OBJECTIVE:To put forward game strategy of drug safety regulation,and to provide reference for decision-making by drug regulation department. METHODS:Based on evolutionary game theory,evolutionary game model of drug safety regula-tion was established,and the stability of evolution during drug safety regulation was analyzed. RESULTS & CONCLUSIONS:There were four possible evolutionary game results of drug safety regulation,including to provide qualified drugs,regulation;to provide unqualified drugs,regulation;to provide qualified drugs,no regulation;to provide unqualified drugs,no regulation. The evolution direction mainly depends on the parameter values involved in the payoff matrix of drug safety regulation. The stable state of drug safety regulation is related to regulation strength,regulation cost,enterprise safety input,probability of accident,acci-dent-related treatment cost,et al. Key strategies to improve drug safety regulation include increasing punishment,improving moni-toring technology,strengthening coordination mechanism,promoting social cohabitation and improving industry self-control.

OBJECTIVE To study the correlation between mutations of gyrA and parC genes and ciprofloxacin-(resistant) clinical isolates of Acinetobacter baumannii from Chengdu.METHODS The genes of gyrA and parC DNA in 28 ciprofloxacin-resistant and 2 ciprofloxacin-susceptible isolates of A.baumannii were amplified by PCR and then analyzed by restriction fragment length polymorphism(PCR-RFLP) and DNA sequencing.(RESULTS) Hinf Ⅰ digestion of the gyrA gene products of susceptible isolates(generated) two fragments,but resistant isolates(generated) one fragment.The parC gene products generated 2 fragments.DNA sequencing of 5 resistant isolates revealed mutations in gyrA gene that resulted in amino acid substitutions: Ser83→Leu and Ala88→Thr,especially,Ser83 point mutation accounting for the disappearance of sequence of Hinf Ⅰ.There was not any mutation in(gyrA) of 1 susceptible isolate;the substitution of Ser108→Ile in parC(gene) of 1 susceptible and 1 resistant isolates were identified,the remaining four isolates had more nosense mutations.CONCLUSIONS Compared with parC gene mutations,(gyrA) gene mutations of A.baumannii appears to be the main molecular mechanism responsible for ciprofloxacin resistance.The high-level ciprofloxacin resistance in A.baumannii probably needs a variety of mutations.

It is very important to assess the role of suitable social medical support level in operation and adjustment of social medical insurance system.The social medical support level in Shandong Province was measured and analyzed,the coordination of social medical support level and economic development was emphasized with suggestions put forward for the development of system and optimization of policies.

It is one of the important tasks to promote the development of traditional Chinese medicine culture crea-tive industry in constructing the culture-rich Shandong Province. The major factors that influence the development of traditional Chinese medicine culture creative industry in Shandong Province and the ranks of their importance were thus analyzed by questionnaire survey and hierarchy analysis, respectively. Certain suggestions were put for-ward for the development of traditional Chinese medicine culture creative industry in Shandong Province.

The paper objectively analyzes the opportunities and challenges of Internet + medical,and puts forward relevant strategies and recommendations for deeply integratingInternet +into the traditional medical industry in several aspects,including strengthening the construction of Internet infrastructure in the medical industry,regulating the market access and improving the industry standards,as well as establishing and improving relevant supporting laws,regulations and policies.

Objective:To investigate the correlation between hyperreflective dots (HRD) and lipid levels and systemic inflammatory factors in patients with branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO).Methods:A cross-sectional clinical study. From December 2016 to June 2020, 118 eyes of 118 patients with retinal vein occlusion diagnosed in the Department of Ophthalmology, Central Theater Command Hospital of People's Liberation Army were included in the study. Among them, 67 cases of BRVO and 51 cases of CRVO were divided into CRVO group and BRVO group accordingly. Peripheral venous blood was drawn from the patients within 3 days after the eye examination to detect the percentage of neutrophils, monocytes, hypersensitive C-reactive protein (CRP), total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and lipoprotein(a). The ratio of monocytes to high-density lipoprotein (MHR) was also calculated. The 3D OCT-2000 instrument from Topcon (Japan) was used to measure the central retinal thickness (CRT) and the numbers of HRD. According to the different distribution position, HRD is divided into inner retina HRD, outer retina HRD, and total retina HRD.The independent sample t test was used to compare the continuous variables of the two groups, and the χ2 test was used to compare the rates. The correlation between HRD counts and blood lipid levels and peripheral blood inflammation indicators in patients with different types of RVO was analyzed by Spearman correlation analysis. Results:The average age of patients in the BRVO group and CRVO group were 60.1±9.5 and 53.6±15.7 years, respectively; the prevalence of hypertension was 53.7% (36/67) and 24.5% (12/51), respectively. Comparison of age ( t=2.634) and prevalence of hypertension ( χ2=11.298) between the two groups showed statistically significant differences ( P<0.05). Gender ( χ2=2.000), course of disease ( t=-1.101), prevalence of diabetes ( χ2=1.315), eye category ( χ2=1.742), baseline visual acuity ( t=1.792), intraocular pressure ( t=0.708), CRT ( t=1.318), and peripheral blood include the percentage of neutrophils, the absolute number of monocytes, CRP, total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, lipoprotein(a), MHR ( t=-0.559, 1.126, 0.579, 1.299, -0.134, 0.556, 1.230, -0.267, 0.483), the difference was not statistically significant. Correlation analysis showed that the HRD counts in the outer retina of BRVO patients were positively correlated with total cholesterol ( r=0.289, P=0.036); the HRD in the inner retina and total HRD counts of CRVO patients were positively correlated with CRP ( r=0.406, 0.343; P=0.004, 0.014). There was no correlation between HRD counts and percentage of neutrophils, absolute number of monocytes, triglycerides, high-density lipoprotein, low-density lipoprotein, lipoprotein(a), and MHR ( P>0.05). Conclusion:The number of HRD is related to the blood lipid level in BRVO patients and CRP (an inflammatory index) in CRVO patients.

Adult ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Infant ; Keratins ; metabolism ; Male ; Mandibular Neoplasms ; metabolism ; pathology ; surgery ; Melanoma ; metabolism ; pathology ; Neuroblastoma ; metabolism ; pathology ; Neuroectodermal Tumor, Melanotic ; metabolism ; pathology ; surgery ; Rhabdomyosarcoma, Embryonal ; metabolism ; pathology ; Synaptophysin ; metabolism

The key words, social network and author cooperation network in papers ( published in 2003-2014 ) on reform in domestic public hospitals were analyzed using Ucinet and CiteSpace visual softwares with CNKI as the data source.The current situation in reform in domestic public hospitals was revealed by mining its research hotspots, progress and author cooperation .Some suggestions were put forward for strengthening the reform in domestic public hospitals .

Humans ; Image Processing, Computer-Assisted ; Lung ; diagnostic imaging ; Pneumoconiosis ; diagnostic imaging ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; methods

Objective To investigate the distribution and antimicrobial resistance profile of the common pathogens isolated during the period from 2009 to 2015.Methods All the bacterial strains isolated from pediatric inpatients in Beijing Children's Hospital during the period from 2009 to 2015 were analyzed. Antimicrobial susceptibility was determined by disk diffusion method and Phoenix 100 Automated Microbiology System. Results were analyzed according to the guidelines of CLSI (2014) using WHONET 5.6 software.Results The total strains were 26630. The most common gram-positive isolates were Streptococcus pneumoniae,Staphylococcusaureusand coagulase-negative Staphylococcus (CNS), while the most frequently isolated gram-negative microorganisms were Klebsiella spp.,Pseudomonas aeruginosa and Escherichia coli. The prevalence of S. pneumoniae was up to 25.7 % (4101/15973) in all respiratory tract specimens. About 50.2 % of the S. pneumoniae isolates were not susceptible to penicillin. The prevalence of methicillin-resistant strains was 20.6 % in S. aureus (MRSA) and 87.8 % in coagulase negative Staphylococcus (MRCNS) on average. The prevalence of MRSA increased from 11.1 % in 2009 to 29.8 % in 2015. No S. pneumoniae or staphylococcal strains were found resistant to vancomycin or linezolid. The Enterococcus strains were still highly susceptible to vancomycin and linezolid. Overall 0.3 % of the Enterococcus faecium isolates were resistant to vancomycin. The extended-spectrum beta-lactamases (ESBLs) producing strains accounted for 71.4 % -78.1 % of E. coli and 65.1 % - 76.9 % of K. pneumoniae isolates. The carbapenem-resistant E. coli and K. pneumoniae were reported for the first time in 2010, but in 2014, the strains resistant to carbapenems had increased to more than 7 % in E. coli, and higher than 20 % in K. pneumoniae. In 2015, up to 27.7 % and 25.7 % of P. aeruginosa isolates were resistant to imipenem and meropenem, respectively, and 59.9 % of the A. baumannii isolates were resistant to imipenem and meropenem. Beta-lactamase was positive in 46.3 % of the H. influenzae isolates. Conclusions MRSA and the carbapenem-resistant strains of E. coli,K. pneumoniae and A. baumannii are still on the rise in pediatric inpatients, which poses a serious threat to clinical practice and implies the importance of strengthening infection control.