. de-structor and the hypopus were isolated,and then made of slide specimens. The slide samples were prepared and observed under an optical microscope. Results The L. destructor hypopus and protonymph were found. The inactive hypopus was oval in shape, the feet were not well-developed,there was a distinct transverse seam on its back,and there were 2 pairs of genital sensory or-gans. Conclusion The optical microscopy shows the morphological characteristics of L. destructor hypopus,which can provide the basis for the biological classification and the prevention.

Objective To investigate the species of Limacodidae and the biological habits on Prunus cerasifera and sycamore in the urban area of Wuhu City,so as to provide the reference for the prevention and control of the diseases caused by Limacodi?dae. Methods Two observation places were selected in the urban area of Wuhu City,and the survey period of the first observa?tion place(A)was from 2014?5?4 to 2014?11?2,and eucleid caterpillar was observed and collected every Sunday(a total of 27 times);the survey period of the second observation place(B)was from 2014?1?5 to 2014?12?28,and eucleid caterpillar was ob?served and collected every Sunday(a total of 52 times). The eucleid caterpillars were collected by the visual inspection and arti?ficial direct collecting method,and then they were identified and classified by the naked eye direct observation and the direct ob?servation with the help of the anatomical lens in the laboratory. Results There were seven kinds of identified Limacodidae from the two observation places and their occurrence regularity,the species composition ratio,and natural enemies were understood. Conclusions Limacodidae larvae not only are the defoliator of the ornamental forests,but also harm the health of residents, that is they can cause eucleid larva dermatitis. Therefore,we should strengthen the prevention and control of Limacodidae,re?ducing its impact on the lives of the residents.