Objective To compare the efficacy and safety of linezolid and vancomycin in the treatment of hospitalized patients with Enterococcus bloodstream infection,to provide medication choices for clinical practice.Methods The clinical data of 99 inpatients with Enterococcus bloodstream infection in Yantai Yuhuangding Hospital from June 2019 to June 2023 were retrospectively collected,and the patients were divided into linezolid group and vancomycin group according to the drug used.confounding factors were controlled by propensity score matching method.The clinical efficacy,inflammatory factor levels,and adverse reactions of the two groups were compared.Results After using propensity score matching,25 patients were assigned to both linezolid group and vancomycin group.There was no significant difference in the effective rate,30-day mortality,incidence of adverse reactions and inflammatory factor levels between the two groups(P＞0.05).Conclusion In the treatment of patients with Enterococcus bloodstream infection,the efficacy and safety of linezolid and vancomycin are the same.Linezolid can be a prioritized medicine when vancomycin causes nephrotoxicity and concentration does not meet the standard or exceeds the standard.Due to limitation of sample size and information collection,more high-quality studies are required to verify above conclusions.

Objective: To investigate the hearing loss and speech disorders in the elderly, to analyze the risk factors of the elderly deafness, as well as to provide reference for the clinical research of the elderly deafness. Methods: From March 2016 to March 2018, 913 elderly people, who were tested for hearing and speech disorders, were examined by a unified questionnaire to investigate the demographic data of the subjects and the related factors of deafness, and the hearing and speech recognition tests were carried out. According to the hearing loss, the hearing impaired group was divided into the hearing impaired group (500, 1 000, 2 000 and 4 000 Hz, the average hearing threshold>25 dBHL) and the non hearing impaired group (the average hearing threshold of the four frequencies ≤25 dBHL), and then the single factor analysis and the unconditional Logistic regression analysis were used. Finally, the risk factors of senile deafness were analyzed. Results: Of the 913 elderly subjects in the survey, 389 (42.61%, 389/913) had no hearing impaired, 345 (37.79%, 345/913) were mild hearing impaired, and 149 (16.32%, 149/913) had moderate hearing loss. Twenty-six patients were severe hearing loss (2.85%, 26/913); 4 patients had severe hearing loss (0.44%, 4/913). Among the 524 hearing-impaired elderly, there were 244 speech-recognition disorders (46.56%, 244/524), of whom 106 were mild hearing-impaired, accounting for 30.72% (106/345), 108 were moderate hearing loss, accounting for 72.48% (108/149), 26 were severe hearing loss, accounting for 100% (26/26), and 4 were the profound hearing loss, accounting for 100% (4/4). Statistical analysis showed that the age, job status, history of hypertension, history of hyperglycemia, and smoking history were independent risk factors for senile hearing loss (P<0.05). Conclusions High incidences of hearing and speech recognition obstacle are found in health examination for the elderly patients. Noise exposure, age, history of hypertension, high blood sugar, and smoking history are high-risk factors for senile deafness, therefore, prevention and rehabilitation programs are urgent to be developed.

OBJECTIVE:To explore losses and gains (L&G) and L&G ratio induced by Essential Medicine System in a county. METHODS:By choosing a county in western China as sample area,field investigation was used to collect outpatient and inpatient visits,outpatient and inpatient income,drug income,total length of stay and medical insurance reimbursement criteria in primary medical institutions (township health centers,village health rooms) of the county during 2009-2015. By setting the year 2009 as the baseline year,the drug cost reimbursed by medical insurance was simulated and calculated when Essential Medicine System were not implemented;L&G and L&G ratio of medical insurance were calculated by comparing with actual drug cost reimbursed by medical insurance. RESULTS:The year 2012,in which the sample county fully implemented the Essential Medicine System was the turning year. Medical insurance funds lost in primary medical institutions of the county during 2010-2011(lost 437000,915000 yuan,respectively),but gained during 2012 to 2015(gained 199000,494000,858000,1290000 yuan, respectively);the L&G ratio increased from -0.67％ to 1.21％. For reimbursed outpatient drug cost and inpatient cost,L&G of medical insurance were different. For reimbursed drug cost of village health room and township health center,L&G of medical insurance were also different. CONCLUSIONS:The implementation of Essential Medicine System benefits to medical insurance within the county and Medical insurance funds can be saved.

Objective To investigate the effect of hyperbaric oxygen (HBO) combined with drugs in the treatment of calcaneal fracture pain.Methods A total of 64 calcaneal fracture patients hospitalized from January,2016 to May 2017 were evenly divided into the experimental group and the control group,each consisting of 32 patients.The control group received conventional analgesic therapy and routine nursing (e.g.elevation of injured limbs,cold compress,drug analgesia,repercussion or relieving of swelling etc.),while the experimental group received HBO in addition to conventional analgesic therapy.NRS scores during the perioperative stage were observed and compared between the patients of the 2 groups.Results At admission into hospital and 2 hours after surgery,there was no statistical significance in the NRS scores for the experimental group,as compared with those of the control group (P ＞ 0.05).The highest,lowest and average Fin scores at rest for the experimental group 3 days after surgery were respectively 5.0 ± 1.5,1.7 ± 0.6 and 2.5 ± 1.0,while those of the control group were respectively 7.5 ± 1.2,3.2 ± 0.7 and 4.0 ± 0.8.The pain scores at motion for the experimental group 7 days after surgery were 3.2 ± 0.6,while those of the control group were 4.6 ± 0.8,with the former being obviously lower than the latter,and statistical significance could be seen when comparisons were made between them (P ＜ 0.01).Conclusions HBO combined with drugs in the treatment of calcaneal fracture could obviously alleviate pain,improve patient life quality and promote recovery after surgery.

Objective To investigate the effect of hyperbaric oxygen (HBO) combined with drugs in the treatment of calcaneal fracture pain.Methods A total of 64 calcaneal fracture patients hospitalized from January,2016 to May 2017 were evenly divided into the experimental group and the control group,each consisting of 32 patients.The control group received conventional analgesic therapy and routine nursing (e.g.elevation of injured limbs,cold compress,drug analgesia,repercussion or relieving of swelling etc.),while the experimental group received HBO in addition to conventional analgesic therapy.NRS scores during the perioperative stage were observed and compared between the patients of the 2 groups.Results At admission into hospital and 2 hours after surgery,there was no statistical significance in the NRS scores for the experimental group,as compared with those of the control group (P ＞ 0.05).The highest,lowest and average Fin scores at rest for the experimental group 3 days after surgery were respectively 5.0 ± 1.5,1.7 ± 0.6 and 2.5 ± 1.0,while those of the control group were respectively 7.5 ± 1.2,3.2 ± 0.7 and 4.0 ± 0.8.The pain scores at motion for the experimental group 7 days after surgery were 3.2 ± 0.6,while those of the control group were 4.6 ± 0.8,with the former being obviously lower than the latter,and statistical significance could be seen when comparisons were made between them (P ＜ 0.01).Conclusions HBO combined with drugs in the treatment of calcaneal fracture could obviously alleviate pain,improve patient life quality and promote recovery after surgery.

Objective:The paper aims at developing a method of defining and visualizing the scope of the basic medical insurance pharmacy service, and provides a new way of thinking for the designated pharmacy planning. Methods:Collecting the basic data and information on administrative divisions in the planning area taking equity and efficiency as the guidance, using ArcGIS and its function modules to define and visualize the scope of the medical in-surance pharmacy service. The procedure of issue focus, method improvement, data simulation, expert consultation, methodology perfecting were followed to define and visualize the scope. Results:Forming a whole set of operative pro-cedures of defining and visualizing the scope of the medical insurance pharmacy service based on medical resources allocation standard, and the operation commands and procedures in ArcGIS were clarified. Conclusion:Operating ac-cording to the appropriate method steps, the following can be achieved:(1) The adjacent scope of medical insurance pharmacy service are adjacent to each other but do not overlap or cross;(2) Spatial relations can be clearly and ef-fectively expressed;(3) The shape is flat and regular;(4) The data collected at different times can be comparable in space, providing good prerequisites for medical insurance designated pharmacy planning.

Objective To investigate the clinical effects of hyperbaric oxygen on the control of serum glucose and healing of incision in the patients with calcaneal fracture complicated with diabetes mellitus following surgery.Methods Sixty cases of calcaneal fracture complicated with diabetes mellitus hospitalized from August 2015 to August 2016 were designated as the HBO group and the control group,in accordance with different wards designated,and each group consisted of 30 cases.The patients in the control group were given conventional postsurgical treatment and nursing,such as elevation of the affected limb,control of blood glucose,repercussion and promotion of bone healing,while the patients in the HBO group received HBO therapy,in addition to conventional therapy and nursing.Serum glucose level and healing of incision 2 weeks after surgery were closely observed and compared between the patients of the 2 groups.Results There was no statistical significance in the level of fasting blood glucose and glycosylated hemoglobin for the patients of the HBO group on the first day after surgery,as compared with those of the control group (P ＞ 0.05).Fasting blood glucose levels of the HBO group on the third,seventh and tenth days after surgery were respectively (5.5 ± 1.1) mmol/L,(5.4 ± 1.2) mmol/L and (5.2 ± 1.2) mmol/L,while those of the control group were (7.6 ± 0.7) mmol/L,(7.4 ± 0.9) mmol/L and (7.5 ± 0.9) mmol/L respectively.Blood glucose levels 2 hours after meal for the HBO group were respectively (8.4 ± 1.1) mmol/L,(7.9 ± 1.2) mmol/L and (8.2 ± 1.2) mmol/L,while those for the control group were (10.5 ± 1.1) mmol/L,(10.4 ± 1.2) mmol/L and (10.9 ± 1.2) mmol/L respectively.Glycosylated hemoglobin level for the patients of the HBO group on the seventh day after surgery was(6.7 ±0.4)％,while that of the control group was (7.3 ±0.6)％,which was obviously higher than that of the observation group.Statistical significance could be seen,when comparisons were made between the 2 groups (P ＜0.01).Clinical efficacy of wound healing 2 weeks after surgery for the experimental group was obviously better than that of the control group,also with statistical significance (P ＜ 0.05).Conclusions HBO therapy after surgery could effectively control serum glucose level and promote incision healing in the patients with calcaneal fracture combined with diabetes mellitus.

Objective To investigate the clinical effects of hyperbaric oxygen on the control of serum glucose and healing of incision in the patients with calcaneal fracture complicated with diabetes mellitus following surgery.Methods Sixty cases of calcaneal fracture complicated with diabetes mellitus hospitalized from August 2015 to August 2016 were designated as the HBO group and the control group,in accordance with different wards designated,and each group consisted of 30 cases.The patients in the control group were given conventional postsurgical treatment and nursing,such as elevation of the affected limb,control of blood glucose,repercussion and promotion of bone healing,while the patients in the HBO group received HBO therapy,in addition to conventional therapy and nursing.Serum glucose level and healing of incision 2 weeks after surgery were closely observed and compared between the patients of the 2 groups.Results There was no statistical significance in the level of fasting blood glucose and glycosylated hemoglobin for the patients of the HBO group on the first day after surgery,as compared with those of the control group (P ＞ 0.05).Fasting blood glucose levels of the HBO group on the third,seventh and tenth days after surgery were respectively (5.5 ± 1.1) mmol/L,(5.4 ± 1.2) mmol/L and (5.2 ± 1.2) mmol/L,while those of the control group were (7.6 ± 0.7) mmol/L,(7.4 ± 0.9) mmol/L and (7.5 ± 0.9) mmol/L respectively.Blood glucose levels 2 hours after meal for the HBO group were respectively (8.4 ± 1.1) mmol/L,(7.9 ± 1.2) mmol/L and (8.2 ± 1.2) mmol/L,while those for the control group were (10.5 ± 1.1) mmol/L,(10.4 ± 1.2) mmol/L and (10.9 ± 1.2) mmol/L respectively.Glycosylated hemoglobin level for the patients of the HBO group on the seventh day after surgery was(6.7 ±0.4)％,while that of the control group was (7.3 ±0.6)％,which was obviously higher than that of the observation group.Statistical significance could be seen,when comparisons were made between the 2 groups (P ＜0.01).Clinical efficacy of wound healing 2 weeks after surgery for the experimental group was obviously better than that of the control group,also with statistical significance (P ＜ 0.05).Conclusions HBO therapy after surgery could effectively control serum glucose level and promote incision healing in the patients with calcaneal fracture combined with diabetes mellitus.

OBJECTIVE:To optimize the formulation of azithromycin sustained-release vaginal suppository(ASVS).METHODS:The ASVS was prepared using S-40 as suppository base,HPMC as sustained-release material and glycerine as humectant.The formulation of ASVS was optimized by orthogonal design with accumulated release percentage and hardness as indexes and the amount of 8% HPMC and glycerol as factors;meanwhile,a verification test and the fitting of in vitro drug release model were performed.RESULTS:The optimized formulation ASVS was as follows:azithromycin 6 g,8% HPMC 23.52 g,glycerol 29.40 g,ethanol absolute 3 g,ethylparaben 0.59 g,and S-40 294 g.Three batches of suppositories prepared under the optimized formulation reached a mean content of 99.5%,with hardness up to the standard,showing good reproducibility and homogenicity in drug release in vitro.The accumulative release rates of all samples were greater than 98% at 180 min,and the release dynamics in vitro were in line with Higuchi equations.CONCLUSION:The optimized ASVS is feasible in formulation,stable and reproducible in preparation technology and up to the standard for sustained-release preparation.