Objective: To investigate the resistance to rifampicin and isoniazid and the changing trends among patients with pulmonary tuberculosis in Luohu District, Shenzhen City, Guangdong Province from 2012 to 2022, so as to provide insights into improving drug-resistant pulmonary tuberculosis control and prevention strategies. Methods: Basic information, treatment classification and drug resistance data of patients with pulmonary tuberculosis and positive pathogenic detection in Luohu District from 2012 to 2022 were collected through the Tuberculosis Surveillance System of Chinese Disease Prevention and Control Information System, and resistance rates of rifampicin and isoniazid and the changing trends were analyzed. Results: A total of 2 126 patients with pulmonary tuberculosis were collected and had a median age of 34 (interquartile range, 25) years, including 1 334 males (62.75%) and 792 females (37.25%). There were 302 patients with drug-resistance in Luohu District from 2012 to 2022, with a resistance rate of 14.21%. Among them, 60 patients were monoresistant to rifampicin (2.82%), 113 patients were monoresistant to isoniazid (5.32%), and 129 patients were multidrug resistant (6.07%). The rate of rifampicin monoresistance showed a downward trend from 2012 to 2022, while the rate of multidrug resistance showed an upward trend (both P<0.05). There was no significant tendency in the rate of isoniazid monoresistance (P>0.05). The rate of multidrug resistance among patients without Shenzhen residence was higher than that among patients with Shenzhen residence; the rates of rifampicin resistance and multidrug resistance among retreated patients were higher than those among treatment-naïve patients (all P<0.05). Conclusions The rate of rifampicin monoresistance appeared a downward trend and the rate of multidrug resistance appeared an upward trend among patients with pulmonary tuberculosis in Luohu District from 2012 to 2022. Attention should be given to non-Shenzhen residence and retreated patients.

OBJECTIVE To construct a predictive model of ultrasound(US),analyze and compare with its diagnostic efficacy in different forms of combination with CT of the neck in predicting central district lymph node metastasis(CLNM)of papillary thyroid carcinoma.METHODS Lesions confirmed as PTC by surgical pathology in our hospital from January 2021 to December 2021 were included for study,The lesions were scored according to the American college of radiology thyroid imaging reporting and data system(ACR TI-RADS),the risk model to predict CLNM was constructed based on the training set and verified internally in the testing set.The model was combined with CT to diagnose CLNM using both serial and parallel modes.The receiver operating characteristic(ROC)curves of CT,model,and model combined with CT for the diagnosis of CLNM was drawn separately,and then calculated and compared the area under the curve(AUC).RESULTS A total of 470 lesions were included in 440 patients.The model can be presented as Y=-4.664+0.171 ×maximum diameter+0.685×gender+0.600×multifoca lity+0.251×ACR TI-RADS score.After ROC curves analysis,the optimal diagnostic cut-off value of the model was 0.407.When Y≥ 0.407(optimal diagnostic cut-off point),CLNM was considered to be positive.In the training set,the C-index of model was 0.780(95％CI:0.661-0.756).In the testing set,the C-index was 0.778(95％CI:0.682-0.874).The Homsmer-Lemeshow goodness-of-fit test showed that the calibration of the model was good(P=0.294,P=0.879).In the testing set,compared with CT,model and the serial mode,the sensitivity(77.5％),diagnostic coincidence rate(80.6％),and negative predictive value(84.6％)of parallel mode were higher,whereas specificity(83.0％)was relatively lower.On diagnostic CLNM,the parallel mode had a higher AUC than the series mode(0.803 vs.0.669,Z=-2.931,P=0.003).CONCLUSION The model combined with CT in parallel mode can improve the clinical accuracy of diagnosis in CLNM and compensate for the shortcomings of traditional imaging techniques such as US and CT,which has specific clinical applicability.

Objective:To analyze the effects of prescription reviews of key monitored drugs using the drug regulatory platform in a district of Shanghai, and the influencing factors for the rate of unqualified prescriptions.Methods:A drug regulatory platform in a district in Shanghai began to implement prescription reviews since June 2018, extracting the reviewed prescriptions of all key monitored drugs and related information from June to December. Taking the unqualified rate of prescription in June as the baseline data, the χ2 test and the logistics regression model were used for data analysis. Results:From June to December 2018, clinical pharmacists reviewed 19 084 outpatient and emergency prescriptions and 10 607 inpatient prescriptions. The unqualified rates of outpatient and emergency prescriptions and inpatient prescriptions dropped from 16.52% and 23.28% in June to 4.45% and 13.80% in December, respectively. Logistics regression analysis showed that the rate of unqualified reviews of outpatient and emergency prescriptions was lower than that of inpatient prescriptions, and the rate of unqualified prescriptions in hospital was significantly lower than that in community health service centers; the rate of unqualified prescriptions for auxiliary drugs and nutritional drugs was significantly lower than that of antibacterial drugs.Conclusions:The prescription reviews of key monitored drugs can effectively promote the rational use of drugs. In the future, it is recommended to strengthen technical support for community health service centers and professional training for clinicians and pharmacists.

Vitamins are classified as either fat-soluble (vitamins A, D, E, K) or water-soluble (vitamins B and vitamin C). Traditional methods of immunoassay have only been developed for vitamins D,B6, B9 and B12. However, they cannot distinguish between vitamin subtypes such as D2, D3 and associated epi isomers (which has higher leveks in infants),giving false positive or negative results. Mass spectrometry has become a gold standard method for small molecule analysis in biological samples with its advantages in speed,resolution,sensitivity and specificity. It is widely used in clinical research and diagnosis and provides an efficient method for simultaneous detection of multivitamins in one injection using one low volume sample collection.

Objectives To investigate the effect of different physical activities on the blood pressure in elderly patients with hypertension,and to provide evidence for the prevention and treatment of hypertension.Methods 256 elderly patients with grade 1,2 hypertension and no other complications,and 256 healthy elderly people were selected as the control subjects.According to the blood pressure and the level of physical activity,the patients were divided into hypertension combined with low physical activity group(HL group),hypertension combined with middle physical activity group(HM group),normal blood pressure combined with low physical activity group(NL group)and normal blood pressure combined with middle physical activity group (NM group).The changes of blood pressure were compared in quiet,during and after physical activity.Results The diastolic blood pressure(DBP) and systolic blood pressure(SBP) measured at rest,peak exercise and 5 minutes after exercise were significantly higher in group HL and HM group than in NL group and NM group,and the differences between groups were statistically significant(SBP:F=11.846、18.337、10.976,all P＜ 0.001 for all;DBP:F=13.182、11.694、11.453,all P＜0.05).The DBP and SBP in HL group at rest and 5 minutes after exercise were significantly higher than those in the HM group,and the difference was statistically significant(P＜0.05).The change magnitudes of DBP and SBP were significantly lower in HL group than in the HM group,and the differences were statistically significant (P ＜ 0.05).Conclusions Taking part in an appropriate exercise can improve blood pressure level and a recovery capability of post-exercise blood pressure in elderly patients with hypertension.

Objective To explore the effects of vacuum sealing combined with NovaBay on improving diabetic foot wound healing, and to offer new insights and methods for treating chronic aporetic wounds. Methods Totally 130 patients with diabetic foot ulcer admitted in the Second Affiliated Hospital of Zhejiang Chinese Medical University between November 2015 and November 2016 were randomly and equally divided into two groups. Patients in the treatment group received 5 ml NovaBay for twice a day on the basis of vacuum sealing drainage (VSD), and received drainage 5 min after treatment with NovaBay, while patients in the control group received vacuum sealing drainage with 5 ml 0.9% sodium chloride solution for twice a day, and received drainage 5 min after treatment of sodium chloride solution. The intervention time of the patients in both groups were 12 days, with NovaBay and ducts replaced every 3 days. The patients in the two groups were evaluated with Pressure Ulcer Scale for Healing (PUSH) and the coverage rate of granulation tissue was calculated 0, 6, and 12 days after the intervention. And the positive rate of bacteria was tested at the end of the intervention. Results The PUSH scores of the patients in the two groups decreased as time went by, indicating that the wound healing was effective (P<0.001). The coverage rate of granulation tissue rose with time, and that of the patients in the treatment group rose more obviously (P<0.001). 12 days after the intervention, the patients in the treatment group (4.62%) showed a lower positive rate of bacteria (P<0.001) than the patients in the control group (47.70%). Conclusions Vacuum sealing combined with NovaBay shows remarkable effects in cleaning infection of chronic and aporetic wounds, thus a new and effective way to improve the growth of granulation tissue and wound healing.

Objective To investigate the effects of phosphocreatine postconditioning on cerebral ischemia-reperfusion(IR)injury in rats.Methods Thirty-six SD rats were randomly divided into three groups:groups Sham,IR (treated with normal saline)and PCr.IR was induced by intraluminal middle cerebral artery occlusion (MCAO).All treatments were given intravenously at the begining of reperfusion.Twenty-four hours after the reperfusion, neurological deficit score and magnetic resonance scan were performed.serum concentrations of malonaldehyde and 4-hydroxynonenal,cere-bral infarct volume and destruction of cerebral cortex were estimated.Neuronal apoptosis was further assessed by immunohistochemistry and immunofluorescent staining of caspase-3 and NeuN. Results Compared with group IR,phosphocreatine significantly decreased neurological deficit score, infarct volume,malonaldehyde and 4-hydroxynonenal levels(P < 0.05 ).Cortex structure was more complete,as well as neuronal apoptotic index was smaller in group PCr (P <0.05).Conclusion PCr can reduce cerebral infarct volume,thereby promote neurofunctional recovery.The mechanism of Pcr is related to reduced oxidative stress and inhibitted apopotosis during IR.

Objective To develop a quality evaluation index system of simulation teaching in nursing. Methods Delphi technique was used to formulate the quality evaluation indicators of simulation teaching through a two-round expert consultation among 27 experts. Results The questionnaire recovery rates were 96. 43% and 100% in two rounds, and the experts′ authority coefficient was 0. 89. Finally the teaching quality evaluation index system of nursing simulation was determined, including 5 first level indicators, 14 secondary level indicators and 62 tertiary level indicators. The primary index was CV 0. 00-0. 08, and the coordination coefficients of secondary and tertiary indexes were 0.515 and 0.589. Conclusions The quality evaluation index system of nursing scene simulation teaching is scientific and reliable, which could provide nursing educators with systematic and objective tool of simulation teaching quality evaluation.

OBJECTIVETo observe the analgesic effect of electroacupuncture (EA) on collagen-induced arthritis (CIA) rats and its regulating effect on inflammation reaction and the endogenous opioid system of synovial tissues. Methods A total of 30 healthy male Wistar rats were randomly divided into a control group, a model group and an EA group, 10 rats in each one. The chronic pain model of CIA rats was made by cattle type-II collagen in the model group and EA group. Rats in the EA group were treated with EA at "Zusanli" (ST 36) and "Kunlun" (BL 60) for 30 min from 16th day after model establishment, once a day for consecutive 10 days. Rats in the control group did not receive any treatment. Rats in the model group were treated with fixation as the EA group. Threshold of pain, arthritis index, paw swelling were measured before model establishment and 16 d, 20 d, 23 d and 25 d after model establishment. The levels of beta-endorphin (β-END), met-enkephalin (met-ENK), dynorphin A (Dyn A) were measured by radioimmunoassay; the mRNA expressions of mu opioid receptor (MOR), kappa opioid receptor (KOR) and delta opioid receptor (DOR) in synovial tissues of CIA rats were detected by I quantitative polymerase chain reaction (qPCR).

RESULTSCompared with the control group, threshold of pain was reduced (all P<0. 01), arthritis index was increased (all P<0. 01) and paw swelling was increased (all P<0. 01) in the model group on the 16th day, 20th day, 23rd day, 25th day after model establishment. Compared with the model group, the threshold of pain was increased in the EA group (all P<0. 01), arthritis index and paw swelling were reduced (all P<0. 01) on the 23rd day and 25th day after model establishment. Compared with the control group, the level of Dyn A in synovial tissues of CIA rats was increased in the model group (P<0. 01); the mRNA expressions of MOR, KOR and DOR were down-regulated lower than 0. 5 fold of normal level. Compared with the model group, the level of β-END in synovial tissues of the knee joint was increased in the EA group (P<0. 05), and the mRNA expressions of MOR, KOR and DOR in synovial tissues of CIA rats were up-regulated more than 2 folds of normal level.

CONCLUSIONThe intervention of EA on chronic pain of CIA rats is superior, which is likely to be related with effects of EA on anti-inflammation and up-regulation of synovial tissue β-END and MOR, KOR, DOR.

Acupuncture Analgesia ; Acupuncture Points ; Analgesics, Opioid ; immunology ; Animals ; Arthritis, Rheumatoid ; immunology ; therapy ; Cattle ; Chronic Pain ; immunology ; therapy ; Dynorphins ; genetics ; immunology ; Electroacupuncture ; Enkephalin, Methionine ; genetics ; immunology ; Humans ; Male ; Rats ; Rats, Wistar ; Receptors, Opioid, mu ; genetics ; immunology ; Synovial Fluid ; immunology ; beta-Endorphin ; genetics ; immunology

Objective To investigate the change of mu opioid receptor ( MOR) in dorsal root ganglion ( DRG) in rat chronic inflammatory pain model and the effect of MOR agonist and antagonis tintraplantarly ( i.pl.) injected on pain threshold, so as to determine the role of peripheral MOR in chron in inflammatory pain .Methods Chronicin flammatory pain model was established by i .pl.injection of CFA in rats.The expression of MOR in DRG was detected by immunohistochemistry .Pain threshold before and after i .pl.injection of MOR agonist and antagonist was measured by radiant heat method .Results Rats suffered from an intraplantar injection of CFA developed chronic inflammatory pain , and the painthreshold still reduced on 18 day after CFA injection compared to that in the normal group . Immunohistochemistry staining revealed that compared with the normal group , the expression of MOR in DRG of CFA rats was increased ( P<0.01 ) .After the paw dorsal surface injection of MOR agonist , the pain threshold of CFA rats was increased, while that of normal rats exhibited no significant change .After the paw dorsal surface injection of MOR antagonist, the pain threshold of CFA rats was reduced , while that of normal rats had no significant change .Conclusion Under chronic inflammatory pain condition , DRG MOR expressionis enhanced , which participates in the regulation of chronic inflammatory pain , and may contribute to the prevention of further more serious pain .