Objective:To identify the current situation of contract signing for family physician services in Luohu District, Shenzhen, and to explore the associated factors with contract signing and access to services.Methods:Using the WeChat official account of"People′s Hospital of Luohu", an online survey was conducted to investigate the status of family physician′s contract services for residents in Luohu District from May 19th to 25th, 2019. A total of 14 487 valid responses were received. Chi-square test and Logistic regression models were used to analyze the contract signing of family physician services and the related factors.Results:8 560 (59.09%) of the participants had signed with a family physician, and 12 696 of them had learnt about the service before. The awareness rate of family doctor services was 87.64%. The contract signing rate of those unemployed, who living or working in Luohu less than 5 years, who living alone, having no Shenzhen medical insurance, or having not heard of family physicians signing services were less than 50%. The signing rate was positively correlated with the awareness of family physician contract service, as well as the possibility of accepting signed medical examination, traditional Chinese medicine services and health information. Only 9.70% of the contractors received health services information.Conclusions:The contract Signing rates and awareness rate of family physicians among young and middle-aged residents in Luohu District are relatively high. However, access to contract services varies considerably. The signing rate and accepted services are mainly affected by job, length of residence in Shenzhen, type of medical insurance, and understanding of contract.

Linezolid is an oxazolidinone antibacterial agent used in infections caused by gram-positive cocci such as methicillin-resistant staphylococcus aureus, penicillin-resistant pneumococcus and vancomycin-resistant enterococcus. Lactic acidosis is one of the adverse reactions of linezolid. The risk factors of lactic acidosis caused by linezolid are long-term exposure, liver dysfunction, renal dysfunction, mitochondrial DNA A2706G polymorphism, combined use of drugs affecting mitochondrial function, etc. The symptoms of lactic acidosis caused by linezolid are nausea, vomiting, drowsiness, shortness of breath, tachycardia, and hypotension, etc., which can be identified early by close monitoring of laboratory indicators such as blood lactic acid, pH, and blood drug concentration. The mechanism of lactic acidosis induced by linezolid may be related to mitochondrial toxicity. The lactic acidosis of linezolid can be caused by reducing drug dose, stopping drug or even in vitro renal replacement therapy, and strengthening symptomatic support therapy if necessary. This review is intended to provide ideas for the clinical prevention and treatment of lactate acidosis caused by linezolid.

A laboratory animal expert consultation system provides an interactive platform for industry experts and users. Based on intelligent mobile terminal used as the application supporter, the platform combines the internet with laboratory animal to share the experts' knowledge, breaks through temporal and spatial restrictions, and resolves other problems such as poor timeliness of inquire service, knowledge data staticization, and irrational exploitation of internet to gain prompt inquire service. The platform would meet the needs of industry users for real-time aids and bridge the gap between industry experts and users. Thus, the transfer of expert' knowledge is realized in pace with the increasing knowledge resource of this platform to accelerate the transformation of theoretical knowledge into the industry. Our study focuses on the system characteristics, the main frame structure, the design of function module and the system implementation.

Objective: To investigate the safety and efficacy of needle-tract assisted standard percutaneous nephrolithotomy (PCNL) for the treatment of complicated upper urinary tract calculi. Methods: The clinical data of 1 562 patients with complicated upper urinary calculi who received standard PCNL from December 2013 to December 2017 at Department of Urology, the First Affiliated Hospital of Xiamen University were retrospectively analyzed. There were large residual stones in 256 patients through B-ultrasound exploration after standard PCNL, could′t be detected with nephoscope in standard PCNL tracts. 16 F mini PCNL tract were established in 120 cases for treatment of residual stones, while needle-tract were established in order to guide nephroscope to find residual stones in 126 cases. Needle-tract were transferred to 16 F mini PCNL tract for treatment of residual stones in 10 patients if these residual stones could′t be detected through needle-tract. Operation time, change of hemoglobin level after operation, incidence of postoperative complications, time of hospitalization and rate of stone clearance were measured in two groups. The statistical methods used included t test, Wilcoxon rank sum test, and χ² test. Results: There were 1 to 3 mini tracts (M(Q_R): 1(1)) established in the mini tracts group and 1 to 7 needle-tracts (M(Q_R): 3(2)) established in the needle-tract group (Z=-10.57, P=0.000). Compared with mini tract group, the operation time ((62.0±18.0) minutes vs. (84.0±15.5) minutes, t=10.242, P=0.000), hospitalization time ((4.40±0.86) days vs. (5.20±0.81) days, t=7.570, P=0.049), hemoglobin dropped ((1.31±0.47) g/L vs. (2.74±0.63) g/L, t=20.12, P=0.000), and incidence of postoperative complications (7.9% (10/126) vs. 19.2% (23/120), χ²=6.674, P=0.01) of needle-tract group were lower, while postoperative stone clearance rate was higher (89.7% vs. 76.7%, χ²=7.497, P=0.006). No perioperative severe complications such as pleural injury, pneumatothorax, perforation of renal, trauma of abdominal organ occurred in two groups. Conclusion Needle-tract assisted standard PCNL for the treatment of complicated upper urinary calculi can significantly improve stone clearance rate, reduce operation time, decrease risk of kidney and surrounding organs damage.

Objective To compare the long-term outcomes of the retropubic tension-free vaginal tape (TVT) versus the transobturator tension-free vaginal tape (TVT-O) for women with stress urinary incontinence (SUI).Methods From July 2001 to June 2011,data of 120 female patients with SUI were retrospectively reviewed,of which 45 patients received TVT treatment,while 75 patients received TVT-O.The median age in TVT group was 45.1 years (range 35-72 years),and the median age in TVT-O group was 50.5 years (range 39-76 years).We retrospectively analyzed the long-term subjective effect,objective effect and the rate of complications in the two groups.Results Median follow-up period was 121 months (range 72-192 months).The complete satisfaction rate was 89％ (40/45) in TVT group,and 92％(69/75) in TVT-O group,with no statistical difference between the two groups.The negative rate of cough test was 84.4％ (38/45) in TVT group,and 76.0％ (57/75)in TVT-O group,with a statistically significant difference.The rate of urinary tract injury was 8.9％ (4/45) in TVT group,and 4.0％ (3/75) in TVT-O group.The rate of thigh pain was 0 in TVT group,and 6.7％ (3/45) in TVT-O group.The rate of micturition frequency and urinary incomplete emptying after operations was 6.7％ (5/75) in TVT group,and 5.3％ (4/75) in TVT-O group.Conclusions The long-term subjective effect between TVT and TVT-O groups was similar.The objective effect in TVT group was better.There was no statistical difference in complication rate between the two groups,which showed different types of complications in different procedures.

Herpesviruses is one of the most common human infectious diseases, which can be divided into different types based on clinical infection degree.Herpes simplex virus usually results in buccal and genital mucocutaneous infections, while cytomegalovirus is the most common opportunistic pathogen associated with significant morbidity and mortality in immunocompromised hosts, especially in transplant and cancer patients.Although nucleoside analogues are effective antiviral drugs, the emergence of drug-resistant viruses has created a barrier for the treatment of herpesviruses infections, especially in immunocompromised patients.Therefore, novel therapeutic agents are needed to avoid the limitations of drug resistance.In this article, research progress in the therapeutic agents for drug-resistant herpesviruses was reviewed from the aspects of non-nucleoside analogues, novel antiviral targets and newly antiviral mechanisms.

Objective To investigate the natural infection of Theiler's murine encephalomyelitis virus (TMEV) in mice,and to survey the distribution of virus in tissues and the changes of serum antibody in the experimentally TMEV-infected mice.Methods Enzyme linked immunosorbent assay (ELISA) and fluorescence quantitative RT-PCR (qRT-PCR) assay were used to detect the antibody and nucleic acid of TMEV in clinical samples.These samples included SPF mice collected from Guangdong area in 2010-2015,mice obtained from a non-barrier laboratory rodent colony,and wild Rattus norvegicus live-trapped around the non-barrier laboratory rodent colony.36 ICR mice were intracerebrally inoculated with TMEV BeAn strain.The clinical signs of the animals were observed daily post-inoculation.Three mice were euthanatized at day 0,3,7,10,17,21,31,39 and 46 post-inoculation (dpi),respectively.Tissue and serum samples were collected for TMEV detection.Results The TMEV antibody and nucleic acid positive rates of SPF mice collected from Guangdong area in 2010-2015 were 5.29％ (n=2834) and 27.27％ (n=457),respectively.The TMEV antibody and nucleic acid positive rates of the mice obtained from a non-barrier laboratory rodent colony were 71.95％ (n=82) and 53.66％ (n=82),respectively.The TMEV nucleic acid positive rate of wild Rattus norvegicus was 25.93％ (n=27).In the TMEV positive mice,only two mice showed obvious clinical symptoms.The cecal contents,feces and brain samples were the best candidates for qRT-PCR assay.The viral nucleic acid could be detected in the brain,heart,liver,lung and stomach of ICR mice at 3 dpi,but no viral nucleic acid was detected in the spleen,kidney,and cecum.The viruses in liver,heart,lungs and stomach were completely cleared at 10 dpi,and the viruses persisted in the brain throughout the experiment.The TMEV antibody could be detected at 7 dpi,and then the antibody positive rate reached 100％ at 17 dpi.The antibody level increased gradually and maintained up to 46 days.ICR mice showed latent infection after TMEV inoculation,with no obvious symptoms and eye pathological changes.Conclusions The experimental mice and wild Rattus norvegicus in Guangdong area are both infected with TMEV,and the infection rate is high.The mice inoculated with TMEV BeAn strain show latent infection.The TMEV antibody produced in mice can be detected at 7 dpi and persisted until the end of the experiment.The viruses are found in the liver,heart,lung and stomach for a short time,but are persisted in the brain for a long time.There is a good consistency of TMEV detection between qRT-PCR and ELISA.The qRT-PCR assay can be used as a powerful complement method for the national standard of laboratory animals.

Objective To observe and identify the microorganism isolated from diseased and dead Ctenogobius gymnauchen cultured in seawater near the Daya Bay of south China sea.Methods GDLAMI-1210 strain was isolated from the diseased Ctenogobius gymnauchen(Bleeker).We applied physiological and biochemical characteristics in the bacterial classification.In order to confirm the results,we amplified a 1438 bp sequence of GDLAMI-1210's 16 S rRNA(HM 362434)and compared with other sequence in GenBank,and followed by artificial infection.Results The GDLAMI-1210 strain was Gram-negative and in a shape of short rod with single polar flagellum.The homology analysis and phylogenetic study showed that the 16 S rRNA sequence of GDLAMI-1210 has the highest similarity to Vibrio sp.espec Vibrio vulnificus,showing 99% identity.Conclusions To our knowledge,this is the first report that the causative pathogen,Vibrio sp,leads to the mortality of Ctenogobius gymnauchen(Bleeker).

Background:Chronic constipation is a major cause of impaired quality of life in modern society. Reasonable and effective management of chronic constipation could be achieved based on the principle of evidence-based medicine and the modern concept of constipation,and this is a challenge facing the clinicians. Aims:To investigate the role of barium-based colonic transit detection in diagnosis and treatment of chronic constipation. Methods:Fifty patients with chronic constipation from Apr. 2013 to Oct. 2014 at the First Hospital of Shanxi Medical University were recruited and randomly allocated into two groups,control group and individualized treatment group. Patients in individualized treatment group received 20 barium markers orally and abdominal plain radiography was performed 48 and 72 hours later,respectively for calculating the colonic transit index. According to the type of colonic transition and the characteristics of colonic motility estimated by colonic transit index and clinical manifestations,an individualized therapeutic regimen was formulated and the efficacy was evaluated. Patients in control group were treated empirically according to the clinical manifestations. Results:Mosapride and lactulose or polyethylene glycol were administered orally in control group;when abdominal pain or abdominal distension was predominant,pinaverium bromide or trimebutine was used respectively instead of mosapride. Barium-based colonic transit detection revealed that 9 patients in individualized treatment group were slow transit constipation,6 were outlet obstructive constipation and 8 were the mixed type. After 2 weeks of empirical or individualized treatment,the defecation rates of the two groups were 24. 0%(6 / 25)and 52. 2%(12 / 23)within 24 hours and 64. 0%(16 / 25)and 87. 0%(20 / 23)within 48 hours,respectively(P all < 0. 05). Conclusions:Barium-based colonic transit detection is a simple,economical and practical modality for guiding the individualized treatment in patients with chronic constipation.

Objective:To study influence of renal sympathetic denervation (RDN)on cardiac function of dogs with heart failure (HF).Methods:A total of 40 dogs were randomly and equally divided into RDN group [received bilat- eral renal artery radiofrequency ablation (RFA)]and model group (only received femoral puncture).Pacemaker was implanted in every dog,and dog HF model was established using rapid right ventricular pacing.Cardiac and re-nal function indexes,BNP and sympathetic activity index levels were observed and compared between two groups be- fore RFA/sham operation,instant and four weeks after model establishment.Results:After operation four weeks, compared with model group,there were significant reductions in levels of epinephrine (E)[(362.69±42.54)ng/ml vs.(290.36±42.32)ng/ml],renin (R)[(305.46± 39.68)ng/ml vs.(230.04±32.80)ng/ml],aldosterone (AD)[(408.00±38.56)ng/ml vs.(246.00± 48.37)ng/ml],angiotensin Ⅱ (ATⅡ)[(280.00±48.08)pg/ml vs.(172.00±25.04)pg/ml]and norepinephrine (NE)[(425.65±50.54)ng/ml vs.(316.76±46.29)ng/ml]in RDN group (P<0.05 all);there were significant reductions in HR,respiratory rate (RR)and BNP level in RDN group,P<0.05 all;there were significant rise in SBP,LVEF,CO,CI,left ventricular pressure maximal rising rate (+dp/dtmax),left ventricular pressure maximal dropping rate (-dp/dtmax)and left ventricular end-systolic pressure (LVESP),and significant reductions in left ventricular end-systolic dimension (LVESd),left ventricular end-diastolic dimension (LVEDd)and left ventricular end-diastolic pressure (LVEDP)in RDN group,P<0.05 all.Conclusion:RDN can decrease renal sympathetic activity,improve heart function,inhibit myocardial remode- ling,its therapeutic effect is significant