Objective:To investigate the construction and operation of research wards in tertiary medical institutions in Guangzhou, and to put forward suggestions for promoting the construction of research wards.Methods:From May to June 2020, an online questionnaire was distributed to tertiary medical institutions in Guangzhou to investigate the construction of research wards, and the questionnaires were collected for statistical analysis.Results:A total of 58 medical institutions completed the questionnaire survey, and 33 of them obtained GCP qualification. Eighteen medical institutions had established research ward, of which 16 were in operation, with 6-226 beds. The research wards of 14 medical institutions were used for phase I clinical trials of innovative drugs and consistency evaluation of generic drugs; 17 medical institutions were equipped with full-time research teams; 17 medical institutions had two or more basic research platforms.Conclusions:The number of medical institutions that have established research wards in Guangzhou is small, the functional positioning is limited, and the allocation of full-time researchers is insufficient. The supporting and auxiliary conditions need to be strengthened. Promoting research wards still faces some challenges.

【Objective】 To investigate the role of thromboelastography (TEG) in the diagnosis and treatment of PICC related venous thrombosis in tumor patients, and provide basis for predicting PIC related venous thrombosis. 【Methods】 148 tumor patients who underwent PICC catheterization in our hospital from January to July 2019 were enrolled. The patients were subjected to TEG examination and ultrasound examination of limb blood vessels on catheterization side regularly one day before catheterization and 4 successive weeks after catheterization(once a week), respectively. The patients with venous thrombosis were subjected to TEG examination and vascular ultrasound regularly for 3 successive weeks(once a week) after anticoagulant therapy. The relationship between the occurrence and time of venous thrombosis and the changes of TEG parameters was analyzed. 【Results】 The pre-/post-catheterization TEG parameter of 81 patients without venous thrombosis indicated that coagulation state was normal (R value F=0.198, K value F=0.047, α value F=0.442, MAvalue F=0.079, CIvalue F=0.026, P>0.05). The TEG parameter of 67 patients, who developed asymptomatic venous thrombosis 1 to 3 weeks after catheterization(38 cases in 1 week, 16 in 2 weeks and 13 in 3 weeks), indicated the blood was hypercoagulable and the TEG parameter was statistically different from the pre-catheterization value(P<0.01). But after anticoagulant treatment, the coagulation state gradually returned to normal as the TEG parameter reached pre-catheterization value for 3 successive weeks (P>0.05). 【Conclusion】 TEG can reflect the status of PICC related venous thrombosis in tumor patients.Strengthening TEG monitor in tumor patients 1 to 3 weeks after PICC catheterization is conducive to early detection, diagnosis and treatment for PICCrelated thrombosis, thus reducing the harm of venous thrombosis to patients.

Clostridioides difficile is a key pathogen of antibiotic related diarrhea and hospital associated infection, causing several outbreaks in Europe and North Americans and resulting in severe disease burden. However, the standardized diagnostic principle and detection specifications in C. difficile infection (CDI) survey are limited in China, and the infection rate and disease burden of CDI in China are unclear. Therefore, National Institute for Communicable Disease Control and Prevention,National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, together with another 11 institutions, draft the group standard entitled "Diagnosis of Clostridium difficile infection (T/CPMA 008-2020)" of Chinese Preventive Medicine Association. Based on the principle of "legality, scientificity, advancement, and feasibility", this standard clarifies risk factors, diagnosis principles, diagnoses and differential diagnoses in order to improve the accuracy of CDI diagnosis in clinical practice, guide the surveillance for CDI, and understand the infection rate and disease burden of CDI in China .

Cardiotocography (CTG) is a commonly used technique of electronic fetal monitoring (EFM) for evaluating fetal well-being, which has the disadvantage of lower diagnostic rate caused by subjective factors. To reduce the rate of misdiagnosis and assist obstetricians in making accurate medical decisions, this paper proposed an intelligent assessment approach for analyzing fetal state based on fetal heart rate (FHR) signals. First, the FHR signals from the public database of the Czech Technical University-University Hospital in Brno (CTU-UHB) was preprocessed, and the comprehensive features were extracted. Then the optimal feature subset based on the -nearest neighbor (KNN) genetic algorithm (GA) was selected. At last the classification using least square support vector machine (LS-SVM) was executed. The experimental results showed that the classification of fetal state achieved better performance using the proposed method in this paper: the accuracy is 91%, sensitivity is 89%, specificity is 94%, quality index is 92%, and area under the receiver operating characteristic curve is 92%, which can assist clinicians in assessing fetal state effectively.

Objective To evaluate the performance of Xpert C. difficile multiplex real-time PCR assay for diagnosis of Clostridium difficile infections in Chinese hospital settings. Methods This study was performed in Huashan Hospital, Ruijin Hospital, Beijing Hospital, Nanfang Hospital and Sir Run Run Shaw Hospital using a standard study protocol. Unique unformed stools from patients with acute hospital-acquired diarrhea were simultaneously analyzed by toxigenic anaerobic cultures and the Xpert C. difficile assay. All specimens displaying discordant results between the Xpert assay and toxigenic culture were sent for Sanger tcdB gene sequencing. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), total concordance rate, and 95％ confidence interval (CI) were calculated before and after resolution of discordant results using SAS 9.3. Results A total of 745 stool specimens were collected and 46 were excluded due to failure of C. difficile recovery. The remaining 699 specimens were included. Compared to the results of toxigenic culture, the sensitivity, specificity, PPV, and NPV of Xpert C. difficile assay were 94.1％ (144/153)(95％CI:89.1％-97.3％), 93.2％ (509/546)(95％CI:96.7％-99.2％), 79.6％ (144/181)(95％CI:72.9％-85.2％)and 98.3％ (509 / 518) (95％CI: 96.7％-99.2％), respectively. Both methods had a Kappa of 0.819. Xpert C. difficile assay showed sensitivity of 98.4％(62/63) (95％ CI: 90.3％-99.9％) and specificity of 93.2％(509/546) (95％ CI: 90.8％-95.2％) for toxin A-negative toxin B-positive strains. After the discordant results resolved by tcdB gene sequencing, PCR assay provided better performance with high sensitivity, specificity, positive predictive value, and negative predictive value [98.8％ (171 / 173), 98.1％ (516 / 526), 94.5％ (171/181) and 99.6％ (516/518), respectively]. Conclusions Compared to the results of toxigenic culture, the sensitivity, specificity and NPV of Xpert C. difficile assay were 94.1％ (144/153) and 93.2％(509/546), respectively. With the results available within 1 h, Xpert C. difficile assay provides prompt and precise laboratory diagnosis in Chinese clinical settings.

Objective To explore the change and significance of blood lipid and oxidative stress in subchnical hypothyroidism during pregnancy.Methods 100 pregnant women with subclinical hypothyroidism during pregnancy were chosen and set as the disease group,while 100 healthy pregnant women were chosen and set as the control group.Thyroid function index:free three iodine thyroid original glycine (FT3),free thyroid hormones (FT4),thyroid stimulating hormone (TSH),blood lipids index:triglyceride (TG),total cholesterol (TC),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),and oxidative stress indicators:superoxide dismutase (SOD),malondialdehyde (MDA),type oxidized low density hpoprotein (ox-LDL) in the two groups were detected and analyzed.Results FT3 and FT4 between the two groups had no statistical significance (P＞0.05).TSH in the disease group was (4.63±1.09) mIU/L,significantly higher than that of the control group(P＜0.05).The comparison of TG,HDL-C between the two groups had no statistical significance(P＞0.05).TC and LDLC in the disease group were significantly higher than those of the control group (P＜0.05).MDA and ox-LDL in the disease group were significantly higher than those of the control group,while SOD was significanTLy lower than that of the control group(P＜0.05).Conclusion Subclinical hypothyroidism during pregnancy can cause metabolic disorder of blood lipid and reduce oxidative stress ability.Monitoring and intervention of blood lipid and oxidative stress status is necessary.

Objective To evaluate the effect of remote limb ischemic postconditioning on the level of adiponectin during myocardial ischemia-reperfusion (I/R) in rats.Methods Fifty-seven male Sprague-Dawley rats,aged 8 weeks,weighing 250-350 g,were randomly divided into 3 groups (n =19 each):sham operation group (group S); group I/R; remote limb ischemic postconditioning group (group RLIP).Myocardial ischemia was induced by occlusion of anterior descending branch of left coronary artery for 30 min followed by 180 min reperfusion in urethane-anesthetized rats.In group S,the anterior descending branch was only exposed but not ligated.The animals underwent 10 min ischemia of bilateral hind limbs starting from 20 min of occlusion of the anterior descending branch,followed by reperfusion in RLIP group.The changes in S-T segment were recorded at 30,60,120 and 180 min of reperfusion.At 180 min of reperfusion,the blood samples were taken from the jugular vein for determination of serum levels of creatine kinase MB (CK-MB) and cardiac troponin Ⅰ (cTnⅠ).The animals were then sacrificed and hearts were removed for measurement of myocardial infarct size (IS) and adiponectin contents in myocardial tissues (by ELISA).Results Compared with group S,S-T segment was significantly elevated at each time point,myocardial IS,and serum cTnⅠ and CK-MB levels were increased,and adiponectin contents were decreased in I/R and RLIP groups.Compared with group I/R,elevation of S-T segment was significantly decreased at each time point,myocardial IS,and serum cTnⅠ and CK-MB levels were decreased,and adiponectin contents were increased in RLIP group.Conclusion The mechanism by which remote limb ischemic postconditioning reduces myocardial I/R injury is related to increased level of adiponectin in the myocardium of rats.

Objective To evaluate the in vitro antibacterial activity of fusidic acid against P.acnes.Methods Fifty strains of P.acnes were clinically isolated from Huashan Hospital,Fudan University from March to September 2013.The minimum inhibitory concentrations (MICs) of several antibacterial agents including fusidic acid against these P.aches isolates were determined by using the agar dilution method according to the recommendations of Clinical and Laboratory Standards Institute (CLSI).Data were analyzed using the WHONET 5.4 software.Results Among the 50 P.acnes isolates,90％ were sensitive to fusidic acid,90％ to moxifloxacin,54％ to clindamycin,46％ to erythromycin,but 100％ were resistant to metronidazole.The minimum concentration required to inhibit the growth of 50％ organisms (MIC50) and 90％ organisms (MIC90) were 0.5 and 1.0 mg/L respectively for fusidic acid,whereas clindamycin and erythromycin both showed higher MIC90 values (＞ 128 mg/L).At the concentration of 128 mg/L,clindamycin inhibited the growth of 70％ of the P.acnes isolates,and erythromycin inhibited the growth of 48％ of them,while the growth of all the isolates was inhibited by fusidic acid at 2 mg/L.Conclusion Fusidic acid exhibits excellent antibacterial activity against clinical isolates of P.acnes in vitro.

[Objective]To investigate the mechanism of Qingre Yiqi Tongluo(QRYQTL) fang in treating the diabetic nephropathy. [Methods]60 Sprague-Dawleg rats were divided into normal control group(N), Diabetic nephropathy model group(M) (model rats were prepared by intraperitoneal injection with STZ after unilateral nephrectomy), then the model rats were assigned into model control group, QRYQTL fang treatment group(Q) and Irbesartan treatment group(I). After 12 weeks of the treatment, the contents of superoxide dismutase(SOD),catalase(CAT),glutathione peroxidase(GSH-Px) and malondialdehyde (MDA) in renal tissue were examined by enzyme linked immunoassay(ELISA); the glomerular area(GA), mesangium area(MA),MA/GA, mean width of the podocyte foot processes(FPW) ,foot process fusion rate(FPFR) and average thickness of glomerular basement membrane(GBMT) were measured. [Results]Compared with N group, the contents of MDA in kidney homogenate and the GA,MA, FPW,FPFR,GBMT were markedly increased (P<0.01or P<0.05),the contents of SOD,CAT, GSH-Px and MA/GA were significantly decreased( P<0.01or P<0.05). QRYQTL fang reduced the level of MDA and decreased the GA, FPW, FPFR and GBMT(P<0.01or P<0.05). Compared with I group ,the QRYQTL fang was superior to Irbesartan in reducing the MDA, FPFR as wel as increasing the SOD,CAT(P<0.05).[ Conclusions]QRYQTL fang has a protective effect on the experimental diabec-tic nephropathy rats. The mechanism may be related to inhibiting oxidative stress, improving the body ’s antioxidant ability and al eviating the glomerular morphologic injury.

[Objective]To study the effect of Qingre Yiqi Tongluo(QRYQTL) preseription on proteinria in diabetic nephropathy(DN) rats by means of ob-servation on the expressions of fibroblast-specific protein 1(FSP1) and P-cadherin in in glomerulus in rats.[Methods]60 Sprague-Dawleg rats were divided into normal control group(N), Diabetic nephropathy model group(M), QRYQTL preseription treatment group(Q) and Irbesartan treatment group(I). DN model rats were prepared by intraperitoneal injection with STZ after unilateral nephrectomy. The rats were sacrificed after 12 weeks of the treatment. The creatinine clearance(Ccr),blood urea nitrogen(BUN) and 24h urinary protein(UPro) were tested. Immunohistochemical staining was performed to explore the expressions of P-cadherin and fsp1 in glomerulus.[Results] ①Compared with M group, the levels of 24-hour upro in Q group were significantly de-creased(P<0.01).The levels of Ccr and BUN in Q group were both lower than those of M group( P<0.05). ② Compared with M group, the expressions of P-cadherin in glomerulus in Q group were increased( P<0.01) and the expressions of FSP1 were obviously decreased( P<0.01). The expressions of FSP1 in Q group were decreased compared with that of I groups(P<0.05).[Conclusions]QRYQTL preseription weakened the epithelial-mesenchymal transition (EMT) of podocyte by means of increasing the expression of P-cadherin and reducing the expression of FSP1, thereby decreased the Upro and protect the renal function.