Factors affecting depressive symptoms among patients withcolorectal cancer in Chengdu City / 预防医学

Objective@#To investigate the factors affecting the depressive symptoms among patients with colorectal cancer in Chengdu City, so as to provide insights into mental health improvement among colorectal cancer patients.@*Methods@#Patients with colorectal cancer were enrolled from three hospitals in Chengdu City using the convenient sampling method. The basic information, life styles and cancer diagnosis and therapy were collected, and the depressive symptoms were evaluated using the Zung Self-Rating Depression Scale ( SDS ). In addition, factors affecting the depressive symptoms were identified using the multivariable logistic regression analysis.@*Results@#A total of 384 patients with colorectal cancer were enrolled, including 247 men ( 64.32% ), and the subjects had a mean age of ( 57.47±11.39 ) years and a mean SDS score of 37.73±9.15. The detection rate of depressive symptoms was 15.36%. Multivariable logistic regression analysis showed that colorectal cancer patients with a history of radiotherapy had a high risk of developing depressive symptoms ( OR=0.468, 95%CI: 0.245-0.895 ), while patients with alcohol consumption ( OR=0.407, 95%CI: 0.172-0.963 ) and drinking tea ( OR=0.470, 95%CI: 0.244-0.904 ) had a low risk of developing depressive symptoms.@*Conclusions@#The detection of depressive symptoms is 15.36% among patients with colorectal cancer in Chengdu City, and a history of radiotherapy, alcohol consumption and drinking tea affect the development of depressive symptoms among patients with colorectal cancer.

Status analysis on microbial contamination of Chinese herbal decoction pieces / 国际中医中药杂志

This paper summarized and analyzed the literature about microbial contamination of Chinese herbal decoction pieces, which analyzed that the pollution status of the total aerobic microbial count (TAMC), the total yeast and mould count (TYMC), the contamined status of the controling bacteria and the heat-resistant bacteria, and analyzed the characteristics of microbial contamination based on different sources, species of the samples and processing methods, etc. It’s found that the general microbial contamination of Chinese herbal decoction pieces at present is quite serious. Foreign standards of pharmacopoeia can be used for reference to establish an individualized microbial limit standard of Chinese herbal decoction pieces, and it is necessary to enlarge the data based on microbial contamination of Chinese herbal decoction pieces.

C-Reactive Protein Gene Variants in Depressive Symptoms & Antidepressants Efficacy

OBJECTIVE: Although the pathogenesis of depression remains unclear, C-reactive protein (CRP) levels are commonly elevated in depressed patients. Thus, CRP single-nucleotide polymorphisms (SNPs) that influence CRP levels may be associated with depression. In the present study, we explored whether CRP SNPs are related to depressive symptoms and antidepressants efficacy in Han Chinese patients.METHODS: We analyzed data from 440 patients with first-episode depression. We obtained genome CRP SNPs, scores of the 17-item Hamilton Rating Scale for Depression 17 (HAMD17) and its four-factor at baseline and after 6 weeks. Quantitative trait analysis was performed using UNPHASED software and curative effects were analyzed using SPSS software.RESULTS: Male patients with SNP rs1800947G exhibited lower insomnia scores and rs2794521CC exhibited lower scores of anxiety/ physical symptoms, total HAMD17 score. Female patients with rs2794521TT exhibited higher scores of insomnia and lower antidepressants efficacy.CONCLUSION: CRP SNPs rs1800947 and rs2794521 may be associated with depressive symptoms in patients with depression in a sex-specific fashion. Furthermore, rs2794521 may be a predictor of the efficacy of antidepressants in female patients.

Cost-effectiveness analysis of cervical cancer screening strategies in urban China / 中华肿瘤杂志

Objective@#To explore the most economically feasible cervical cancer screening strategies in urban China.@*Methods@#A series of Markov models were constructed to evaluate health and economic outcomes of different screening strategies. There were 24 screening strategies including four screening methods: liquid-based cytology (LBC), human papillomavirus (HPV) DNA genotyping, HPV DNA genotyping with LBC triage (HPV DNA+ LBC), HPV DNA genotyping and LBC co-testing (HPV DNA-LBC), along with three intervals (every 1, 3 or 5 years) and two starting age for screening (30 or 35 years old) were compared. Models parameters were obtained from a cervical cancer screening study in urban China and literature reviews.@*Results@#The cumulative incidence and mortality risk of cervical cancer declined over 69% and 82% respectively for each screening strategy as compared with the no screening scenario. LBC every five years starting from 35 years old strategy cost the least (RMB 690 per capita) and could save life years compared with no screening. The cost effectiveness ratios of 24 strategies ranged from -10 903 to 117 992 RMB per life year saved. All strategies were cost-effective compared to no screening. In the incremental cost-effectiveness analysis, LBC every 5 years starting from 30 strategy, HPV DNA genotyping every 3 years starting from 30 strategy, LBC every 3 years starting from 30 strategy and LBC every year starting from 30 strategy were dominant strategies.@*Conclusions@#Screening can effectively prevent cervical cancer. In urban Chinese areas with insufficient socioeconomic resources, LBC every 5 years from 35 years old strategy is recommended. In relatively more affluent areas, LBC every 5 years from 30 years old strategy, LBC every 3 years from 30 years old strategy, HPV DNA genotyping every 3 years from 30 years old strategy, and LBC every year from 30 years old strategy are recommended successively.

Economic evaluation of fifteen cervical cancer screening strategies in rural China / 中华妇产科杂志

Objective To evaluate the feasible cervical cancer screening strategies in rural China. Methods The study was based on the health industry scientific research project of National Health Commission in 2015, cervical cancer screening technology and demonstration research suitable for rural areas in China, we collected health economics and epidemiological parameters and established the unscreening model and screening model with Treeage Pro 2011 software. Combining with the data acquired from site investigation, including population screening, treatment-related clinical materials and cost data, we simulated the occurrence and the development of cervical cancer of rural women in China under different screening and intervention programs and predicted the screening effects [cumulative incidence, cumulative risk of disease, life years and quality adjusted life years (QALY), gains] and costs after 20 years, and using health economic evaluation analysis (cost-effectiveness analysis, cost-utility analysis, cost-benefit analysis). Screening programs included five screening strategies [visual inspection with acetic acid/lugol's iodine (VIA/VILI), careHPV, ThinPrep cytology test (TCT), careHPV+TCT, careHPV+VIA/VILI] and three screening intervals (1-year, 3-year, 5-year), a total of fifteen screening programs. Results Compared with no screening, fifteen screening programs reduced the cumulative incidence by 22.65%-51.76%. Compared with TCT or VIA/VILI, for the same screening interval, the reduced cumulative incidence, the amounts of life-year saved and QALY and benefits gained of careHPV were the highest. The cost-effectiveness ratios of these screening programs ranged (0.44-3.24)×104 Yuan per life-year saved, cost-utility ratios ranged (0.15-1.01)×104 Yuan per QALY, benefit-cost ratios ranged 7.73-59.10. The results of incremental cost-effectiveness ratios showed that VIA/VILI every five years, VIA/VILI every three years, careHPV every five years, careHPV every three years and careHPV every year were dominant programs. Conclusions VIA/VILI screening is cost-effective, careHPV is slightly more expensive but more effective. In rural China, careHPV screening every five years could be recommended. This study provides a basis for the determination of cervical cancer screening methods feasible for rural areas in China.

Analysis of the Development Status of Neuropsychiatric Therapeutic Drug Monitoring in Terms of the External Quality Evaluation / 中国药房

OBJECTIVE： To analyze the development status of neuropsychotropic therapeutic drug monitoring （TDM）， and to provide reference for improving the quality of TDM in neuropsychiatry department. METHODS： The laboratory data of neuropsychotropic TDM external quality assessment （EQA） were collected from Website of Clinical Laboratory Center of Ministry of Health （http：//www.clinet.com.cn） during 2008-2017， and then analyzed statistically in respects of TDM project， the number of involved laboratory， monitoring method， etc. RESULTS： By the end of 2017， the Clinical Laboratory Center of the Ministry of Health had conducted 5 neuropsychiatric TDM projects involving 4 drugs， including 3 items of serum TDM （carbamazepine， valproic acid， phenytoin）， lithium ion monitoring （lithium carbonate） in biochemical routine and newly added pharmacokinetic laboratory biological sample monitoring （carbamazepine） in 2014. From 2008 to 2017， the number of involved laboratories increased from 209 to 603， with carbamazepine （serum， plasma） and valproic acid showing good annual growth trend， exceeding 200 and phenytoin 107， but only 27 in lithium carbonate until 2017. Among all monitoring methods of involved laboratories， the number of laboratories which adopted fluorescence polarization immunoassay （FPIA） decreased year by year. By the end of 2017， there were fewer than 10 laboratories. The number of laboratories using acridinium direct chemiluminescence， enzyme-multiplied immunoassay technique （EMIT）， and high performance liquid chromatography （HPLC） had steadily increased. By the end of  2017， acridinium direct chemiluminescence was the most used in laboratory， followed by EMIT and HPLC. CONCLUSIONS： Due to the increasing number of participating laboratories， it can be seen that the consciousness of quality control of laboratory personnel is increasing day by day； but the complexity of TDM monitoring methods limits the types of drugs used in external quality evaluation. It is suggested to formulate guidelines， quality control standards and operation rules as soon as possible， so as to ensure the accuracy of test results.

Economic evaluation of fifteen cervical cancer screening strategies in rural China / 中华妇产科杂志

Objective@#To evaluate the feasible cervical cancer screening strategies in rural China.@*Methods@#The study was based on the health industry scientific research project of National Health Commission in 2015, cervical cancer screening technology and demonstration research suitable for rural areas in China, we collected health economics and epidemiological parameters and established the unscreening model and screening model with Treeage Pro 2011 software. Combining with the data acquired from site investigation, including population screening, treatment-related clinical materials and cost data, we simulated the occurrence and the development of cervical cancer of rural women in China under different screening and intervention programs and predicted the screening effects [cumulative incidence, cumulative risk of disease, life years and quality adjusted life years (QALY) , gains] and costs after 20 years, and using health economic evaluation analysis (cost-effectiveness analysis, cost-utility analysis, cost-benefit analysis). Screening programs included five screening strategies [visual inspection with acetic acid/lugol's iodine (VIA/VILI), careHPV, ThinPrep cytology test (TCT), careHPV+TCT, careHPV+VIA/VILI] and three screening intervals (1-year, 3-year, 5-year), a total of fifteen screening programs.@*Results@#Compared with no screening, fifteen screening programs reduced the cumulative incidence by 22.65%-51.76%. Compared with TCT or VIA/VILI, for the same screening interval, the reduced cumulative incidence, the amounts of life-year saved and QALY and benefits gained of careHPV were the highest. The cost-effectiveness ratios of these screening programs ranged (0.44-3.24)×104 Yuan per life-year saved, cost-utility ratios ranged (0.15- 1.01)×104 Yuan per QALY, benefit-cost ratios ranged 7.73-59.10. The results of incremental costeffectiveness ratios showed that VIA/VILI every five years, VIA/VILI every three years, careHPV every five years, careHPV every three years and careHPV every year were dominant programs.@*Conclusions@#VIA/VILI screening is cost-effective, careHPV is slightly more expensive but more effective. In rural China, careHPV screening every five years could be recommended. This study provides a basis for the determination of cervical cancer screening methods feasible for rural areas in China.

Study on direct economic burden and influencing factors in patients with cervical cancer and precancerous lesions / 中华预防医学杂志

Objective@#To account the direct cost of uterine cervix carcinoma treatment in China and to explore the related factors which influence the direct financial burden of the disease.@*Methods@#Data was collected through the medical record system and telephone interviews in 14 county-level hospitals and 9 provincial and municipal hospitals from 14 provinces/municipalities enrolled in the Chinese National Health Industry Research Project in 2015. The direct financial burden of uterine cervix carcinoma treatment consisted of the direct medical cost and the direct non-medical cost of treatment in different pathological cervical cancer stages and precancerous lesions. Multiple liner regression method was used to analyze the factors affecting the costs.@*Results@#The age of the 3 246 patients was (46.40±10.43) years, including 2 423 patients from provincial and municipal hospitals and 823 patients from county-level hospitals. The direct financial burden for one patient of pathological uterine cervix carcinoma stage or precancerous lesion ranged from 10 156.3 yuan to 75 716.4 yuan in provincial and municipal hospitals, and for patients from county-level hospitals, the cost was between 4 927.9 yuan and 47 524.8 yuan per person. There was a wide gap between the direct financial burden of patients in different disease stages. The direct financial burden of patients with precancerous lesions ranged from 4 927.9 yuan per person to 11 243.0 yuan per person, as for patients of pathological uterine cervix carcinoma stages, the direct financial burden was between 29 274.6 yuan and 75 716.4 yuan per person. The factors which influence direct financial burden would include: the levels of the hospital, pathological period, medicare reimbursement, days of treatment, and the methods of treatment (P<0.001).@*Conclusion@#The direct financial burden of diseases in patients with pathological uterine cervix carcinoma stage or precancerous lesion differed in different levels of hospital and pathological periods. In addition, medicare reimbursement, days of treatment, and the methods of treatment all had impact on it.

Effect of Mepilex on postoperative skin reactions and phlebitis for peripherally inserted central catheter in critical patients / 中国实用护理杂志

Objective To compare the clinical effect of two different kinds of wound dressing on postoperative skin reactions and phlebitis for PICC in critical patients. Methods A total of 313 PICC critical patients were divided into control group (157 cases) and treatment group (156 cases) by random digits table method. After PICC, the control group was attached to transparent dressing, the experimental group was attached to Mepilex, all of the patients were received routine nursing. The incidences of adverse effect, and the degree of local skin pruritus by Visual Analogue Scale(VAS) were compared in two weeks. Results The incidence of skin allergy, infection, and mechanical phlebitis were 24.20%(38/157), 10.83%(17/157), 18.47%(29/157) in control group and 7.69%(12/156),4.49%(7/156), 3.21%(5/156) in treatment group, and there were significant differences between two groups (χ2=13.99, 4.44, 18.83, P<0.01 or<0.05). The score of VAS in control group and treatment group were (4.84±1.29) points and (3.15± 1.82) points respectively, and the difference was statistically significant (t=8.66, P<0.01). Conclusions Application of Mepilex for PICC in critical patients can decrease the incidences of adverse effect, and increase the degree of comfort. It is worth utilizing widely in the clinic.

Differences and influencing factors of Wechsler's cognitive test in first-episode depressive patients with or without sleep disorder / 中华行为医学与脑科学杂志

Objective To investigate the difference of Wechsler's cognitive test and its influencing factors in first-episode depression patients with and without sleep disorder.Methods 156 patients with de-pression were divided into two groups according to their sleep conditions,including sleep disorder group(n=77)and non-sleep disorder group(n=79).Wechsler Intelligence Scale(WAIS)and Wechsler Memory Scale(WMS)were used to assess the cognitive function,while Hamilton Depression Scale(HAMD-17) were used to assess depressive symptoms.Results (1)Sleep disorders group had lower scores on verbal IQ (95.51±16.45),performance IQ(90.94±13.87),FIQ scores(92.48±15.49)than those in the non-sleep disorder group((105.59±15.20),(96.19±13.62),(101.20±14.70)respectively),the differences were statistically significant(P<0.05).Sleep disorder group had lower scores in immediate memory(10.47 ± 3.88),short-term memory(49.87±14.35)and memory quotient(87.90±18.25)than those in the non-sleep disorder group((11.86±3.47),(56.52±13.03),(97.27±18.76)respectively),the differences were statisti-cally significant(all P<0.05).(2)Multivariate linear regression analysis showed that education and age ex-plained 24% of variance in verbal IQ(F=21.258,P<0.01).Education,sleep disorder factors explained 12.9% of variation in performance IQ(F=9.825,P<0.01).Education,sleep disorder factors explained 22.3% of variance in total IQ(F=22.847,P<0.01).Education,age,sleep disorder factors explained 28.4%of variation in short-term memory(F=23.850,P<0.01).Education and age explained 20.4% of variation in immediate memory(F=18.10,P<0.01).Education and sleep disorder factors explained 21.9% of variation in memory quotient(F=26.162,P<0.01).Conclusion The intelligence and memory impairment in first-epi-sode depression patients with sleep disorders is more serious,and the education,sleep disorder and age are the most important factors.

Influencing factors of anxiety symptoms in patients with depression / 中国神经精神疾病杂志

Objective To investigate the status of depression with anxiety symptoms, and analyze the influencing factors of anxiety symptoms from demographic data and social psychological factors. Methods Hamilton depression rat?ing scale (HAMD), Hamilton anxiety rating scale (HAMA), Eysenck personality questionnaire (EPQ), life event scale (LES), trait coping style questionnaire (TCSQ) and social support scale (SSS) were used to evaluate 729 patients with de?pression. According to HAMA scores, patients were divided into non anxiety symptoms group (HAMA14). Social psychological factors were compared between two groups, and the influencing fac?tors of anxiety symptoms were analyzed. Results The incidence of anxiety symptoms in depression was 58.85% (429/729), and 119 cases (16.32%) were certainly without anxiety symptoms. Compared with the group without anxiety symp?toms, the anxiety symptoms group had higher scores on neuroticism, psychoticism, negative life events and negative cop?ing style (P<0.001), but lower scores on introversion and extroversion (P=0.010). Degree of depression (OR=9.255, 95%CI:4.726~18.127), neuroticism (OR=1.595, 95%CI:1.197~2.125), negative life events (OR=1.009, 95%CI:1.001~1.017) and negative coping style (OR=1.046, 95%CI:1.013~1.080) were the risk factors of anxiety symptoms (P<0.05). Conclu?sion The incidence of anxiety symptoms in patients with depression is high. Patients with higher degree of depression and typical neurotic personality experiencing more negative life events and those with tendency to adopt negative coping style are more susceptible to anxiety symptoms.

Therapeutic effect of continuous renal replacement therapy on different types of cardiorenal syndrome / 心血管康复医学杂志

Objective:To observe therapeutic effect of continuous renal replacement therapy (CRRT ) on different types of cardiorenal syndrome (CRS) .Methods :According to patient′s conclition ,a total of 247 CRS patients were divided into type 1 group (n=47) ,type 2 group (n=51) ,type 3 group (n=55) ,type 4 group (n=49) and type 5 group (n=45) .All patients received CRRT ,echocardiography and plasma level of N terminal pro B type natriuretic peptide (NT‐proBNP) detect to evaluate cardiac function status ;the 24h urine volume and endogenous creatinine clearance rate (Ccr) were measured to assess renal function status before and after treatment . Results:Compared with before treatment ,on one week after CRRT ,LVEF ,urine volume and Ccr level significantly rose ,NT‐proBNP level significantly reduced ( P<0.05 or <0.01) .Compared with type 4 and 5 group ,there were significant rise in LVEF [ (48.98 ± 1.55)% ,(44.67 ± 1.48)% vs .(55.13 ± 4.27)% ,(53.73 ± 3.52)% ,(57.95 ± 2.89)% ] ,urine volume [ (1118.83 ± 168.09 ) ml , (1125.47 ± 177.28 ) ml vs . (1655.67 ± 198.37 ) ml , (1697.47 ± 171.27 ) ml , (1702.72 ± 179.28) ml] and Ccr level [ (40.11 ± 1.79) ,(41.11 ± 1.39) vs .(52.33 ± 2.49) ,(50.97 ± 2.11) , (51.32 ± 2.01 )] , and significant reduction in NT‐proBNP level [ (3738.19 ± 118.77 ) , (3378.38 ± 121.82 ) vs . (2137.51 ± 123.59) ,(2421.12 ± 121.22) ,(2139.81 ± 147.28)] in type 1 ,2 and 3 group ,P<0.05 all .Conclusion:CRRT is effective on different types of CRS ,but it′s best on type 1~3 than those of type 4~5 , which may be re‐lated to different pathological mechanisms of CRS different types .

Role of CT angiography in the detection of mechanical obstructive cause of deep vein thrombosis of lower extremity / 中华放射学杂志

Objective To explore the diagnostic value of the CT angiography (CTA) in the detection of mechanical obstructive cause of deep venous thrombosis of lower extremity. Methods Forty-seven cases of CTA and DSA image data of DVT in lower extremity with mechanical obstruction were retrospectively analyzed. The CTA three-dimensional reconstruction images were compared with DSA results, and the position and size of thrombus, collateral circulation of blood vessels, vascular compression area and the corresponding outside vascular lesions were evaluated. The causes of venous occlusion were analyzed. Diagnostic agreement of CTA and DSA was assessed by Kappa statistics. The difference of the accuracy between CTA and DSA in the diagnosis of the left and right iliac femoral vein, inferior vena cava, internal iliac vein thrombosis were analyzed with χ2 test. Results There were 47 patients with lower extremity DVT. Of them, DVT was detected in the left leg in 28 patients, in the right leg in 14 patients and in both lower extremities in 5 patients. Mechanical obstruction caused DVT in all of them. There were 27 patients of iliac vein compression syndrome(IVCS)complicated with lower limb DVT. The left iliac vein was oppressed by the right common iliac artery with compression degree from 55.41%to 100.00%,and mean of(77.1 ± 16.8)%. There was congenital stenosis or occlusion of inferior vena cava in 3 patients. There was Budd-Chiari syndrome in 2 patients. There was pelvic mass pressing the common iliac vein in 4 patients. Enlarged right inguinal lymph nodes oppressed the right femoral vein in 3 patients and enlarged left inguinal lymph nodes oppressed the left femoral vein in 2 patients. Other mechanical obstruction factors caused DVT in 6 patients, including right iliac artery aneurysms,spontaneous hematoma, etc. The agreement of CTA and DSA on the diagnosis of the iliac femoral thrombosis was good (Kappa=0.978), the diagnosis agreement on the inferior vena cava thrombus was good (Kappa = 0.737), while the diagnosis agreement on the internal iliac vein thrombosis was poor (Kappa=0.189). The difference of CTA and DSA in the diagnosis of left and right iliac femoral venous thrombosis was not statistically significant (52,51 case;χ2=0.00, P>0.05), neither was the diagnostic difference of inferior vena cava thrombus (21,17 cases;χ2=1.50, P>1.50). However, the difference of the diagnosis of the iliac vein thrombosis was statistically significant (14,2 cases;χ2=8.33, P<0.05) . Conclusions CTA can clearly show the location and scope of the thrombus. Compared with conventional DSA, CTA shows higher diagnostic coincidence rate, and can accurately determine the mechanical obstruction causes of lower extremity DVT.

In vitro susceptibility of commonly used antibiotics on community-acquired uncomplicated urinary tract infection pathogens in Beijing / 中华泌尿外科杂志

Objective To investigate the distribution and susceptibility patterns of common uropathogens causing community-acquired urinary tract infection (UTI) in Beijing.MethodsA total of 300non-duplicate isolates were randomly collected from 3 hospitals in Beijing between Jan,1 2010 and Mar,312011.Minimal inhibitory concentrations (MICs) were determined by the broth microdilution methods,which were performed and interpreted according to the guidelines established by the Clinical and Laboratory Standards Institute (CLSI).A panel of 8 antimicrobial agents were tested:amikacin,cefaclor,cefepime,cefoperazone/sulbactam,ciprofloxacin,levofloxacin,gentamicin and nitrofurantoin. Fosfomycin trometamol MICs were determined by the agar-dilution method in cation-adjusted MH agar supplemented with glucose 6-phosphate at a concentration of 25 mg/L as detailed in the guidelines issued by 2010 CLSI. All the Escherichia coli,Klebsiella pneumoniae and Proteus mirabilis strains were screened and confirmed by double-disk synergy test for extended-spectrum β-lactamase (ESBLs).Results Among the organisms cultured,E.coli wasthepredominantpathogen(65.0％ ), followedby Enterococcus(11.7％ ),Staphylococcus( 6.3％ ), Klebsiella pneumoniae( 5. 3％ ), Proteus mirabilis( 4. 7％ ), and Pseudomonas aeruginosa (3.0％).Lower susceptibility rates to ciprofloxacin and levofloxacin (31.4％ -47.4％ ) were observed among all the stains.Amikacin,cefoperazone/sulbactam,nitrofurantoin and fosfomycin trometamol were the most active drugs (92.1％,92.1％,88.4％ and 87.9％ susceptible strains,respectively) among the Gram-negative strains.Isolates of Staphylococcus were highly sensitive to amikacin ( 100.0％ ),cefoperazone/sulbactam (94.7％),nitrofurantoin ( 100.0％ ).Higher susceptibility rates to nitrofurantoin (91.4％) and fosfomycin trometamol (90.0％) were observed in Enterococcus.ESBLs-producing strains accounted for 52.3％ (102/195) in E.coli,43.8％ (7/16) in K.pneumoniae and 14.3％(2/14) in P.mirabilis,respectively.ConclusionsResistance is most common to ciprofloxacin and levofloxacin of all the stains.Currently,the most appropriate agents for the empirical management of uncomplicated UTI seems to be amikacin,cefoperazone/sulbactam,nitrofurantoin and fosfomycin trometamol.

Analysis of encephaloflucgram in survivors of the coal mine flooding accident / 中华行为医学与脑科学杂志

Objective To investigate the change characteristics of the brain neurotransmitters of human with stress events by the Encephaloflucgram technology (ET) at the noninvasive condition. Methods Extract shocking informations with neurotransmitter requlation systems in EEG ( S spectral line) by ET and analyze thechange characteristics of the brain neurotransmitters of human with stress events, the clincial symptons of the patients were evaluated by the post-traumatic stress disorder-check scale (PCL-C). Results ①Compared with expected number,the activity of neurotransmitters such as γ-aminobutyric acid (GABA) were significantly decreased (4.64 ±2.88,8.45 ±0.42, P＜0. 01 ) and the activity of neurotransmitters such as dopamine( DA ) ( 17.01 ±7.41,7.59±0.55, P＜0. 01),acetylcholine(Ach) (17.01 ±7.41,14.95 ±0.65, P＜0.05) ,norepinephrine (NE ) ( 13.07 ± 4.33,11.82 ± 0.84, P ＜ 0. 05 ) were increased. ②There was a significant difference on GABA ( t =6.902, P ＜ 0. 01 ) between suspect of post-traumatic stress disorder and non-post-traumatic stress disorder. ③In PCL-C scale score, intrusion factor had negative correlation to the activity of GABA ( r = - 0.777, P ＜ 0.01 ), and positive correlation to the activity of DA ( r = 0.360, P ＜ 0.01 ), hyper-arousal factor was positive correlated with the activity of NE ( r=0.221, P＜0.05) ,escaping/numbness factor was negative correlated with the activity ofGlu( r= -0.274, P＜0.05). Conclusion In traumatic stress events GABA,Ach,DA,NE neurotransmitters aresignificantly changed ,and meybe participat stress responses.

Study of resistance to carbapenems of Pseudomonas aeruginosa in 5 Beijing hospitals / 中华检验医学杂志

Objective To investigate the molecular mechanism of resistance to carbapenems in Pseudomonas aeruginasa from 5 teaching hospitals in Beijing. Methods A total of 213 non-duplicate imipenem-resistant Pseudomonas aernginosa (IRPA) isolates were collected from 5 hospitals in Beijing from June 2004 to December 2005. The minimal inhibitory concentrations (MICs) of meropenem, imipenem and others antibiotics were determined by agar dilution method. Disk diffusion test was used for screening metalloenzymes. The bla IMP,bla VIM and OprD2 genes were amplified by PCR and only sequenced. Results Out of 213 isolates, OprD2 loss was detected in 84 isolates and IMP-1 enzyme was detected in 6 isolates simultaneously. Thirteen IRPAs only produced IMP-1 and 2 isolates only produced VIM-2. Conclusion OprD2 loss and metallo-β-lactamuse production are the parts of the mechanisms of resistance to carbapenems in Pseudomonas aeruginosa in Beijing.

Continuous surveillance of antimicrobial resistance among gram-positive coccus from 1999 to 2006 at Beijing Chaoyang Hospital / 中华微生物学和免疫学杂志

Objective To investigate the change of antimicrobial resistance among gram-positive cocci from 1999 to 2006 in Beijing Chaoyang Hospital. Methods Antimicrobial susceptibility test was car-ried out by MIC method, data were analyzed by WHONET 5.3 software. Results A total of 6192 clinical isolates were collected. The top four pathogens were Staphylococcus coagulase-negative, Staphylococcus au-reus, Enterococcus faecalis and Enterococcus faecium. The prevalence of methicillin-resistant S. aureas and coagulase-negative were identified in 88.4% and 86.9%, respectively. The resistance rates of S. aureus to penicillin G and ampicillin were more than 90.0% during 1999-2006. Neither strains of S. aureus nor strains of coagulase-negative Staphylococcus were found resistant to vancomycin. Vancomyein-resistant Enterococci (VRE) strains were firstly isolated in 2003, thirteen vancomycin-resistant E.faecalis isolates were identified as VanB genotype by PCR and sequencing. The VanA gene was confirmed by PCR and sequencing in seven-teen vancomycin-resistant E.faecium, vancomycin-resistance E.faecium rate increased sharply. The most ac-tive antibiotics against E. faecalis were vancomycin, ampicillin, penicillin with the susceptible rates of 98.7%, 95.7% and 85.6%, however, the susceptibility rate of E. faecalis to penicillin decreased from 94.3%-84.6%. The resistance rates of E.faecalis to clindamycin was 99.0%. The resistance rates of E. faecium to erythromycin and clindamycin were more than 95.0%. The resistance rates of E.faecium to ampi-cillin, penicillin, ciprofloxacin were more than 90.0%. The most active antibiotics against E. faecium was vancomycin. The susceptibility rate of E.faecium to tetracycline increased from 27.8% to 82.6%. Conclu-sion Vancomycin remains highly active against gram-positive cocci. A total of 30 Enterococci isolates were found resistant to vancomycin.

Treatment with Liyuan Pure Lysothrombusase(办源精纯溶栓酶) for 60 cases with unstable angina pectoris / 中国中西医结合急救杂志

Objective:To investigate the clinically curative effects of Liyuan Pure Lysothrombusase(LYPL，力源精纯溶栓酶) on unstable angina pectoris (UAP) and to observe its safety.Methods:One hundred and twenty cases with UAP were selected and in accordance with the proportion of one to one randomly divided into treated and control group.Based on conventional therapy the LYPL infused intravenously was added in treated group.The conditions of symptomatic convalescence,the changes in electrocardiography (ECG),and the parameters of blood rheology were observed for two groups.Results:The curative effects on symptoms and ECG were 93.33％ and 88.33％ respectively in treated group but in control group they were 70.00％ and 68.33％ respectively.The difference in comparison between two groups was significant (all P<0.01).In treated group the parameters of blood rheology were obviously improved meanwhile in control group they were not.Conclusions:LYPL possesses the actions on improving blood rheology.Its curative effects on UAP are marked and it is safe and easy to use.