Objective:To evaluate the clinical status, and analyz obstacles and facilitators for perioperative deep vein thrombosis prevention of brain neoplasms based on the Ottawa model of research use (OMRU).Methods:A total of 93 patients with brain tumors who were admitted to the Department of Neurosurgery, the First Affiliated Hospital of Nanjing Medical University from April to May 2021 and 33 nurses in the neurosurgery ward and operating room neurosurgery special group were selected as the baseline review subjects by convenience sampling. Based on the framework of evidence-based continued quality improvement of Fudan University, we searched BMJ Best Practice, UpToDate, The Joanna Briggs Institute Library, International Guideline Library, American Guideline Network, Scottish Intercollegiate Guideline Network, National Institutes for Health and Clinical Technology Optimization, Medline, Medlive, China National Knowledge Infrastructure, VIP, Wanfang and SinoMed according to the '6S' evidence pyramid from inception to January 1, 2021 for all clinical decisions, recommended practices, best practice information, evidence summary, guidelines and expert consensus on venous thrombosis assessment, prevention, screening, nursing and health education. The best evidence was summarized, and the final review indicators were formulated through two rounds of expert correspondence. According to the results of baseline review, barriers and facilitators were analyzed, and countermeasures were developed guided by OMRU.Results:A total of 19 best evidences were included, and 34 review indicators were developed in this study. Among them, only 4 indicators had a compliance rate of 100%, 18 ones had a compliance rate of 0, and the other 12 ones had a compliance rate of 6.5%-97.8%. A multi-factor analysis of the review results showed that the main obstacles of evidence implementation were the feasibility and comprehensibility at evidence level, the lack of knowledge and heavy workloads at the potential practitioner level, insufficient education materials, trainings and preventive equipment at system level. Furthermore, the reliable sources of evidence at evidence level, supports from practitioners at the potential practitioner level and system resources (such as training, national and hospital policies, etc.) at system level may contribute to the clinical application of evidence.Conclusions:There was still a huge gap between the best evidence and clinical practice. The obstacles and facilitating factors in evidence transformation should be evaluated scientifically and comprehensively, and corresponding countermeasures should be given to promote the application of evidence in clinical practice.

Self-advocacy can improve cancer survivors' symptom burden, quality of life, and well-being, which also plays a pivotal role in promoting cancer survivors' participation in medical decision-making and self-management. Based on research in China and abroad, this article introduces the concept of cancer survivors' self-advocacy and its role in cancer survivors, expounds the relevant factors that affect self-advocacy, and analyzes the application status and limitations of assessment tools and intervention methods. This article puts forward a prospect for the future research on self-advocacy of cancer survivors in China, in order to promote the participation in medical decision-making and the quality of self-management of cancer survivors in China from the new perspective of self-advocacy.

Objective To study the epidemiology of hand,foot,and mouth disease (HFMD) and the spectrum of serotypes in the other enterovirus (EV) (non-EV-A71 and non-Coxsaekievirus group A 16,CV-A 16) from 2016 to 2017 in Guangzhou,to provide the basis for its treatment,prevention and control.Methods Enteroviruses universal type,EV-A71 and CV-A16 were detected by real time reverse transeription-polymerase chain reaction in the specimens from HFMD suspected patients from 2016 to 2017.The positive specimens of non-EV-A71 and non-CV-A16 were amplified and sequenced based on 5'-untranslated region (UTR) region.The spectrum of serotypes was analyzed with BLAST in NCBI on the basis of 5'-UTR region.Results A total of 25779 specimens from HFMD patients were collected during 2016-2017,16 300 (63.23 ％) of which were positive.The positive rates of EV-A71,CV-A16,non-EV-A71 and non-CV-A16 were 4.57％ (1 178/25 779),12.70％ (3 274/25 779) and 45.96％ (11 848/25779),respectively.The average positive rate of non-EV-A71 and non-CV-A16 in 2017 was 55.68％,which was higher than that in 2016.Sequence analysis showed that there were 16 genotypes in 95 non-EV-A71 and non-CV-A16 positive specimen,including CV-A6,CV-A10,CV-A4,CV-A2,CV-A8,CV-A12,CV-A9,Coxsakievirus B5 (CV-B5),CV-B2,CV-B4,CV-B3,Echovirus 1 (E1),E16,E30,E2 and E18.CV-A6 (26.32％),and CV-A10 (15.79％) were the most common genotypes,followed by CV-A4 (6.32％)、CV-A8(4.21％),and CV-A2 (4.21％).Conclusions The infection rate of EV-A71 is very low during 2016-2017.From April to July 2016,there is a small peak of CV-A16 infection.The non-EV-A71 and non-CV-A16 enterovirus becomes the main causative agent of HFMD during 2016 to 2017.CV-A6 and CV-A10 are the most prevalent pathogens of non-EV-A71 and non-CV-A16 enterovirus.Research and monitoring of CV-A6,CV-A10 as the main non-EV-A71and non-CV-A16 virus should be strengthened.

Objective To investigate the related factors that affect the short outcome of abdominal surgery among elderly patients with acute abdomen.Methods Clinical data of 378 patients aged >60 years with acute abdo-men were retrospectively analyzed.The key factors under analysis in this study were the occurrence of major complica-tions,death from any cause within 30 days and related factors after the operation.Results The most common diagno-ses were acute appendicitis (134 cases,35.4%),biliary tract disease (96 cases,25.4%),intestinal obstruction (68 cases,20.0%)and inguinal hernia(42 cases,11.1%).The majority of patients(327cases,86.5%)underwent open surgery.12cases(23.5%)of all 51 cases underwent laparoscopic surgery were converted to open surgery.The 30 day mortality rate and rate of operation -related complications were 9.5% and 22.0%,respectively.Analysis showed that patients'age,low body mass index,open surgery and ASA grade Ⅲ or above may increase mortality(all P <0.05).Conclusion The acute abdomen in elderly patients was with much complications,operation treatment is still the first choice.The patient's older age,low body mass index,open surgery may increase the mortality rate.ASA grade higher may predict a bad prognosis.The operation of elderly patiens had a high morbidity and mortality,as general surgeon,we should pay more attention to acute abdomen in elderly patients.

Objective To investigate the prevalence and resistance mechanisms of Proteus mirabilis in the ward of neurology de‐partment of our hospital .Methods For a total of 20 clinic isolates of Proteus mirabilis ,PCR were used for the detection of AmpC , ESBLs ,KPC and MBLs and then DNA sequencing was performed .The integrons were also detected by using PCR and then sequen‐cing was carried out .The genetic relationship between isolates were detected and analysed by pulsed‐field gel electrophoresis(PF‐GE) .The results of drug sensitivity tests were analysed .Results TEM‐1 and CTX‐M‐14 gene were found in all the 20 isolates ,the 10 isolates of Proteus mirabilis were also found carrying CMY‐2 gene .Class Ⅰ integrons were amplified from 19 strains carrying gene cassettes aacA4+cmlA1,dfrA12+orfF+aadA2and dfrA32+ereA+aadA2 respectively .PFGE analysis revealed that the 20 isolates were grouped into 11 PFGE types P1-P11 ,the 12 isolates of P1-P3 were same clones .The sensitive rates of the i‐solates to Meropenem ,Amikacin ,Aztreonam ,Ceftazidime and Tazocin were high .Conclusion Nosocomial transmission of the same clone of Proteus mirabilis was appeared in the ward of neurology department of our hospital .The predominance drug‐resistance genes were CTX‐M‐14 andCMY‐2 .The incidence of carrying class Ⅰ integrons was high ,and the major gene cassettes wereaacA4+cmlA1and dfrA12+orfF+aadA2.The 20 isolates were all sensitive to Meropenem ,Amikacin and Aztreonam .Other Clinical departments should also pay attention to the nosocomial infection caused by Proteus mirabilis and strengthen the infection control measures .

In this study we synthesized a micro- and mesoporous material, SBA-16. And later on we functionalized it with octyltrimethoxysilane and octadecyltrimethoxysilane, respectively. The materials of SBA-16 and its functionalized form were characterized by nitrogen adsorption isotherms at 77K, small angle X-ray scattering (SAXS), Fourier-transform infrared (FT-IR), thermal gravimetric analysis (TGA), and adsorption isotherms of single component n-heptane, toluene and water vapour. The data of FT-IR and TGA demonstrated the successful chemical modification of surface and porous wall of SBA-16 with different hydrocarbon chains. The results of SAXS, nitrogen adsorption at 77K, and adsorption isotherms of probe molecules revealed that the functionalized SBA-16 materials possessed relatively less regularity, smaller BET surface area and pore volumes, and lower adsorption capacities for the probe molecules compared to the original SBA-16. However, the functionalized SBA-16 materials showed much less affinity to polar molecules such as water. This work provides useful fundamental information for future study of novel mesoporous silica materials as potential drug delivery carriers.
Adsorption ; Drug Carriers ; chemistry ; Porosity ; Silicon Dioxide ; chemistry ; Surface Properties

Objective To clone and express human autoantigen Sm B'in methylotrophie yeast Pichia Pagtoris.Methods The gene Sm B' was cloned bv PCR The PCR product wag inserted into the vector pPIC9k.The recombinant plasmid pPIC9k.Sm B' was transformed into yeast Sm D1168 by electroporation.The positive clones were screened in MD plates.The high copy number transformants were rapidly selected by using G418 and were induced by methan01.Supematants after induction were analyzed by SDS-PAGE and western blot.Sera collected from thirty patients with SLE.thirty patients with mixed connective tissue disease(MCTD)and thirty healthy volunteers were detected by immunodot and immunoblot.Results The PCR product wag about 700 bD in size which Wag in accordance with predicted 657 bp.The pPIC9k-Sm B'showed the same seqencing result with GenBank's report and restriction enzyme analysis confirmed our prediction.The pPIC9k-Sm B' positive clone produced a 32 000 protein which had natural immunogenicitv of human autoantigen Sm B'by SDS-PAGE and western blot.The positive rate of immunodot and IBT were 46.7%(42/90)and 51.1%(46/90),respectively.The agreement between immunodot and IBT was very close(Kappa value=0.911 2,P＜0.01).Conclusion Successfully cloning and expression of human autoantigen Sm B' in methylotmphic yeast Pichia Pagtoris hid a foundation for further research work.

In this paper is recommended a highly sensitive and reagent-safe method to determine plasma heamoglobin (FHb) in viscacha hemolytic test. The 2,4-dichlorophenol method (2,4-DCP) of Trinder reaction has been improved. The performance of 2,4-DCP is verified. The sensitivity of 2,4-DCP is 2.39 times that of phenol method. It is well used with run precision and day-to-day precision. The reaction color is stable. The reference value FHb is 1-36.7 mg/L. Sodium citric is an excellent anticoagulant liquid to keep erythrocyte. The 2,4-DCP method is neither carcinogenic nor poisonous;it is suitable for viscacha hemolytic test in clinical and biomedical engineering.
Chlorophenols ; Coombs Test ; methods ; Hemoglobins ; analysis ; Hemolysis ; Humans ; Sensitivity and Specificity

87%. CONCLUSIONS The surveillance of overexpressing AmpC ?-lactamases in cefoxitin-resistant Gram-negative bacillus must be enhanced.The therapy of infections caused by related bacillus should make imipenem and meropenem a chief choice.DHA-1,CMY-2 and CMY-22 AmpC enzymes are found in Fuzhou.