ABSTRACT
Objective To investigate the class I integrons and their gene cassettes of imipenem-resistant Pseudomonas aeruginosa (IRPA) , and to analyze the correlation between integrons and drug resistance. Methods PCR was used to determine the presence of integrase genes and class I integrons. The variable regions were detected by sequencing. Resistance genes of integron gene cassettes including metal-β-lactamases, aminoglycoside modifying enzymes (AMEs), 16SrRNA methylating enzyme and the OprD2 genes were detected by PCR. The VITEK-2 automated system was used to determine the antibiotic susceptibility of integron-positive IRPA strains. Results The positive rates of integrase genes and class I integrons were 23.3%(20/86)and 8.14%(7/86) , and five kinds of gene cassettes were detected in 86 IRPA strains. The class I integrons-positive bacterial strains exhibited different resistant patterns to 12 antibiotics with large number of resistance genes. Conclusion The class I integrons and their gene cassettes are associated with multiple drug resistance of IRPA.
ABSTRACT
Objective To analyze the key factors influencing the number of diseases or conditions in which clinical pathways ( CPs) were implemented at public hospitals of China. Methods Based on the questionnaire survey of 51 public hospitals that had implemented CPs in Shanghai, Hubei province, and Gansu province, a multivariate logistic model was used to analyze the factors that influenced the number of CPs implemented in hospitals. Results In terms of the 14 issues and difficulties found in CPs′implementation, the overall acceptance rate was 38. 8% on average among surveyed hospitals, yet with a great variation(from 7. 1% to 100. 0%). A multivariate logistic model showed that the recognition of public hospitals on the issues and difficulties in CPs′implementation did not affect the number of implemented CPs, and tertiary public hospitals had significantly higher number of CPs implemented than secondary hospitals. Conclusions The resources and management capabilities of public hospitals in China are the determinants of CPs′promotion.
ABSTRACT
Objective To study the compliance of medical care with corresponding national clinical pathways for inpatients of cholecystectomy for cholecystolithiasis with acute cholecystitis at public hospitals of China. Methods Thirty medical records of the inpatients with cholecystectomy admitted in 2014 were randomly sampled from 18 public hospitals in Shanghai, Hubei province and Gansu province, for assessment on their compliance with corresponding national clinical pathways. Results The average compliance rate of inpatient care of cholecystectomy at public hospitals was 67. 7%. The study found low compliance rates in both severity assessment and timely examinations/diagnosis within two days after admission ( 5. 8% and 35. 3%, respectively) . Conclusions Public hospitals in China should strengthen their supervision over the medical care process for inpatients of cholecystectomy with acute cholecystitis, and the clinical pathways in question should be updated and improved in time.
ABSTRACT
Objective To study the compliance of medical care with corresponding national clinical pathways for inpatients of cholecystectomy for cholecystolithiasis with acute cholecystitis at public hospitals of China. Methods Thirty medical records of the inpatients with cholecystectomy admitted in 2014 were randomly sampled from 18 public hospitals in Shanghai, Hubei province and Gansu province, for assessment on their compliance with corresponding national clinical pathways. Results The average compliance rate of inpatient care of cholecystectomy at public hospitals was 67. 7%. The study found low compliance rates in both severity assessment and timely examinations/diagnosis within two days after admission ( 5. 8% and 35. 3%, respectively) . Conclusions Public hospitals in China should strengthen their supervision over the medical care process for inpatients of cholecystectomy with acute cholecystitis, and the clinical pathways in question should be updated and improved in time.
ABSTRACT
Objective: To study mental health of children in special families. Method: Achenbach Children Behavior Checklist was used to investigate 2048 children aged 8-16 of divorced family, separation family, spouse-loss family, remarried family, under poverty-line family, child-handicapped family, foster family, parent-handicapped family, criminal family, and orphan in twenty districts/counties of Shanghai. Results: The prevalence of behavior problem of them was 8.1%, while the rate in boys (9.6%) was significantly higher than that in girls (6.4%, ? 2=8.58, P