With dwindling number of new antibiotics and inappropriate use of antibiotics, the emergence and spread of antibiotics resistance occurs commonly in healthcare institutions worldwide. In China, antibiotics are commonly overprescribed and misused. This study is to assess the effect of the nationwide special campaign on antibiotic stewardship program (ASP) at specialized hospitals in China by investigating prescription information from 2011 to 2012. Data on the hospital consumption and prescription of systemic antibiotics were obtained from four specialized hospitals, including maternity, children's, stomatological and cancer hospitals. Systematic random sampling was used to select outpatient prescriptions and inpatient cases. A total of 105 specialized hospitals in 2011 and 121 specialized hospitals in 2012 were analysed. The defined daily doses (DDDs) per 100 inpatient days, the percentage of antibiotic use in outpatient prescriptions, and the percentage of antibiotic use in inpatient cases were used as measurements of antibiotic use. The overall antibiotic use density in the selected hospitals decreased between 2011 and 2012 from 39.37 to 26.54 DDD/100 inpatient days (P<0.001). The percentage of antibiotic use in outpatient prescriptions (range: 24.12%-18.71%, P=0.109) and inpatient cases (64.85%-60.10%, P=0.006) also decreased within the two years. Significant changes were observed among regions and different hospitals within the two years. And antibiotic consumption was correlated with the type and size of specialized hospital in 2012, but not with the regions. This analysis of antibiotic consumption of specialized hospitals allows relevant comparisons for benchmarking and shows that national ASP has improved antibiotic rational use in China. The data will assist policymakers in formulating effective strategies to decrease antibiotic overuse and identify areas that require further work.

Objective To explore the effect of the open and closed endotracheal suction on the infection prevention and control among adults after cardiac surgery.Methods Totals of 159 patients after cardiac surgery with mechanical ventilation were randomly divided into the closed suction group (n =77 ) and the open suction group (n =82).There was no significantly difference in the average ages,gender composition,disease composition between two groups.The white blood cell (WBC) count of two groups in the day and the first,second and third days after surgery,the positive rate of sputum culture before extubation,and total duration time of mechanical ventilation of two groups were observed and compared,respectively.Results The WBC count of closed suction group in the day and the first day was ( 10.42 ± 3.81 ) × 109/L,( 12.03 ± 3.87 ) × 109/L and that of the open suction group was (9.44 ± 3.36) × 109/L,( 11.32 ± 3.59) × 109/L,and the difference was no statistically significant( P ＞0.05 ).There was significantly difference in the WBC between closed suction group and open suction group in second and third days after surgery[ (16.14±5.78) × 109/L vs (14.81 ±3.68) × 109/L),( 15.09 ± 5.91 ) × 109/L vs ( 12.65 ± 3.18 ) × 109/L;t =- 2.044,- 2.409,respectively; P ＜ 0.05 ) ].The positive rate of sputum culture showed no difference between closed suction group and open suction group ( 12.2％ vs 10.4％ ; x2 =0.129,P ＞ 0.05 ),and the total mechanical ventilation time of the closed suction group was significantly longer than that of the open suction group [ ( 14.48 ± 4.71 ) h vs ( 12.15 ± 4.47 ) h ;t =2.994,P ＜ 0.05 ) ].Conclusions The effect of open endotracheal suction is better than closed suction in the mechanical ventilation patients after cardiac surgery,and it is not expensive than closed suction for the patients with short period mechanical ventilation.

Toxoplasma gondii is a worldwide distribution of Apicom-plexans,which are widely parasitic in human and warm-blooded animals.Due to the factors such as host and geographical distribution,the population structure has rich genetic diversity.At present,the study of the genotype of Toxoplasma gondii and summary papers are relatively few.This paper reviews the biological information that has been reported in the world regarding the toxoplasmosis of birds such as domesticated chickens,ornamental birds,pet birds and wild rare birds,and to provide basis for further research on biological information such as epidemiology of bird toxoplasmosis and population structure of insects.

Objective To develop and explore the effect of model of theory-clinic synchronous practice with double instructors on the nursing undergraduates.Methods Totals of 58 junior students received theory-clinic synchronous practice under the instructions of faculty and clinic instructors.They were investigated with a self-designed clinical teaching satisfaction questionnaire with the dimensions of cases learning (4 items),seminar before and after clinic practice (8 items),practice process (6 items),and its cronbach' s a respectively were 0.75,0.91,0.93.Results Scores of all items and dimensions of satisfaction questionnaire were higher than 4,and the satisfaction score of medium term and practice end were more than 4 too.Scores of dimensions of ‘ cases information',‘ pre and post conferrence' and the total satisfaction score measured at the end of practice were significantly higher than that of medium item (P ＜ 0.05).The score of self-efficacy after practice was significantly higher than that before practice [(3.15 ± 0.42) vs (2.85 ± 0.57)] (t ＝-2.28,P ＝ 0.027).Conclusions The model of theory-clinic synchronous practice with double instructors can improve satisfaction and self efficacy of nursing undergraduates,and will benefit the improvement of comprehensive ability of students.

OBJECTIVETo establish a HPLC method for determination two constituents in bark of Paeonia Suffuticosa.

METHODThe reversed phase HPLC system consisting of an Alltima ODS column (4.6 mm x 150 mm, 5 microm) and a mixture of water-THF-methanol-HAc (60:20:20:0.05) as the mobile phase was used. The flow rate was 0.8 mL x min(-1) and UV detection was set at 274 nm.

RESULTThe assay displayed good linearity over the concentration ranges of 0.06-1.0 microg (r = 0.999 9, gallic acid) and 0.16-2.58 microg (r = 0.999 9, paeonol) respectively. The average recoveries (n = 9) of gallic acid and paeonol were 98.6% (RSD = 3.0%), 98.2% (RSD = 2.5%), respectively. The samples were extracted with methanol for 24 h bu maceration.

CONCLUSIONThe method is simple, accurate and can be used for the quality study of bark of P. suffruticosa.

Acetophenones ; analysis ; Chromatography, High Pressure Liquid ; methods ; Gallic Acid ; analysis ; Paeonia ; chemistry ; Plant Bark ; chemistry ; Plants, Medicinal ; chemistry ; Quality Control

With dwindling number of new antibiotics and inappropriate use of antibiotics, the emergence and spread of antibiotics resistance occurs commonly in healthcare institutions worldwide. In China, antibiotics are commonly over prescribed and misused. This study is to assess the effect of the nationwide special campaign on antibiotic stewardship program (ASP) at specialized hospitals in China by investigating prescription information from 2011 to 2012. Data on the hospital consumption and prescription of systemic antibiotics were obtained from four specialized hospitals, including maternity, children's, stomatological and cancer hospitals. Systematic random sampling was used to select outpatient prescriptions and inpatient cases. A total of 105 specialized hospitals in 2011 and 121 specialized hospitals in 2012 were analysed. The defined daily doses (DDDs) per 100 inpatient days, the percentage of antibiotic use in outpatient prescriptions, and the percentage of antibiotic use in inpatient cases were used as measurements of antibiotic use. The overall antibiotic use density in the selected hospitals decreased between 2011 and 2012 from 39.37 to 26.54 DDD/100 inpatient days (P<0.001). The percentage of antibiotic use in outpatient prescriptions (range: 24.12%-18.71%, P=0.109) and inpatient cases (64.85%-60.10%, P=0.006) also decreased within the two years. Significant changes were observed among regions and different hospitals within the two years. And antibiotic consumption was correlated with the type and size of specialized hospital in 2012, but not with the regions. This analysis of antibiotic consumption of specialized hospitals allows relevant comparisons for benchmarking and shows that national ASP has improved antibiotic rational use in China. The data will assist policymakers in formulating effective strategies to decrease antibiotic overuse and identify areas that require further work.
Anti-Bacterial Agents ; China ; Drug Prescriptions ; statistics & numerical data ; Drug Utilization ; statistics & numerical data ; trends ; Drug Utilization Review ; methods ; statistics & numerical data ; Geography ; Hospitals ; classification ; statistics & numerical data ; Humans ; Inpatients ; statistics & numerical data ; Outpatients ; statistics & numerical data

OBJECTIVETo investigate the pathology, diagnosis and treatment of a patient with hemotidrosis.

METHODSCoagulation tests, coagulation factor activities, von Willebrand factor concentration, bleeding time and platelet aggregation were measured. The bloody exudates from the skin was examined under light microscopy. The involved skin area biopsy was examined histologically.

RESULTSThe bloody exudates contained all kinds of normal blood cells mixed with sweat-like fluid, rather than true-sweat. Histopathologic examination showed normal sweat gland structure without blood cells. The patient was successfully treated with propranolol.

CONCLUSIONSympathetic nerve activation in the vasculature might play a role in hemotidrasis, and beta-blockers might be an effective drug for treatment.

Bleeding Time ; Blood Coagulation Tests ; Humans ; Platelet Aggregation ; von Willebrand Diseases ; von Willebrand Factor

The phyA(m) gene encoding acid phytase and optimized neutral phytase phyCs gene were inserted into expression vector pPIC9K in correct orientation and transformed into Pichia pastoris in order to expand the pH profile of phytase and decrease the cost of production. The fusion phytase phyA(m)-phyCs gene was successfully overexpressed in P. pastoris as an active and extracellular phytase. The yield of total extracellular fusion phytase activity is (25.4+/-0.53) U/ml at the flask scale and (159.1+/-2.92) U/ml for high cell-density fermentation, respectively. Purified fusion phytase exhibits an optimal temperature at 55 degrees C and an optimal pH at 5.5~6.0 and its relative activity remains at a relatively high level of above 70% in the range of pH 2.0 to 7.0. About 51% to 63% of its original activity remains after incubation at 75 degrees C to 95 degrees C for 10 min. Due to heavy glycosylation, the expressed fusion phytase shows a broad and diffuse band in SDS-PAGE (sodium dodecyl sulfate-polyacrylamide gel electrophoresis). After deglycosylation by endoglycosidase H (EndoH(f)), the enzyme has an apparent molecular size of 95 kDa. The characterization of the fusion phytase was compared with those of phyCs and phyA(m).
6-Phytase ; genetics ; isolation & purification ; metabolism ; Amino Acid Sequence ; Fermentation ; Genetic Vectors ; Molecular Sequence Data ; Pichia ; genetics ; Recombinant Fusion Proteins ; biosynthesis ; isolation & purification

OBJECTIVEThe effects of primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) induced by left main (LM) artery occlusion were analyzed retrospectively in this study.

METHODSA total of 1343 consecutive AMI patients who underwent primary PCI between January 1995 and December 2004 were retrospectively studied.

RESULTSLM occlusion or severe stenosis were found in 11 patients [all male, mean age (56.4 +/- 9.2) years (range 43-70 years)], cardiogenic shock was overt in 6 patients. Primary PCI were performed under the assistance of intra-aortic balloon pump (IABP) in these patients [8 stent implantation, 3 balloon dilation and 2 necessitating emergency CABG after balloon dilation]. In-hospital mortality was 45.5% (5/11). Three-month follow-up were made in all survivals (6/11). Analysis showed good collateral circulation flow from right coronary artery to left coronary artery was existed in all survival cases before PCI.

CONCLUSIONPrognosis of AMI patients with LM artery obstruction or severe stenosis was poor. Patients with pre-existed collateral circulation before primary PCI and IABP had a better clinical outcomes.

Adult ; Aged ; Angioplasty, Balloon, Coronary ; Arterial Occlusive Diseases ; complications ; Coronary Stenosis ; complications ; Emergency Treatment ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; etiology ; therapy ; Prognosis ; Retrospective Studies

Aim To investigate the mechanisms of Chaijin JieYu Anshen formula modulating the depres-sive behaviors and the synaptic plasticity of hippocam-pal neurons in insomnia-concomitant depression rats based on the histone deacetylase 5(HDAC5)/myocyte enhancer factor 2C(MEF2C)pathway.Methods A rat model of insomnia-concomitant depression was es-tablished by PCPA injection combined with chronic un-predictable mild stress(CUMS),and the experiment was divided into the control group,the model group,the high,medium and low dose group of Chaijin JieYu Anshen formula,and the positive drug group.The de-pression of rats was evaluated by sugar-water prefer-ence test,open field test and morris water maze.The levels of 5-hydroxytryptamine(5-HT)and dopamine(DA)in serum were measured by enzyme linked im-munosorbent assay(ELISA).The pathological damage of hippocampal neurons was observed by HE staining and Nissl staining.The damage of dendritic spines of hippocampal neurons was observed by Golgi staining,and the levels of HDAC5,MEF2C,postsynaptic densi-ty-95(PSD-95)and synaptophysin 1(SYN1)in hip-pocampus were measured by Western blot,immunohis-tochemistry and immunofluorescence.Results Com-pared with the model group,the Chaijin JieYu Anshen formula could increase the sugar-water preference rate of the model rats,reduce the immobility time in the open field experiment,increase the total activity dis-tance,shorten the evasion latency in the localization navigation experiment,and prolong the residence time in the quadrant where the platform was located in the space exploration experiment(P＜0.05,P＜0.01).Moreover,the Chaijin JieYu Anshen formula improved the hippocampal neuron and dendritic spine damage and increase the dendritic branch length and dendritic spine density of hippocampal neurons(P＜0.01,P＜0.01),restore the serum levels of 5-HT and DA in insomnia-concomitant depression rats(P＜0.05,P＜0.01),down-regulate the HDAC5 protein,and up-regulate the expression of MEF2C,PSD-95,and SYN1 protein(P＜0.05,P＜0.01 or P＜0.001).Conclusions Chaijin JieYu Anshen formula may alle-viate the depression-like behavior of model rats by re-ducing the expression of HDAC5 protein,thus deregu-lating the inhibition of transcription factor MEF2C,promoting the expression of PSD-95 and SNY1 protein,and exerting a protective effect on hippocampal neurons and synapses.