Objective To evaluate systematically whether or not the treatment of herbs invigorating spleen and removing dampness,blood stasis and toxin with chemotherapy is better than chemotherapy alone for advanced colorectal cancer.Methods The randomized controlled trails (RCT) involving combined treatment of herbs with chemotherapy,published from January 2000 to October 2015,were searched in CBM,CNKI,Wanfang Data,VIP,PubMed,Embase databases.Stata 14.0 software was used to analyze the data.Results 19 RCT containing 941 patients were included in this reta-analysis.Compared with chemotherapy alone,the combined treatment of Chinese herbal medicine and chemotherapy was obviously better in 1-year survival rate (RR =1.28,95 ％ CI 1.14-1.45),2-year survival rate (RR =1.52,95 ％ CI 1.05-2.18),3-year survival rate (RR =2.76,95 ％ CI 1.56-4.88),objective response (RR =1.11,95 ％ CI 1.04-1.19),Karnofsky score (RR =1.46,95 ％ CI 1.27-1.68) and traditional chinese medicine (TCM) symptom score (RR =1.58,95 ％ CI 1.33-1.75).The adverse effect rate was statistically reduced in the combined treatment group:leukopenia (RR =0.59,95 ％ CI 0.40-0.8),nausea and vomiting (RR =0.68,95 ％ CI 0.59-0.79),diarrhea (RR =0.67,95 ％ CI 0.53-0.85),neurotoxicity (RR =0.79,95 ％ CI 0.65-0.96).Conclusion Compared with chemotherapy alone,the treatment of herbs invigorating spleen and removing dampness,blood stasis and toxin combined with chemotherapy for advanced colorectal cancer can significantly increase survival rate and objective response rate,improve the quality of life,and meanwhile decrease the adverse effect rate.

AIM To study the epidermal growth factor (EGF) and transforming growth factor ? (TGF ?)and the epidermal growth factor receptor(EGFR)during the course of rats gastric ulcer natural cure expressing and its possible biology meaning. METHODS We injected acetic acid to make the ulcer animal model, location expression characteristic of EGF and TGF ? and EGFR were studied by immunohistochemistry. RESULTS The normal rats stomach mucosa EGF,TGF ? and EGFR all expressed weakly at masculine. EGF and TGF ? was located at cytoplasm,and EGFR expressesed at cytoplasm and cell membrane and the expression position of the three ovrlopped with each other. EGF concentrated mainly on the cervical part of gastric gland, and TGF ? and EGFR, on the cervical and base parts of the gastric gland. Positive 9 expression cells were primarily parietal[FQ(11?46,X-WZ] and neck cells of the stamook muc. For materials taken during the course of ulcer natural recovery, regular ohanges were observed in TGF, TGF ? and EGFR expression. Higher expression was found in ulcer tissunes than in normal tissues, while the expression was not detectable in necrotic tissues and rarely detectable in granlation and scar tissnes. The expression became apparant only during healing and scar stages of ulcer but not in early stage. CONCLUSION ①TGF ?/EGFR autocrine system probably plays a leading role in maintaining rats mucosa completeness under the normal circumstances; ②EGF/EGFR and TGF ?/EGFR autocrine system may have important effect on the differentiation, hyperplasia, moving of cell and restraining the gastric acidity.

Objective To evaluate the effect of comprehensive intervention measures on improving hand hygiene (HH)compliance of health care workers(HCWs)in intensive care units (ICUs)by multicenter study.Methods A total of 47 hospitals in 12 provinces and cities were enrolled in the study,from October 2013 to September 2014, HH compliance among HCWs in ICUs was investigated according to World Health Organization HH investigation method,HH compliance rates before and after intervention were compared.Results HH compliance rate of HCWs in ICUs increased from 73.70%(11 155/15 135)before intervention to 78.70%(18 206/23 132)after intervention (χ2 =128.16,P <0.01);except northeast region ,HH compliance of HCWs in the other provinces increased signif-icantly after intervention(all P <0.05);among all departments,HH compliance of HCWs in general ICUs,respira-tory ICUs,emergency ICUs,and surgical ICUs increased significantly(all P <0.05);HH compliance of HCWs of all kinds of occupations increased significantly(all P <0.05);HH compliance rates before touching a patient,before clean/aseptic procedure,after touching a patient,and after touching patient surroundings increased significantly after intervention(all P <0.01 ).Conclusion Comprehensive interventions are helpful for improving HH compliance of HCWs in ICUs. Objective To evaluate the effect of comprehensive intervention measures on improving hand hygiene (HH)compliance of health care workers(HCWs)in intensive care units (ICUs)by multicenter study.Methods A total of 47 hospitals in 12 provinces and cities were enrolled in the study,from October 2013 to September 2014, HH compliance among HCWs in ICUs was investigated according to World Health Organization HH investigation method,HH compliance rates before and after intervention were compared.Results HH compliance rate of HCWs in ICUs increased from 73.70%(11 155/15 135)before intervention to 78.70%(18 206/23 132)after intervention (χ2 =128.16,P <0.01);except northeast region ,HH compliance of HCWs in the other provinces increased signif-icantly after intervention(all P <0.05);among all departments,HH compliance of HCWs in general ICUs,respira-tory ICUs,emergency ICUs,and surgical ICUs increased significantly(all P <0.05);HH compliance of HCWs of all kinds of occupations increased significantly(all P <0.05);HH compliance rates before touching a patient,before clean/aseptic procedure,after touching a patient,and after touching patient surroundings increased significantly after intervention(all P <0.01 ).Conclusion Comprehensive interventions are helpful for improving HH compliance of HCWs in ICUs.

Objective To develop the reference values of carotid intima?media thickness (cIMT) in Chinese children aged 6-11 years. Methods A convenient cluster sampling method was used to conduct a cross?sectional survey from November 2017 to January 2018 in a primary school in Huantai County, Zibo City, Shandong Province. A total of 1 033 children aged 6-11 years (excluding children with obesity or hypertension) were included. Percentile curves for cIMT were drawn using the lambda, mu and sigma (LMS) method. Results This study developed the cIMT reference values (P90 and P95) for sex and age aged 6-11 years, including P90 and P95 reference values of mean cIMT, left cIMT and right cIMT, respectively. With the increase of age, the cIMT percentile values also increased. For the same age and the same percentile, the cIMT values of boys were higher than those of girls. Conclusion This study developed sex?specific and age?specific cIMT percentile reference values in children aged 6-11 years.

Objective To develop and validate a simplified height?specific blood pressure cutoffs table for screening hypertension in Chinese children and adolescents. Methods We developed a simplified height?specific blood pressure cut offs table according to Chinese Blood Pressure Reference for Children and Adolescents aged 7-18 years (WS/T 610?2018) (hereafter referred to as "complex definition"). Populations from Early Warning, Diagnosis and Treatment of Children Cardiovascular Disease Project ("Ji′nan sample") and Shandong Children Cardiovascular Cohort Study Project ("Zibo sample") were used as validation populations for evaluating the screening effect of the simplified table for elevated blood pressure and hypertension in children and adolescents. Results We developed simplified height?specific blood pressure cutoffs table including 7 height groups and 28 cutoffs. Both Ji′nan and Zibo samples were selected by convenient sampling method, and the former included 7 233 participants aged 7 to 17 years, among whom 3 790 (52.4%) were boys. Latter population included 1 277 participants aged 7 to 11 years, among whom 681 (53.3%) were boys. The simplified table performed well for identifying elevated blood pressure in Ji′nan sample, with values of area under the receiver operating curve (AUC) (95%CI), sensitivity, specificity, and Kappa statistic as 0.96 (0.95-0.97), 93.0%, 98.5% and 0.91, respectively, which were similar with results in Zibo sample [the values were 0.92 (0.90-0.95), 87.0%, 98.0% and 0.85, respectively]. The simplified table also performed well for identifying hypertension in Ji′nan sample with values of AUC (95%CI), sensitivity, specificity, and Kappa statistic as 0.92 (0.91-0.94), 86.9%, 98.1% and 0.85, respectively, which were similar with results in Zibo sample [the values were 0.94 (0.91-0.96), 88.2%, 98.9% and 0.88, respectively]. Conclusion Screening for elevated and high blood pressure based on simplified height?specific blood pressure cutoffs table is easy to use and it shows satisfying effect.

Objective To develop the reference values of carotid intima?media thickness (cIMT) in Chinese children aged 6-11 years. Methods A convenient cluster sampling method was used to conduct a cross?sectional survey from November 2017 to January 2018 in a primary school in Huantai County, Zibo City, Shandong Province. A total of 1 033 children aged 6-11 years (excluding children with obesity or hypertension) were included. Percentile curves for cIMT were drawn using the lambda, mu and sigma (LMS) method. Results This study developed the cIMT reference values (P90 and P95) for sex and age aged 6-11 years, including P90 and P95 reference values of mean cIMT, left cIMT and right cIMT, respectively. With the increase of age, the cIMT percentile values also increased. For the same age and the same percentile, the cIMT values of boys were higher than those of girls. Conclusion This study developed sex?specific and age?specific cIMT percentile reference values in children aged 6-11 years.

Objective To develop and validate a simplified height?specific blood pressure cutoffs table for screening hypertension in Chinese children and adolescents. Methods We developed a simplified height?specific blood pressure cut offs table according to Chinese Blood Pressure Reference for Children and Adolescents aged 7-18 years (WS/T 610?2018) (hereafter referred to as "complex definition"). Populations from Early Warning, Diagnosis and Treatment of Children Cardiovascular Disease Project ("Ji′nan sample") and Shandong Children Cardiovascular Cohort Study Project ("Zibo sample") were used as validation populations for evaluating the screening effect of the simplified table for elevated blood pressure and hypertension in children and adolescents. Results We developed simplified height?specific blood pressure cutoffs table including 7 height groups and 28 cutoffs. Both Ji′nan and Zibo samples were selected by convenient sampling method, and the former included 7 233 participants aged 7 to 17 years, among whom 3 790 (52.4%) were boys. Latter population included 1 277 participants aged 7 to 11 years, among whom 681 (53.3%) were boys. The simplified table performed well for identifying elevated blood pressure in Ji′nan sample, with values of area under the receiver operating curve (AUC) (95%CI), sensitivity, specificity, and Kappa statistic as 0.96 (0.95-0.97), 93.0%, 98.5% and 0.91, respectively, which were similar with results in Zibo sample [the values were 0.92 (0.90-0.95), 87.0%, 98.0% and 0.85, respectively]. The simplified table also performed well for identifying hypertension in Ji′nan sample with values of AUC (95%CI), sensitivity, specificity, and Kappa statistic as 0.92 (0.91-0.94), 86.9%, 98.1% and 0.85, respectively, which were similar with results in Zibo sample [the values were 0.94 (0.91-0.96), 88.2%, 98.9% and 0.88, respectively]. Conclusion Screening for elevated and high blood pressure based on simplified height?specific blood pressure cutoffs table is easy to use and it shows satisfying effect.

Objective To investigate the status and risk factors of surgical site infection (SSI)in hospitals in Chi-na,so as to provide theoretical basis for the prevention and treatment of SSI.Methods Four types of surgeries (colorectal surgery,abdominal hysterectomy,femoral neck repair surgery,and vascular surgery)in 29 hospitals were monitored prospectively,risk factors for SSI were analyzed.Results A total of 6 309 surgical procedures were investigated,incidence of SSI was 1 .60%.Incidences of SSI in patients receiving colorectal surgery,abdominal hys-terectomy,femoral neck repair surgery,and vascular surgery were 4.47%(74/1 655 ),1 .03%(22/2 139),0.21 %(5/2 372),and 0.00% (0/143 )respectively.The incidences of SSI were different among different regions (χ2 =114.213,P <0.05).The most common SSI was superficial incisional infection,the next was deep incisional infec-tion.The major pathogens causing SSI were Escherichia coli ,Enterococcus spp .,coagulase negative staphylococ-cus ,Staphylococcus aureus ,and Klebsiella pneumoniae .The independent risk factors for SSI were male patients, long duration of surgery,and high NNIS score.Conclusion The risk of SSI is varied with different types of surger-ies.Male,long duration of surgery,and high NNIS score can increase the risk of postoperative SSI.

Objective To assess the current status and factors associated with the mental health condition of older adults. Methods A convenience sampling survey was conducted using symptom check list 90 (SCL-90) among the Chinese older adults aged 60 or above from January to March, 2018. The older adults aged 80 or above were selected for this study. Chi-square test and binary logistic regression model were used to analyze the influencing factors. Results The total participants were 485. The SCL-90 positive detection rate was 20.21%. The symptoms of the four highest detection rates were somatization (39.38%), others (25.15%), obsessive-compulsive symptoms (24.33%) and depression (22.68%). The older adults with normal BMI (OR=0.537, 95% CI: 0.250-0.857, P=0.027) and lived in county town (OR=0.224, 95% CI:0.075-0.667, P=0.007) showed lower SCL-90 positive detection rate. These who had been educated for 1-5 years (OR=11.092, 95% CI: 4.446-27.671, P<0.001), 6-8 years (OR=9.800, 95% CI: 3.464-27.721, P<0.001), 9~11 years (OR=19.279, 95% CI : 6.722-55.297, P<0.001), 12 years and above (OR=24.321, 95% CI: 7.894-74.929, P<0.001) had higher SCL-90 positive detection rate compared with those who were uneducated. Conclusion The mental health condition of Chinese older adults is mainly influenced by residence place, education level, family income self-evaluation and BMI status.

Objective To investigate the epidemiological characteristics of device-associated infection (DAI)in neonatal intensive care units(NICUs)of tertiary first-class hospitals in China,and provide scientific evidence for the prevention and control of neonatal DAI.Methods Neonates in NICUs at 17 hospitals of 9 provinces from October 2013 to September 2014 were selected for multicenter study,DAI was surveyed prospectively according to the uni-form diagnostic criteria and methods.Results A total of 12 998 neonates were monitored,the total patient-days were 126 125 d,13 cases of central line-associated bloodstream infection (CLABSI)and 70 cases of ventilator-asso-ciated pneumonia (VAP)occurred,central line utilization rate was 15.56%,incidence of CLABSI was 0.66/1 000 device-days;ventilator utilization rate was 7.67%,incidence of VAP was 7.23/1 000 device-days.Utilization rates of central line and respirator in neonates with body weight ≤ 1 000 g was the highest,which were 61 .06% and 29.91 % respectively;In NICUs with 20-30 beds,utilization rate of central line was the highest(16.67%),and res-pirator was the lowest(4.11 %);of hospitals in different regions,central line and respirator utilization rate in south-west China was the highest.Of different sizes of ICUs,VAP per 1 000 device-days was the lowest in NICUs with 20-30 beds(2.36 ‰).Difference in incidence of CLABSI and VAP per 1 000 device-days in neonates at NICUs of different regions were significantly different;incidence of CLABSI and VAP per 1 000 device-days was highest in southern China(2.68 ‰ and 31 .06‰ respectively),followed by southwest region.Of different quarters,incidence of CLABSI,and VAP per 1 000 device-days were not significantly different(all P >0.05).Conclusion Device utili-zation rate and incidence of DAI in China are both high,and are different in neonates of different birth weight,at different sizes of NICUs,as well as different regions,monitoring should be intensified,prevention and control measures should be implemented according to infection characteristics.