Objective To understand the pathogen detection of hospitalized patients before antimicrobial therapy in a hospital through implementation of comprehensive intervention measures,and provide reference basis for the de-velopment of targeted measures.Methods Hospitalized patients who received therapeutic antimicrobial agents in this hospital were selected as the research subjects.Patients who were hospitalized from January to May 2022 were selected as the pre-intervention group,comprehensive intervention measures were taken from June to October 2022,and those who were hospitalized from November 2022 to March 2023 were selected as the post-intervention group.The pathogen detection rate before antimicrobial therapy,sterile specimen detection rate,antimicrobial use rate,de-tection rate of key multidrug-resistant organisms of patients before and after the intervention were analyzed.Results Compared to before intervention,the proportion of pathogen detection rate before antimicrobial therapy(62.09％vs 74.04％),detection rate of healthcare-associated infection diagnosis-related pathogens(62.82％vs 92.73％),and sterile specimen detection rate(35.17％vs 41.06％)of hospitalized patients after intervention all increased signifi-cantly,with statistically significant differences(all P＜0.05).After intervention,pathogen detection rate before the combination use of key antimicrobial agents was not statistically different from before intervention(93.33％vs 90.48％,P＞0.05),while antimicrobial use rate was lower than before intervention(39.93％vs 44.95％,P＜0.05).There was no statistically significant difference in the detection rate of key multidrug-resistant organisms be-fore and after intervention(all P＞0.05).Conclusion Adopting scientific and rational intervention measures can improve the pathogen detection rate,provide a reference basis for the rational use of antimicrobial agents.There was no significant improvement in the pathogen detection rate before the combination use of key antimicrobial agents and the detection rate of key multidrug-resistant organisms,indicating that relevant measures still need to be further optimized.

Objective To observe the course and diameter of facial artery branches and its adjacent structures in nasolabial groove area and the positional relationship,so as to provide reference for clinicians to carry out facial cosmetic repair surgery.Methods A total of 40 adult head and neck specimens were dissected on the spot,and the course and position of the facial artery branches,facial vein and facial nerve in the nasolabial groove area were observed,their diameters were measured,and relevant data were recorded.Results There were 4 types of facial artery branches in the nasolabial groove area:type Ⅰ(upper lip type)accounted for 12.5%,type Ⅱ(nasal type)accounted for 62.5%,type Ⅲ(classical type)accounted for 20.0%,and type Ⅳ(double severe type)accounted for 5.0% .There were 4 kinds of positional relationship between the facial artery and the facial vein in the nasolabial groove area:42.5% of the orofacial artery was located on the medial side of the facial vein,32.5% of the orofacial artery was located on the lateral side of the facial vein,17.5% of the two were close to and wrapped in a fascial sheath,7.5% of the orofacial artery and the main trunk of the facial vein were crossed,and the vein was located in the deep surface of the artery.There were 3 kinds of positional relationship between the facial artery and the marginal mandibular branch of the facial nerve:87.5% of the facial artery was deep on the marginal mandibular branch of the facial nerve,7.5% of the facial artery was superficial on the marginal mandibular branch of the facial nerve,and 5.0% of the facial artery was held or surrounded by two branches of the marginal mandibular branch of the facial nerve on the superficial or deep surface.Conclusion The positional relationship among facial artery,facial vein and facial nerve in the nasolabial groove area is complicated.Familiarity with its positional relationship can avoid damaging blood vessels and nerves during the nasorabial groove surgery,reduce surgical complications and improve surgical safety.

Objective:To study correlation between high density lipoprotein-cholesterol(HDL-C)and red cell dis-tribution width(RDW)in patients with coronary heart disease(CHD).Methods:According to coronary stenotic severity,a total of 151 patients undergoing coronary CT angiography in our hospital were divided into CHD group(n=72)and non-CHD group(n=79).General clinical data were compared between two groups.Correlation be-tween HDL-C and RDW,influencing factors of CHD and diagnostic value of HDL-C and RDW for CHD were analyzed.Results:Compared with non-CHD group,there were significant rise in percentage of diabetes mellitus,age,serum triglyceride(TG)level and RDW,and significant reduction in serum HDL-C level in CHD group(P＜0.05 or＜0.01).Pearson correlation analysis indicated that serum HDL-C level was significant inversely correla-ted with RDW(r=-0.373,P=0.001),and there was a significant negative correlation between two indexes in CHD group and non-CHD group(r=-0.415,-0.243,P=0.001,0.031).Multivariate Logistic regression a-nalysis indicated that TG and RDW were independent risk factors for CHD(OR= 1.794,1.588,P=0.030,0.020),and HDL-C was its independent protective factor(OR=0.212,P=0.036).ROC curve indicated that AUC of combined detection of HDL-C and RDW diagnosing CHD was 0.674,its sensitivity was 58.33%and spe-cificity was 70.89%.Conclusion:RDW possesses certain diagnostic value for patients with coronary heart disease.

OBJECTIVES: To investigate the incidence of extrauterine growth retardation (EUGR) and its risk factors in very preterm infants (VPIs) during hospitalization in China. METHODS: A prospective multicenter study was performed on the medical data of 2 514 VPIs who were hospitalized in the department of neonatology in 28 hospitals from 7 areas of China between September 2019 and December 2020. According to the presence or absence of EUGR based on the evaluation of body weight at the corrected gestational age of 36 weeks or at discharge, the VPIs were classified to two groups: EUGR group (n=1 189) and non-EUGR (n=1 325). The clinical features were compared between the two groups, and the incidence of EUGR and risk factors for EUGR were examined. RESULTS: The incidence of EUGR was 47.30% (1 189/2 514) evaluated by weight. The multivariate logistic regression analysis showed that higher weight growth velocity after regaining birth weight and higher cumulative calorie intake during the first week of hospitalization were protective factors against EUGR (P<0.05), while small-for-gestational-age birth, prolonged time to the initiation of total enteral feeding, prolonged cumulative fasting time, lower breast milk intake before starting human milk fortifiers, prolonged time to the initiation of full fortified feeding, and moderate-to-severe bronchopulmonary dysplasia were risk factors for EUGR (P<0.05). CONCLUSIONS It is crucial to reduce the incidence of EUGR by achieving total enteral feeding as early as possible, strengthening breastfeeding, increasing calorie intake in the first week after birth, improving the velocity of weight gain, and preventing moderate-severe bronchopulmonary dysplasia in VPIs.
Female ; Fetal Growth Retardation ; Gestational Age ; Hospitalization ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Prospective Studies ; Risk Factors

Actinin/genetics* ; Anemia ; Blood Platelets/pathology* ; Female ; Humans ; Male ; Megakaryocytes ; Mutation, Missense ; Pedigree ; Thrombocytopenia/genetics*

In this paper， the key technical problems in the research and development of famous classical formulas are analyzed. Firstly， the puzzled problem for a long-time， which is conversion relationship from medicinal metrology of Han dynasty （HD） to that of modern （gram，g）， is comprehensively expounded that one Liang （两） of HD=3 g is more appropriate. Secondly， the model and principles of quality consistency evaluation are given for the transformation from the quality of authoritative basic sample prepared by casserole （ABS-C） to the quality consistency in Laboratory process， pilot-scale process and industrial production. The consistency evaluation model is ξ_ABS-X=K₁（Q₁^ABS-X/Q₁^ABS-C）+K₂（Q₂^ABS-X/Q₂^ABS-C）+……+K_i（Q_i^ABS-X/Q_i^ABS-C）=∑K_i（Q_i^ABS-X/Q_i^ABS-C）（i=1，2，3……n）. In the formula， ABS-X means laboratory reference sample ABS-C （ABS-L）， pilot-scale ABS-C （ABS-mP） or industrial production ABS-C （ABS-P）， ξ_ABS-X means the quality consistency rate or similarity degree of ABS-L， ABS-mP and ABS-P processes with ABS-C， K_i means the weight of each quality evaluation index （i）， Q_i^ABS-X is the data of i in ABS-L， ABS-mP， ABS-P samples， and Q_i^ABS-C is the data （or mean） of i in ABS-C sample. Thirdly， in order to control the quality of the herbal medicines whose active ingredients were unknown， their chemical constituents should be studied deeply， and if necessary， the bioassay research should be carried out according to the main efficacy or indication of famous classical formulas. Finally， for the special processing of some herbal medicines， it is difficult to formulate the processing method， technology and standard of prepared slices. It is suggested that the scientific connotation and historical evolution of the special processing method should be thoroughly sorted out， and its technological characteristics are summarized， the modern processing technology and production processes are simulated， and then the corresponding processing methods and quality standards are formulated.

Atractylodis Rhizoma is a kind of commonly used clinical Chinese medicine （TCM）， which was first recorded in Shennong Bencaojing （《神农本草经》）. At that time， it was called "Zhu"， which is the general name of Atractylodis Rhizoma and Atractylodis Macrocephalae Rhizoma. After Song dynasty， Atractylodis Rhizoma and Atractylodis Macrocephalae Rhizoma were separated. Atractylodis Rhizoma can be divided into Atractylodes lancea and A. chinensis. In history， A. lancea as authentic， that its quality is better than A. chinensis. However， the quality of Atractylodis Rhizoma was evaluated by the index component atractylodin in the 2020 edition of Chinese Pharmacopoeia. The general results showed that the content of atractylodin in A. lancea was low， even failed to meet the specified standard， and its content in A. chinensis was significantly higher than that in A. lancea. The results were inconsistent with the records of ancient books and documents， and the quality theory of "genuine medicine is the best". It could not reflect the quality advantage of genuine Atractylodis Rhizoma， and may even affect the clinical application and development momentum of genuine medicine. In short， the quality standard of TCM should not only conform to the historical experience， but also have the connotation of modern science and technology， which can stand the test of practice. Based on this， the author intends to sort out relevant laws and regulations， sort out the literature related to the authenticity， composition and efficacy of Atractylodis Rhizoma， and analyze the rationality of the current standard of Atractylodis Rhizoma by integrating the relevant records of historical classics and modern research results， so as to provide a basis for the improvement of the quality standard of Atractylodis Rhizoma.

Colchicine/therapeutic use* ; Coronary Artery Disease ; Coronary Disease/prevention & control* ; Humans ; Plaque, Atherosclerotic

Objective: To analyze the clinical characteristics of children with Burkitt lymphoma (BL) and to summarize the mid-term efficacy of China Net Childhood Lymphoma-mature B-cell lymphoma 2017 (CNCL-B-NHL-2017) regimen. Methods: Clinical features of 436 BL patients who were ≤18 years old and treated with the CNCL-B-NHL-2017 regimen from May 2017 to April 2021 were analyzed retrospectively. Clinical characteristics of patients at disease onset were analyzed and the therapeutic effects of patients with different clinical stages and risk groups were compared. Survival analysis was performed by Kaplan-Meier method, and Cox regression was used to identify the prognostic factors. Results: Among 436 patients, there were 368 (84.4%) males and 68 (15.6%) females, the age of disease onset was 6.0 (4.0, 9.0) years old. According to the St. Jude staging system, there were 4 patients (0.9%) with stage Ⅰ, 30 patients (6.9%) with stage Ⅱ, 217 patients (49.8%) with stage Ⅲ, and 185 patients (42.4%) with stage Ⅳ. All patients were stratified into following risk groups: group A (n=1, 0.2%), group B1 (n=46, 10.6%), group B2 (n=19, 4.4%), group C1 (n=285, 65.4%), group C2 (n=85, 19.5%). Sixty-three patients (14.4%) were treated with chemotherapy only and 373 patients (85.6%) were treated with chemotherapy combined with rituximab. Twenty-one patients (4.8%) suffered from progressive disease, 3 patients (0.7%) relapsed, and 13 patients (3.0%) died of treatment-related complications. The follow-up time of all patients was 24.0 (13.0, 35.0) months, the 2-year event free survival (EFS) rate of all patients was (90.9±1.4) %. The 2-year EFS rates of group A, B1, B2, C1 and C2 were 100.0%, 100.0%, (94.7±5.1) %, (90.7±1.7) % and (85.9±4.0) %, respectively. The 2-year EFS rates was higher in group A, B1, and B2 than those in group C1 (χ²=4.16, P=0.041) and group C2 (χ²=7.21, P=0.007). The 2-year EFS rates of the patients treated with chemotherapy alone and those treated with chemotherapy combined with rituximab were (79.3±5.1)% and (92.9±1.4)% (χ²=14.23, P<0.001) respectively. Multivariate analysis showed that stage Ⅳ (including leukemia stage), serum lactate dehydrogenase (LDH)>4-fold normal value, and with residual tumor in the mid-term evaluation were risk factors for poor prognosis (HR=1.38,1.23,8.52,95%CI 1.05-1.82,1.05-1.43,3.96-18.30). Conclusions: The CNCL-B-NHL-2017 regimen show significant effect in the treatment of pediatric BL. The combination of rituximab improve the efficacy further.
Adolescent ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Burkitt Lymphoma/drug therapy* ; Child ; Disease-Free Survival ; Female ; Humans ; Lactate Dehydrogenases ; Lymphoma, B-Cell/drug therapy* ; Male ; Prognosis ; Retrospective Studies ; Rituximab/therapeutic use* ; Treatment Outcome

Objective: To evaluate the efficacy of the Hodgkin lymphoma (HL)-2013 regimen in the treatment of children with HL, and to investigate the prognostic factors of childhood HL. Methods: Clinical data of 145 children (aged ≤18 years) with newly diagnosed HL, treated with HL-2013 regimen in 8 tertiary referral centers for childhood cancer from August 2011 to April 2021 were analyzed retrospectively. All the diagnosis were confirmed by histopathological morphology and immunohistochemical examination. The clinical characteristics and treatment outcomes were summarized, and the patients were divided into different groups according to clinical characteristics. Kaplan-Meier method was used for survival analysis, and the comparison of survival rates between groups was performed with Log-rank test. Results: Of the 145 cases, there were 115 males and 30 females, the age at diagnosis was 7.9 (5.8, 10.6) years. Cervical lymph node enlargement (114 cases, 78.6%) was the common symptom of the disease, and 57 patients (39.3%) were accompanied by large masses. The most common pathological classification was mixed cell type (93 cases, 64.1%). According to the Ann Arbor staging system, there were 9 cases of stage Ⅰ, 62 cases of stage Ⅱ, 45 cases of stage Ⅲ, 29 cases of stage Ⅳ. According to the risk stratification: there were 14 cases of low-risk group, 76 cases of medium-risk group and 55 cases of high-risk group. Of all patients, 68 cases (46.9%) achieved an early complete remission (CR) after 2 courses of chemotherapy, and the CR rate was 93.8% (136/145) after first-line treatment. Disease recurrence or progression occurred in 22 cases (15.2%). Of all patients, 125 cases survived, 6 cases died and 14 cases were lost to follow-up. Among the survived cases, 123 cases were continuously at CR state,and the follow-up time was 55 (40, 76) months. The 5-year overall survival (OS) and event free survival (EFS) rates were (95.3±1.9)% and (84.2±3.0)% for the entire group, respectively. 5-year OS and EFS rates for patients with stage Ⅲ-Ⅳ were both lower than those for patients with stage Ⅰ-Ⅱ (χ²=6.28 and 7.58, both P<0.05), the 5-year OS and EFS rates for patients in high-risk group were both lower than those for patients in low-risk and medium-risk group (χ²=10.93, 7.79, both P<0.05). The 5-year OS rates for the patient with early CR and without early CR were 100.0% and (90.9±3.6)% (χ²=5.77, P=0.016). EFS rates for the patient with early CR (68 cases) and without early CR (77 cases) were (93.8±3.0)% and (75.8±5.0)% (χ²=8.78, P=0.003). Conclusions: HL-2013 regimen is significantly effective in the treatment of pediatric HL. However, the patients in high-risk group and those without early CR are prone to disease recurrence or progression. Stage Ⅲ-Ⅳ and without early CR were associated with worse prognosis.
Child ; Female ; Male ; Humans ; Hodgkin Disease ; Retrospective Studies ; Neoplasm Recurrence, Local ; China ; Antineoplastic Combined Chemotherapy Protocols ; Prognosis ; Disease-Free Survival