Objective To investigate the therapeutic effect of licorice zinc on melasma.Methods Thirty-six BALB/c mice were equally divided into blank group,model group,licorzinc low-dose group,licorzine medium-dose group,licorzinc high-dose group and tranexamic acid group.Melasma was induced by 100 mJ/cm2 UVB irradiation combined with 15 mg/kg progesterone injection.Mice were treated with tranexamic acid(0.065 g/kg)and low(0.65 g/kg),medium(1.3 g/kg),or high(2.6 g/kg)doses of zinc licorice for 14 days.Skin was taken for HE and Masson-Fontana staining and measurement of SOD,MDA,GSP-Px,TNF-α,IL-1β,IL-6,plasma protein Nrf-2,nuclear protein Nrf-2 and HO-1 expression levels.Results Compared with model group,high-dose licorice zinc group showed decreased melanocyte formation,collagen cell necrosis,and inflammatory infiltration(P＜0.01);decreased MDA,IL-6,IL-1β,TNF-α and plasma protein Nrf-2 expression(P＜0.01);and increased GSP-Px,SOD and nuclear protein Nrf-2 and HO-1 expression(P＜0.01).Conclusions Zinc licorice activates the Nrf-2/HO-1 pathway to initiate high expression of HO-1,SOD and GSP-Px and fight oxidative stress,thereby reducing melanogenesis.

Objective:To investigate the clinical efficacy of 30% supramolecular salicylic acid combined with 420 nm intense pulsed light in the treatment of facial seborrheic dermatitis.Methods:A total of 60 patients with facial seborrheic dermatitis were selected from January 2018 to December 2021, that were randomly divided into 30% salicylic acid group, 420 nm intense pulsed light group and combined group. Each group had 20 patients. They were treated once every two weeks in four consecutive rounds. The adverse reactions of patients were followed up each time, and the data were analysed and evaluated four weeks after the last treatment.Results:After treatment, the total score of clinical symptoms and signs in the combined group were significantly lower than those in the other groups (3.95±1.731 vs. 7.15±2.059, 7.50±1.732, F=22.434, P<0.05). The effective rate in combined group was 95%, which was significantly higher than 65% of salicylic acid group and 60% of intense pulsed light group (χ 2=7.33, P<0.05), and no obvious adverse reactions were found in the three groups. Conclusions:30% supramolecular salicylic acid combined with 420 nm intense pulsed light is safe and effective in the treatment of facial seborrheic dermatitis.

Objective:To study the clinical characteristics of neonatal sepsis caused by raoultella ornithinolytica.Methods:From January 2010 to December 2020, clinical data of seven cases of neonates with raoultella ornithinolytica sepsis in the Department of Neonatology of our hospital were analyzed. Literature published from the establishment of the databases to December 31, 2020 were searched and reviewed on this topic. The databases included PubMed, Web of Science, Embase database, Wanfang Database, CNKI, National Science and Technology Library and Chinese Science Paper Online.Results:Among the 7 cases admitted to our hospital, 6 male and 1 female, 6 premature and 1 full-term small-for-gestational-age (SGA), 6 patients presented with lethargy, 5 patients had fever and 3 showed dyspnea. 4 patients had necrotizing enterocolitis (NEC), 1 congenital intestinal malrotation, 1 congenital jejunal atresia, 1 intestinal adhesion and stricture. 4 patients had history of surgery. Leucocytosis was found in 3 cases and leukopenia in 1 case. Thrombocytopenia and increased inflammatory indicators were found in all cases. All 7 patients recovered and were discharged. 4 articles on 4 newborn cases (3 males, 1 female including two premature infants) were found for literature review. 3 cases had skin flushing, 3 cases showed dyspnea, 2 cases had fever and 1 case presented with lethargy. 1 case received surgery for congenital heart disease. Leucocytosis was found in 2 cases, leukopenia in 1 case, thrombocytopenia in 2 cases and elevated inflammatory indicators in 3 cases. 1 patient died due to septic shock and the other three recovered and were discharged.Conclusions:Raoultella ornithinolytica neonatal sepsis may occur in infants with intestinal comorbidities, history of invasive procedures, premature birth or full-term SGA and congenital malformations. Most anti-infective therapies are effective. However, if the patient had septic shock, the prognosis is poor.

Objective To determine the relationship between osteosarcopenia and distal radius fracture in postmenopausal women.Methods Fifty-five cases who diagnosed as distal radius fracture by X-ray in the Affiliated Hospital of Shenyang Medical College from January 2018 to January 2019 was as study group,and 55 cases matched by age for postmenopausal women without distal radius fracture was as control group.Grip strength and gait speed were measured with the recommendation of Asian Sarcopenia Working Group,hip and lumbar bone mineral density(BMD),body mass index (BMI),relative skeletal muscle index (RSMI) and resting metabolic rate (RMR) were measured and compared by dual energy X-ray (DXA),and compared between two groups.Results In study group,32 cases of osteoporosis,21 cases of sarcopenia,15 cases of osteosarcopenia;while 26 cases of osteoporosis,12 cases of sarcopenia and 9 cases of osteosarcopenia in control group.The rate of sarcopenia and osteosarcopenia in study group were significantly higher than those in control group:38.2％ (22/55) vs.21.8％(12/55),27.3 ％(15/55) vs.16.4％(9/55),P＜0.01.Compared with the control group,grip strength of study group was decreased significantly:(17.4 ± 4.7) kg vs.(19.2 ± 6.1) kg,P＜0.01.However,there was no significant difference in gait speed between the two groups (P＞0.05).The RMR,RSMI,BMD of femoral and total hip in study group were significantly lower than those in control group:(1.02 ± 0.45)kcal/d vs.(1.38 ± 0.39) kcal/d,(5.21 ± 1.10) kg/m2 vs.(6.12 ± 1.20) kg/m2,(0.85 ± 0.25) g/cm2 vs.(1.12 ± 0.32) g/cm2,(0.87 ± 0.16) g/cm2 vs.(1.08 ± 0.43) g/cm2,P＜0.01.However,there was no significant difference in lumbar BMD between the two groups (P＞0.05).Conclusions Fracture prevention and post-fracture management should include evaluation and treatment of muscles and bones.The clinical significance is that increasing the muscle mass above the critical value of the elderly may help to reduce the risk of distal radius fracture.

Objective: To analyze the clinical characteristics of cases of novel coronavirus pneumonia and a preliminary study to explore the relationship between different clinical classification and liver damage. Methods: Consecutively confirmed novel coronavirus infection cases admitted to seven designated hospitals during January 23, 2020 to February 8, 2020 were included. Clinical classification (mild, moderate, severe, and critical) was carried out according to the diagnosis and treatment program of novel coronavirus pneumonia (Trial Fifth Edition) issued by the National Health Commission. The research data were analyzed using SPSS19.0 statistical software. Quantitative data were expressed as median (interquartile range), and qualitative data were expressed as frequency and rate. Results: 32 confirmed cases that met the inclusion criteria were included. 28 cases were of mild or moderate type (87.50%), and four cases (12.50%) of severe or critical type. Four cases (12.5%) were combined with one underlying disease (bronchial asthma, coronary heart disease, malignant tumor, chronic kidney disease), and one case (3.13%) was simultaneously combined with high blood pressure and malignant tumor. The results of laboratory examination showed that the alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (ALB), and total bilirubin (TBil) for entire cohort were 26.98 (16.88 ~ 46.09) U/L and 24.75 (18.71 ~ 31.79) U/L, 39.00 (36.20 ~ 44.20) g/L and 16.40 (11.34- ~ 21.15) mmol/L, respectively. ALT, AST, ALB and TBil of the mild or moderate subgroups were 22.75 (16.31- ~ 37.25) U/L, 23.63 (18.71 ~ 26.50) U/L, 39.70 (36.50 ~ 46.10) g/L, and 15.95 (11.34 ~ 20.83) mmol/L, respectively. ALT, AST, ALB and TBil of the severe or critical subgroups were 60.25 (40.88 ~ 68.90) U/L, 37.00 (20.88 ~ 64.45) U/L, 35.75 (28.68 ~ 42.00) g/L, and 20.50 (11.28 ~ 25.00) mmol/L, respectively. Conclusion The results of this multicenter retrospective study suggests that novel coronavirus pneumonia combined with liver damage is more likely to be caused by adverse drug reactions and systemic inflammation in severe patients receiving medical treatment. Therefore, liver function monitoring and evaluation should be strengthened during the treatment of such patients.

Objective To understand the development of healthcare-associated infection(HAI)management organ-izations in China in the past 30 years.Methods Development of HAI management organizations in 12 provinces (municipalities,autonomous regions)in China was surveyed.Results A total of 166 hospitals were surveyed,96 (57.83%)were tertiary hospitals.Among 164 hospitals which had a history of development of HAI management department,46(28.05%)before 1995,63(38.14%)in 1995-2005,and 55(33.54%)in 2005-2015 set up HAI management departments.HAI management professionals per 1 000 beds in 165 hospitals decreased from 4.80 in 1995 to 4.09 in 2015,occupational categories in HAI management departments in 1995 -2015 were significantly different (χ2 =26.22,P <0.01).The constituent ratios of education background and profession of HAI manage-ment professionals in each province in 1995-2015 were significantly different(χ2 =242.91,47.10,respectively,all P <0.01).In 1995 and 2005,70.81%,53.30% of professionals were with college degree or below;in 2015,the percentage of professionals with bachelor’s degree,doctoral degree,and master’s degree were 53.79%,2.45%, and 22.86% respectively.Most professionals were nursing staff,but the percentage decreased from 58.38% in 1995 to 45.96% in 2015.Conclusion Although HAI management organizations have developed for 30 years and made some achievements,there still remain some problems,the proportion of professionals needs to be enhanced,and personnel structure should be optimized.

Objective To explore the direct economic loss caused by healthcare-associated infection(HAI)in general hospitals in China.Methods 68 hospitals were selected,a retrospective 1:1 matched survey was conducted to compare the direct medical cost in patients with and without HAI between January 1,2015 and December 31,2015. Results A total of 2 123 pairs of patients with and without HAI were included in the survey.The average cost of hospitalization in HAI and non-HAI groups were ￥25 845.30 and ￥12 006.14 respectively,￥13 839.16 on average was increased due to HAI.The average economic loss in provincial and ministerial levels of hospitals were￥21 409.83.The average economic loss in different regional hospitals were ￥9 725.42-￥18 909.59,and north China ranked the first.Economic loss caused by bloodstream infection and lower respiratory tract infection were more than other sites,which were ￥23 190.09 and ￥18 194.50 respectively.Conclusion HAI resulted in considerable direct economic loss.Prevention and control of HAI,especially bloodstream infection and lower respiratory tract infection should be paid more attention.

Objective To understand the current situation of occupational exposure and protection among health care workers (HCWs ), and provide evidence for formulating preventive measures of occupational exposure. Methods From April 6,2016 to May 6,2016,questionnaire surveys were conducted in 158 different levels of hos-pitals in 13 provinces in China,occupational exposure,protection management,and monitoring of occupational expo-sure in the first year,2010,and 2015 was surveyed by cluster random sampling method.Results Occupational ex-posure in 81.65% (129/158)of hospitals was responsible by healthcare-associated infection management depart-ments;98.73%(156/158)of hospitals set up the relevant rules and regulations;77.22%(122/158)of hospitals had missing report of occupational exposure.A total of 11 116 times of occupational exposure occurred (1 542 cases in the first year,2 474 in 2010,and 7 100 in 2015).Of various types of occupational exposure,sharp injury accounted for 96.76%;among HCWs sustained occupational exposure,nursing staff accounted for 53.90%;the major de-partment that HCWs who sustained occupational exposure were general wards,operating rooms,and intensive care units;the main medical appliances related to occupational exposure were syringes,scalp needles,and surgical suture needles;high-risk behavior causing occupational exposure were intravenous injection,putting needles into the sharp con-tainers,and surgical suturing;among occupational exposure sources,HBV accounted for 58.69%.Conclusion HCWs in China face a high risk of occupational exposure,occurrence of occupational exposure should be reduced through gov-ernment legislation,application of safety appliances,standardizing behavior of HCWs,proper using of personal pro-tective equipment,strengthening education and training of HCWs,and establishing a sound occupational exposure report,evaluation and follow-up system.

Objective To realize the current situation of prevention and control of catheter-associated urinary tract infection (CAUTI)since the development of healthcare-associated infection(HAI)management in China in the re-cent 30 years.Methods Random cluster sampling was used to select 165 secondary and tertiary hospitals in 13 provinces and cities in China,questionnaires were filled in,the content included time,scope,method,data feed-back,and incidence of CAUTI monitoring.Results Of 165 hospitals,92.12% (152/165)have implemented targe-ted monitoring,the implementation rate in tertiary hospitals was higher than secondary hospitals (98.08% [102/104]vs 81.97%[50/61],χ2 =13.748,P <0.001).Most hospitals (82.24%[125/152])only implemented monito-ring in intensive care units(ICUs)or partial ICUs.HAI management professionals,HAI control doctors and nurses in 69.08%(105/152)of hospitals jointly took responsibility for CAUTI monitoring.95.39% (145/152)of hospitals diagnosed CAUTI by combination of clinical manifestations and laboratory examination results.98.68%(150/152) of hospitals have gradually implemented intervention measures,such as strictly mastering the indications of urinary indwelling catheters,hand hygiene of health care workers,non-frequent change of urinary indwelling catheters,and necessity for daily assessment of catheterization.75.66% (115/152)of hospitals conducted feedback of monitored results to the whole hospital.Incidences of CAUTI in pre-2010,2010,and 2015 were 3.10‰,4.72‰,and 1.89‰respectively.Conclusion In the recent 30 years,monitoring on CAUTI in China has obtained achievement,CAUTI monitoring is gradually standardized and scientific,but the development at all levels of medical institutions is still imbalance,which needs to be improved further.

Objective To understand the development situation of healthcare-associated infection (HAI)manage-ment departments in the rational antimicrobial application and management in hospitals in China.Methods A total of 166 hospitals from 12 provinces,municipalities,autonomous regions,and military hospitals were selected for survey,the participation of HAI management departments in the rational clinical antimicrobial application and man-agement in different years was compared.Results Of 166 hospitals,68(40.96%)in 2005,119(71.69%)in 2010, and 160(96.39%)in 2015 participated in the establishment of management organizations for rational antimicrobial application (χ2 =121.143,P <0.001).The percentage of HAI management departments participating in antimicro-bial management increased from 10.24%(n=17)in 2005 to 22.29%(n=37)in 2010,and 31.33%(n=52)in 2015 (χ2 =22.172,P < 0.001 ).The percentages of HAI management departments participating in formulating cata-logues for antimicrobial varieties and classification,stipulating permission for antimicrobial use,joining antimicrobi-al management teams,monitoring bacterial resistance,managing antimicrobial prophylaxis in clean incision,super-vising clinical antimicrobial use,conducting clinical consultation,and evaluating prescription were 10.87% -30.72% in 2005,25.90%-65.06% in 2010,and 36.14%-95.18% in 2015 (all P <0.01).Intensity of antimicro-bial use (defined daily dose/100 bed-days,DDD/ 100 bed-days)decreased from 69.16 in 2005 to 41.40 in 2015, antimicrobial usage rate decreased from 46.98% in 2005 to 36.90% in 2015,among patients receiving therapeutic antimicrobial use,specimens sending for pathogenic detection increased from 20.58% in 2005 to 49.39% in 2015. Conclusion Departments of HAI management in China play important role in management of rational antimicrobial application.