Objective To analyze the prevalence of common chronic diseases and comorbidities in the elderly ≥65 years old in Xinzhou District, Wuhan. Methods A questionnaire survey, physical examination and a retrospective analysis of 12 common chronic diseases comorbidities were conducted in 2016 and 2018 in the resident elderly ≥65 years old. Results In 2016, the medical examination rate of the elderly aged ≥65 years old, the prevalence rate of ≥1 chronic disease, and the comorbidity rate of ≥2 chronic diseases in Xinzhou District were 57.37%, 82.53%, and 48.13%, respectively; in 2018, the medical examination rate, The prevalence of ≥1chronic diseases and the prevalence of ≥2 comorbidities were 47.57%, 83.13%, and 50.02%, respectively. The comparison of the three rates in two years was statistically significant (P＜0.006).The comorbidity of chronic diseases in the elderly accounted for more than 58.32%. The physical examination rate of the elderly is higher in women than in men, and higher in rural areas than in urban areas. The prevalence of chronic diseases is higher in women than in men, and the prevalence of chronic diseases is gradually increasing as the elderly ages. The prevalence of chronic diseases in people with normal BMI is lower than those with abnormal BMI, and the prevalence tend increased gradually with the increase of BMI in abnormal people. Hypertension (70.75%), hyperlipidemia (24.97%), diabetes (16.61%), osteoarthropathy (12.65%), hyperuricemia (9.35%), stroke (8.32%), eyes and appendages (5.88%)ranked the same in 2016 and 2018. Except for hyperuricemia, the prevalence of the other six diseases decreased in 2018 compared with 2016. Conclusion The prevalence of chronic diseases in the elderly ≥65 years old in Xinzhou District is relatively high, showing a slow upward trend. About 50.00% of the elderly suffer from comorbidities. The situation of chronic disease prevention and control is still severe. It is recommended to develop comprehensive prevention and control interventions among this population.

ObjectiveTo investigate the effect of the combined application of organic fertilizer and chemical fertilizer at different ratios on the growth， yield and quality of two-year-old Belamcanda chinensis and provide a scientific basis for fertilization to achieve high yield and quality of this medicinal plant. MethodIn a field plot experiment， we designed five fertilization patterns with organic fertilizer and chemical fertilizer at different ratios： OM₀ （pure chemical fertilizer）， OM₁ （30% organic fertilizer + chemical fertilizer， application of organic fertilizer at 2 567 kg·hm^-2）， OM₂ （50% organic fertilizer + chemical fertilizer， application of organic fertilizer at 4 283 kg·hm^-2）， OM₃ （70% organic fertilizer + chemical fertilizer， application of organic fertilizer at 6 000 kg·hm^-2）， and OM₄ （pure organic fertilizer， 8 567 kg·hm^-2）. The effect of different fertilization patterns on the agronomic properties， herb yield， flavonoid content， mineral element content， and fertilizer utilization rate of B. chinensis were determined. ResultThe combined application of organic fertilizer and chemical fertilizer at an appropriate ratio increased the leaf width and promoted tillering， thereby improving the yield of B. chinensis. The yield of OM₁ and OM₂ groups increased by 6.65% and 13.10%， respectively， compared with that of OM₀ group， while too high a proportion of organic fertilizer led to a decrease in yield. With organic fertilizer application， the content of mangiferin， tectoridin， iridin， tectorigenin， irigenin， and irisflorentin in the rhizomes of B. chinensis increased. Moreover， a certain proportion of organic fertilizer facilitated the accumulation of functional elements such as K， Fe and Cu. The results of the principal component analysis showed that the overall quality of B. chinensis was ranked in the order of OM₃ > OM₂ > OM₁ > OM₄ > OM₀. The OM₂ group had the maximum accumulation of N， P and K and the maximum partial factor productivity of fertilizer. ConclusionAccording to the agronomic traits， yield， quality indexes and fertilizer utilization rate of B. chinensis under different fertilization patterns， we recommended to apply 4 283 kg·hm^-2 organic fertilizer in combination with chemical fertilizer to the production of two-year-old B. chinensis， so as to improve the quality and yield of B. chinensis.

ObjectiveTo clarify the accumulation and distribution characteristics of dry matter and mineral elements in Artemisia argyi var. argyi cv. Qiai， and to provide technical support for the high yield of and efficient utilization of nutrients in this medicinal species. MethodTwo cultivars of this species， Qiqing 1 and Qihuang 1 were selected， and the composition of dry matter in different organs， the content， accumulation， and distribution of mineral elements in each organ of the two cultivars， and the dynamic changes of volatile oil content and index components eucalyptol and borneol in leaves of the two cultivars were monitored at different growth stages. ResultThe period from February to March marked the early growth stage of Qiai， and the dry matter was mainly distributed in the leaves. It accelerated the growth in April， and the period from April to mid-June witnessed the vigorous vegetative growth of Qiai， during which the dry matter was mainly found in the stems and leaves. It began the reproductive growth from late June and the dry matter was mainly distributed in the stems. In the flowering stage in August， no dry matter accumulation occurred. As for the volatile oil， the content was high （> 1.10%） at the vigorous vegetative growth stage and peaked on June 14 （1.33% in Qiqing 1， and 1.23% in Qihuang 1）. The relative mass fraction of eucalyptol was the maximum at the vegetative growth stage （8.67% in Qiqing 1， and 13.07% in Qihuang 1）. The relative mass fraction of borneol peaked at the early growth stage （2.63% in Qiqing 1， and 5.94% in Qihuang 1）. The content of nitrogen， phosphorus， potassium， and zinc in leaves was in significantly positive correlation with the content of volatile oil and the relative content of eucalyptol and borneol. The content of macroelements nitrogen， phosphorus， potassium， and calcium and trace elements iron and zinc peaked at the early growth stage， and the content was the highest in stem and leaf. The content of macroelement magnesium and trace elements manganese and copper was the highest at vegetative growth stage when the content of other elements decreased and the nutrients were gradually transferred to the buds， flowers and other organs. In the whole growth period， the distribution of potassium， calcium， and zinc was in the order of leaf > stem > root， and the distribution of nitrogen， phosphorus， copper， magnesium， and manganese followed the order of leaf > root > stem. The distribution of iron was in the order of root > leaf > stem. There was a significantly positive correlation between the total amount of dry matter and the absorption of nutrients in 'Qiai'. The absorption of macroelements by Qiai was in the order of potassium > nitrogen > calcium > phosphorus > magnesium， and the ratio of absorbed elements was about 2.66∶2.51∶0.6∶0.11∶0.04. The absorption of trace elements followed the order of manganese > iron > zinc > copper， and the ratio of absorbed elements was about 0.25∶0.17∶0.05∶0.04. In terms of the production of medicinal materials， 'Qiai' needed about 4.11 kg potassium， 3.58 kg nitrogen， 0.91 kg phosphorus， 0.18 kg calcium， 0.06 kg magnesium， about 6.64 g manganese， 2.56 g iron， 1.30 g zinc， and 0.92 g copper to produce 100 kg medicinal materials. ConclusionEnough organic fertilizer and phosphorus and potassium fertilizers should be applied as base fertilizers for Qiai. The vegetative growth stage （April-June） marks the high accumulation of dry matter and large demand of nutrients， during which topdressing should be conducted timely and early， especially nitrogen fertilizer， and appropriate amount of micro-element fertilizer should be added. Qiai needs a large amount of calcium and magnesium fertilizers from the mid-vegetative growth stage， and they should be applied in time in the late stage to ensure the vegetative growth of the plants for seeds and the quality of the medicinal material of Qiai.

Objectives:To investigate the antibacterial effects of Acinetobacter baumannii on Acinetobacter SPP. Methods:A Acinetobacter baumannii strain named SL- A.baumannii that can inhibit other Acinetobacter baumannii strains was isolated from the bronchoalveolar lavage fluid of a critically infected patient in the department of neurology, Henan Provincial Hospital on December 10, 2020. To better understand this inhibition effect, the drug resistance, homology and protein fingerprint of the new Acinetobacter baumannii strain, along with 40 other Acinetobacter SPP isolates, were analyzed. Results:Multilocus sequence typing (MLST) revealed that a novel allele combination (gltA/gyrB/gdhB/recA/cpn60/gpi/rpoD) 33, 12, 40, 26, 48, 54, 5 was found in SL- A.baumannii, and ST-2442 was assigned by PubMLST (Oxford). Moreover, 36 isolates, including 30 Acinetobacter baumannii strains, 2 Acinetobacter lwoffii strains, 3 Acinetobacter pittii strains and 1 Acinetobacter ursingii strain, were inhibited by SL- A.baumannii, the inhibition rate was 90% (36/40). Among those strains, 18 (50%) were sensitive to all the antibacterial drugs; 16 (44.44%) showed multi-drug resistance(MDR), including 2 pan-drug resistance(PDR) and 11 extensive drug resistance (XDR) strains; the other 2 (5.56%) were only resistant to Trimethoprim/Sulfamethoxazole(SXT). Conclusion:The new sequence type (ST-2442) Acinetobacter baumannii isolate SL- A.baumannii (PubMLST/Acinetobacter baumannii isolates database/id: 6942) had shown a significantinhibitory effect on Acinetobacter SPP with different drug-resistant phenotypes.

To analyze the clinical characteristics and drug resistance in patients with non-tuberculous mycobacteria (NTM) pulmonary disease in Changsha Central Hospital of Hunan Province in recent three years.
 Methods: The clinical data of 153 patients with NTM pulmonary disease, who were diagnosed in Changsha Central Hospital of Hunan Province from February 2014 to May 2017, were retrospectively analyzed. According to the concentration of drug sensitivity test, the patients were divided into a low concentration group and a high concentration group. The status of drug sensitivity and drug resistance were examined.
 Results: Among 153 patients, 79 patients (51.63%) were male, 74 patients (48.37%) were female. The mean ages were (60.27±19.46) years. The NTM pulmonary disease mainly occurred in the individuals with bronchiectasis, and the course of disease was long (mean 7.8 years). The clinical symptoms were not specific and mostly misdiagnosed as pulmonary tuberculosis (92.81%). Mycobacterium avium-intracellulare (56.21%) and mycobacterium chelonae-abscess (20.92%) were the majority. The drug-resistance rate of the first-line and second-line anti-tuberculosis drugs was high. The majority was resistant to more than eight drugs, 38.56% patients in the low concentration group were resistant to total drugs, and 25.49% patients in the high concentration group were resistant to total drugs.
 Conclusion: The NTM pulmonary disease is easily misdiagnosed, and the drug resistance rate is high. Identification of mycobacterium species and detection of drug sensitivity play an important role in clinical diagnosis and treatment.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Mycobacterium Infections, Nontuberculous ; Nontuberculous Mycobacteria ; Retrospective Studies

Objective To investigate the effect of nucleus localization signal linked nucleic kinase substrate short peptide-conjugated chitosan (NNSCS)-mediated human miR-140 gene local transfection on the repair of articular cartilage defect in rabbits.Methods Eukaryotic expression plasmid GV268-miR-140 was constructed,and then negative controls GV268 and GV268-miR-140 were respectively combined with NNSCS to form NNSCS/GV268 and NNSCS/GV268-miR-140 complexes.Eighteen healthy male New Zealand white rabbits were randomly divided into transgenic group (Group A),negative control group (Group B),and sham operation group (Group C),with 6 rabbits per group.Both Groups A and B were prepared for the total cartilage damage model of femur trochlear,and Group C only exposed the articular surface of the femur trochlear.One week after operation,Group A was treated with NNS CS/GV268-miR-140 complex,Group B was given NNS CS/GV268 complex,and Group C was given equal amount of isotonic saline,twice a week for 7 weeks.The experimental animals were sacrificed at the end of the eighth week after operation.Real time fluorescence quantitative PCR (RT-qPCR) was used to detect the expression of miR-140,Sox9,Aggrecan and Hdac4 in the defect area.HE staining,safranine O/fast green staining,and Aggrecan immunohistochemical staining were used to evaluate cartilage repair in the defect area.Results RT-qPCR showed the expression of miR-140 in Group A (3.16 ± 0.37) was significantly higher than that in Group B (1 ± 0.24) and in Group C (1.24 ± 0.18) (P ＜ 0.05).The miR-140 expression in Group A obviously up-regulated the expression of SOx9 gene (4.38 ± 0.66) compared with Group B (1.04 ± 0.04) and Group C (1.19 ± 0.3),(P ＜ 0.05).The miR-140 expression in Group A obviously up-regulated the expression of Aggrecan gene (3.63 ± 0.58) (P ＜0.05) compared with Group B (1.21 ± 0.14) and Group C (1.34 ± 0.13).The miR-140 expression in Group A obviously down-regulated the expression of Hdac4 (0.37 ±0.06) compared with Group B (0.81 ± 0.06) (P ＜ 0.05).According to results of HE staining,safranine O/fast green and Aggrecan,cartilage repair was evident in Group A,while fibrous tissue proliferation and inflammatory cell infiltration were seen in the defect region in Group B,showing no cartilage repair.Conclusions NNS CS can carry exogenous genes into chondrocytes and the genes can abundantly express locally.High expression of miR-140 might significantly improve the repair of articular cartilage defect in vivoby up-regulating expressions of Aggrecan and Sox9 as well as down-regulating Hdac4 expression.

The paper probed into the reform of healthcare personnel′s payroll system , identifying such problems as the staffing quota management system curbing rational flow of healthcare personnel ,lack of enthusiasm of such personnel ,delayed progress of the implementation of the occupational pension and the shortage of talents in urgent need.With current outcomes confirmed ,the authors recommended to remove the staffing quota system and introduce a market mechanism ;to build an income growth mechanism for higher incentives ;to enhance primary institutions′team building ,and develop talents in urgent need ;to unify social insurance standards and enhance local fiscal support .

Objective To assess the patient enablement level in a general hospital and its related factors,to investigate the relationship of patient enablement with patient's overall satisfaction and doctor's empathy levels.Methods Patients attending the Family Medicine Clinic of HKU-Shenzhen Hospital in September 2014 and met the inclusion criteria were asked to complete a questionnaire survey which included general characteristics,overall satisfaction;the Patient Enablement Instrument (PEI) and the Consultation and Relational Empathy Measure Scale (CARE) after the consultation.Results Total 2 326 questionnaires were issued and 1 818 were retrieved,of which 1 478 were qualified questionnaires.The qualified rate of PEI was 81.3％ and the qualified rate of patient overall satisfaction was 96.28％.The positive rate of patient enablement was 97.70％ (1 444/1 478),and the mean score of PEI was 8.21 ±3.33.Multivariate linear regression analysis showed that the PEI scores were not influenced by gender and education level of the patients,gender of the consulting doctors and initial/follow up consultation.The PEI scores were influenced by the age of the patients,the types of clinic (general practice/chronic practice clinic) and the reasons for consulting (P ＜ 0.05).There were correlations between PEI score and overall satisfaction of patients (r =0.383,P ＜ 0.001),patient's recommendation of the clinic (r =0.595,P ＜ 0.001) and CARE scores (r =0.546,P ＜ 0.001).Conclusion The results show that the PEI scores of patients visiting family medicine clinic of this hospital are higher than those reported in other studies.The PEI score may be influenced by the age of the patients,the types of clinic and the reasons for consulting.Positive correlations between patient enablement and the overall satisfaction,patient's recommendation and doctor empathy were observed.

Objective To assess the empathy level of general practitioners (GPs) in the outpatient clinics of a general hospital,and to investigate the related factors.Methods Patients attending the Family Medicine Clinic of HKU-Shenzhen Hospital in September 2014 and met the inclusion criteria were asked to complete the questionnaire which included general characteristics,overall satisfaction and the Measure-Consultation and Relational Empathy Measure (CARE) Scale after the consultation.Results Of the 1 818 questionnaires retrieved,1 690 CARE scales were completed (intact rate was 92.96%).The overall satisfaction rate was 95.92% (1 621/1 690).And 97.28% (1 644/1 690) of the patients would recommend family medicine service to their friends or relatives.The total score of CARE scale was (45.47±6.26),and the scores of 4 CARE components were (4.63 ± 0.59),(4.43 ± 0.81),(4.54 ± 0.69) and (4.55 ± 0.66),which showed significant difference (P<0.01).The multivariate linear regression analysis showed that the mean CARE scores were not influenced by gender and education levels of the patients,gender of the consulting doctors,initial/follow up consultation,and the location of the consultation.The mean CARE scores were influenced by age of patients and the reasons for consulting (P<0.05).There was a moderate correlation of the CARE scores with the overall satisfaction of patients (r=0.613,P<0.001) and patient's recommendation of the clinic (r=0.466,P<0.001).Conclusion Doctors who were evaluated in this study have a higher empathy level than results from other countries.There is positive correlation between doctor's empathy level and patient's overall satisfaction.The result of doctor's empathy level may be influenced by patient's age and the reasons for consulting.

Since γH2 AX was firstly found in 1998 , it has been one of the most important scientific topics and research tools in the related scientific fields. At present, a series of advanced testing methods and analytical technologies have been developed, which exhibited a quite attractive application prospect in the area of life science and medical science. This paper reviewed the latest progress about γH2AX in terms of molecular mechanism of phosphorylation/dephosphorylation, development of testing technologies, and the related applications.