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Objective To investigate the implementation of surveillance,prevention and control measures for healthcare-associated infection(HAI)in maternal and child healthcare(MCH)institutions,and provide policy evi-dence for optimizing HAI prevention and control in MCH institutions.Methods Stratified sampling was conducted among the MCH institutions at provincial,municipal and county levels in 8 provinces/autonomous regions.A uni-fied questionnaire was designed and the online survey was conducted through"Questionnaire Star".Results The data from 123 MCH institutions were included in the analysis.90.24%of the MCH institutions carried out compre-hensive surveillance on HAI.The ratios of MCH institutions which implemented targeted surveillance on HAI in neonatal intensive care unit(NICU),surgical site infection,multidrug-resistant organisms(MDROs)and HAI in intensive care units(non-NICU excluded)were 89.66%,85.96%,80.77%,and 74.19%,respectively.51.22%MCH institutions adopted information surveillance system on HAI cases.94.31%MCH institutions carried out surveillance on hand hygiene compliance.Over 90%MCH institutions carried out surveillance on environment hy-giene in high-risk departments.71.54%MCH institutions conducted centralized cleaning,disinfection,sterilization and supply for reusable medical instruments in the central sterile supply department(CSSD).Over 90%MCH insti-tutions established three-level pre-examination triage systems.86.18%set up transitional wards.MCH institutions generally adopted a management model with established effective communication,full appointment visits,and sepa-rate visits for special medical groups,such as registered pregnant women,high-risk newborns,healthcare groups,and long-term rehabilitation patients.However,the ratio of institutions conducting on-line follow-up visits was less than 50%.Conclusion MCH institutions have generally carried out comprehensive and targeted surveillance on HAI.Information surveillance need to be facilitated.Hand hygiene and environmental hygiene surveillance has been popularized to a certain extent at all levels of MCH institutions.The cleaning,disinfection,sterilization,and supply processes of reusable medical devices in a few MCH institutions are not standardized.Special medical populations get effective management.On-line healthcare is to be further promoted.
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Objective::To analyze and identify the metabolites of major components of Shaoyao Gancaotang in urine and feces of normal and polycystic ovary syndrome (PCOS) rats, and to explore the effect of PCOS on the metabolism of Shaoyao Gancaotang. Method::Female SD rats were randomly divided into normal group and PCOS group. PCOS rat model was prepared by administration of letrozole solution for 21 days, and the estrous cycle of rats was observed. UHPLC-QTRAP-MS/MS technique and LightSight 2.3 software were used to analyze and identify the metabolites of major components of Shaoyao Gancaotang in urine and feces of normal and PCOS rats. The mobile phase was water-methanol for gradient elution, the flow rate was 0.3 mL·min-1, electrospray ion source was employed under negative ion mode. Result::Phase Ⅰ and phase Ⅱ reactions mainly occurred in drug metabolism. A total of 27 metabolites were detected in urine of normal rats, and 34 metabolites were detected in urine of PCOS rats. A total of 29 metabolites were detected in feces of normal rats, and 27 metabolites were detected in feces of PCOS rats. Conclusion::The metabolites in the urine of PCOS rats are more diverse than those of normal rats, and the disease status of PCOS may affect the in vivo metabolic pathway of active ingredients in Shaoyao Gancaotang.
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Objective To investigate the association between serum uric acid and brachial-ankle pulse wave velocity (baPWV) levels and to examine any possible effect modifiers among hypertensive patients in rural areas of Eastern China. Methods This cross-sectional study was conducted in Lianyungang and Anqing Cities from July to September 2013. Hypertensive patients with serum uric acid and baPWV measurements were included in this study. Multivariate linear regression was used to assess the relationship between serum uric acid levels and baPWV. Results Finally, a total of 4 278 participants were included in this study. The mean age was 65.2 (standard deviation(SD):7.4) years and the mean value of baPWV levels were 1835.1 (SD: 383.4) cm/s. Regression analysis showed that there is a positive correlation between serum uric acid and baPWV levels (per SD increment, β=20.5 cm/s, 95% CI: 8.5-32.5, P=0.001. When uric acid was categorized in tertiles, a significantly higher baPWV level was found in participants in tertile 3 (≥349μmol/L)(β=51.2 cm/s, 95% CI: 23.8-78.6, P=0.001), compared with those in tertile 1(<277 μmol/L). Furthermore, the serum uric acid-baPWV association was significantly stronger in those systolic blood pressure (SBP)≥140 mm Hg (vs.<140 mm Hg; p-interaction=0.001). Conclusion There is a positive relationship between uric acid levels and baPWV among hypertensive patients, especially in those with higher SBP levels.
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Objective To explore the relationship between fasting blood glucose and branchial-ankle pulse wave velocity (baPWV) levels among hypertensive population in rural areas of Eastern China. Methods A cross-sectional analysis were conducted among hypertensive population in Lianyungang and Anqing city from July to September 2013. Multivariable linear regression models were used to analyze the association of serum glucose and baPWV. Results A total of 3 894 hypertensive participants were included in the present study. The prevalence of normal fasting glucose (NFG), impaired fasting glucose (IFG) and diagnosed diabetes (DM) were 44.5%, 43.0%, and 12.5%, respectively. Each 1-mmol/L increase in fasting blood glucose levels was significantly associated with a 26.2 cm/s increase in baPWV levels (95% CI: 19.6-32.8, P<0.001). Consistently, significantly higher baPWV levels were observed in participants with IFG (β=50.4 cm/s, 95% CI: 28.4-72.3, P<0.001) and DM (β=113.4 cm/s, 95% CI: 80.2-146.5, P<0.001) when compared to those with NFG. Furthermore, a stronger positive association between fasting blood glucose and baPWV was observed in participants with systolic blood pressure (SBP) ≥140 mmHg (β=34.3 cm/s, 95% CI: 24.5-44.2, P<0.001; vs.<140 mmHg; β=18.1 cm/s, 95% CI: 9.1-27.2, P<0.001; Pinteraction=0.027). Conclusion There was a positive association between fasting blood glucose and baPWV levels among hypertensive population in rural areas of Eastern China.
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Complicated intra-abdominal infections(cIAIs)remain a majorchallenge in clinical practice.In addition to significant morbidity and mortality for patients,they consume substantial hospitalresources.It is compounded by the aging of thepopulation and the burden of chronic disease in these patients,as well as the increased prevalence of resistantbacteria in both the healthcare setting and the community.Besides timely effective source control and fluid resuscitation,rational use of antimicrobials isanintegral part of good clinical practice.Once cIAIs are suspected or diagnosed,anti-infective treatment should be given as soon as possible.At this time,empirical antiinfective treatment is particularly important due to the lack of microbial culture and drug susceptibility results.In the process of anti-infective treatment,the application of anti-infective drugs can be adjusted according to the culture of pathogens and the results of drug sensitivity experiments.
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<p><b>OBJECTIVE</b>To explore the association between C825T polymorphism of G protein beta3 subunit (GNB3) gene and different Hilit types of essential hypertension (EH) in the Uygur nationality of Xinjiang.</p><p><b>METHODS</b>According to Uygur medical theories, EH patients (as the EH group) and non-EH patients (as the control group) were assigned to four Hilit groups. The C825T polymorphism of GNB3 was detected in 161 EH patients and 379 non-EH subjects of different Hilit types by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) to explore the difference of the genotypes and allelic frequencies and hypertension.</p><p><b>RESULTS</b>(1) In Xinjiang Uygur population, the distribution frequencies of GNB3 C825T polymorphism were in accordance with Hardy-Weinberg (chi2 = 0.871, P = 0.647). (2) There was no statistical difference in the distribution frequencies of three genotypes and two alleles of GNB3 between the EH group and the control group (P > 0.05). (3) There was statistical difference in distribution frequencies of three genotypes between the abnormal Sapra and non-abnormal Sapra group (the sum of abnormal Sewda, abnormal Kan, and abnormal Balhem) (chi2 = 6.905, P = 0.032), especially between the abnormal Sapra and abnormal Balhem groups (chi2 = 10.404, P = 0.006), but there was no statistical difference in distribution frequencies of alleles between the two groups (P > 0.05). (4) In 161 EH patients, there was statistical difference in the distribution frequencies of three genotypes and two alleles between the abnormal Sapra and non-abnormal Sapra group (chi2 = 9.034, P = 0.011; chi2 = 4.701, P = 0.03).</p><p><b>CONCLUSIONS</b>Both TT genotype and T allele of GNB3 C825T polymorphism might not be associated with EH patients in Xinjiang Uygur populations. However, they were correlated with hypertension patients of non-abnormal Sapra, indicating the pathogeneses of EH with different Hilit types might be different.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Alleles , Case-Control Studies , Essential Hypertension , Gene Frequency , Genotype , Heterotrimeric GTP-Binding Proteins , Genetics , Hypertension , Classification , Diagnosis , Genetics , Medicine, Chinese Traditional , Minority Groups , Polymorphism, GeneticABSTRACT
<p><b>OBJECTIVE</b>The aim of this study is to assess of cochlear implantation in children with auditory neuropathy and cochlear nerve aplasia by using Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR).</p><p><b>METHODS</b>Twenty one children with cochlear implants participated in this study. They all received cochlear implant surgery at our hospital from January 2004 to October 2010. All children had hearing aid trial and hearing and speech rehabilitation before surgery at least three months.Nine children (7 male, 2 female) were diagnosed with auditory neuropathy, twelve (7 male, 5 female) with cochlear nerve aplasia. Twenty children (10 male, 10 female) with sensorineural hearing loss served as a control group. All the children received cochlear implant for more than six months. Forty two children with normal hearing served as another control group which were divided into three subgroups according to their age.Group A included 18 children aged under two yrs, group B consisted of 16 children aged from two to four yrs and group C comprised eight children aged above four yrs. CAP and SIR were used to evaluate among all the children and the scores were compared.</p><p><b>RESULTS</b>The CAP scores of children with auditory neuropathy, cochlear nerve aplasia, sensorial neural hearing loss and the three subgroups children with normal hearing were 4.44 ± 1.50, 4.83 ± 1.69, 4.55 ± 1.66, 5.22 ± 1.11, 6.75 ± 0.45 and 7.00 ± 0.00 respectively, and SIR scores were 2.66 ± 1.11, 2.33 ± 1.15, 2.40 ± 0.75, 2.56 ± 1.04, 4.12 ± 0.81 and 5.00 ± 0.00 respectively. There were significant differences among the six groups for CAP scores(χ(2) = 35.481, P < 0.001) and SIR scores(χ(2) = 40.549, P < 0.001).No significant differences for CAP and SIR scores were observed between children with auditory neuropathy/cochlear nerve aplasia and sensorial neural hearing loss as well as group A (P > 0.05 for each), and there were significant differences were shown between children with auditory neuropathy/cochlear nerve aplasia and group B as well as group C (P < 0.01 for each aplasia).</p><p><b>CONCLUSIONS</b>The auditory and speech capabilities of children with auditory neuropathy and cochlear nerve deficiency can can get benefits from cochlear implants as children with sensorineural hearing loss, however not achieve the level of those with normal hearing after cochlear implantation. The long term effects still need follow-up and evaluation.</p>
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Child , Female , Humans , Male , Cochlear Implantation , Cochlear Implants , Cochlear Nerve , Physiology , Hearing , Hearing Aids , Hearing Loss, Central , General Surgery , Hearing Loss, Sensorineural , Hearing Tests , Speech , Speech Intelligibility , Speech Perception , Vestibulocochlear Nerve DiseasesABSTRACT
<p><b>OBJECTIVE</b>To screen for genetic mutations in 35 patients with Leber's hereditary optic neuropathy (LHON).</p><p><b>METHODS</b>Polymerase chain reaction and DNA sequencing were used to screen for the presence of mitochondrial DNA mutations.</p><p><b>RESULTS</b>The total detection rate of top 3 common LHON mutations were 20.0%, which included 6 cases of ND4 11778 G to A, 1 case of ND1 3460 G to A. No ND6 14484 T to C mutation was detected. A ND4 G11719A synonymous mutation was found in all patients. In addition, 21 other mutations were discovered among 23 patients, among which 13 had a single mutation, 8 had a second mutations, and 2 had a third mutation. Among the 21 mutations, ND4 11778 G to A had a frequency of 28.6%(6/21). ND1 3552 T to A, ND6 14470 T to C, ND4 11794 T to C, ND1 3497 C to T and 3644 T to C respectively had a frequency of 19.0% (4/21), 19.0%(4/21), 14.3%(3/21), 9.5%(2/21) and 9.5%(2/21). Among the 3 patients who harbored a ND4 11794 T to C mutation, 2 were heteroplasmic and one was homoplasmic in nature.</p><p><b>CONCLUSION</b>The ND4 11778 G to A mutation is common in the Top "3" primary mutations of patients with LHON. Candidate LHON mutation ND1 3552 T to A or ND1 3644 T to C resulted in LHON pathogenesis as single or synergistic effect. The visual impairment at onset of the disease with candidate mutation were better than the eyes with the ND4 11778 G to A mutation.</p>
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Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , DNA, Mitochondrial , Genetics , Mutation , Optic Atrophy, Hereditary, Leber , GeneticsABSTRACT
<p><b>OBJECTIVE</b>To study the relationship between two polymorphisms, Arg194Trp and Arg399Glu, of DNA repair gene X-ray repair cross-complementing group 1 (XRCC1) and the susceptibility of breast cancer in Chinese women.</p><p><b>METHODS</b>A case-control study with 698 histologically-confirmed female breast cancer cases and 813 cancer-free controls frequency-matched by age and residential area was conducted, and the genotypes were determined by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assays. Logistic regression analysis was used to evaluate the odds ratios (ORs) and 95% confidence intervals (CIs) of XRCC1 Arg194Trp and Arg399Glu with susceptibility of breast cancer. A Meta-analysis was used to evaluate the association of Arg399Glu with breast cancer in Chinese women.</p><p><b>RESULTS</b>The genotype frequencies of Arg/Arg, Arg/Trp, Trp/Trp, Arg/Trp + Trp/Trp of XRCC1 gene 194 locus were 48.81% (327/670), 39.85% (267/670), 11.34% (76/670), 51.19% (343/670) in cases and 48.80% (387/793), 41.99% (333/793), 9.21% (73/793), 51.20% (406/793) in controls. Compared to Arg/Arg, the adjusted ORs (95%CIs) were 0.98 (0.75 - 1.28), 1.17 (0.76 - 1.80), 1.09 (0.86 - 1.40). The frequencies of Arg/Arg, Arg/Trp, Trp/Trp, Arg/Gln + Gln/Gln of XRCC1 399 locus were 52.40% (349/666), 38.29% (255/666), 9.31%(62/666), 47.60% (317/666) in cases and 52.22% (412/789), 38.53% (304/789), 9.25% (73/789), 47.78%(377/789) in controls. Compared to Arg/Arg, the adjusted ORs (95%CIs) were 0.93(0.63 - 1.08), 0.96 (0.42 - 1.09), 0.91 (0.62 - 1.05). No significant associations were found between these two polymorphisms and breast cancer risk, also in subgroups stratified by menopause status, history of breast-feed, reproduction and taking oral contraceptives. The overall ORs (95%CIs) of 399 Arg/Trp + Trp/Trp vs Arg/Arg from Meta analysis was 0.97 (0.85 - 1.10).</p><p><b>CONCLUSION</b>The XRCC1 Arg194Trp and Arg399Gln may not play an important role in the susceptibility of breast cancer in Chinese women.</p>
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Adult , Female , Humans , Middle Aged , Asian People , Genetics , Breast Neoplasms , Genetics , Case-Control Studies , DNA-Binding Proteins , Genetics , Gene Expression Regulation, Neoplastic , Genetic Predisposition to Disease , Polymorphism, Single Nucleotide , X-ray Repair Cross Complementing Protein 1ABSTRACT
<p><b>OBJECTIVE</b>To monitor the seasonal distribution of influenza types and subtypes in Wuxi area during 2005-2008, and to investigate the variation in hemagglutinin (HA) genes of A/H3N2 strains in 2008.</p><p><b>METHODS</b>Nose-throat swab specimens were collected in Wuxi area from flu-like patients from outpatient departments of hospitals as well as from clustering flu-like outbreak patients from workspace, followed by MDCK cell inoculation. Types and subtypes of positive influenza isolates were identified using standard antiserum. We then sequenced the HA genes for H3 subtype influenza viruses isolated from 2008 specimens to investigate the variation in HA genes.</p><p><b>RESULTS</b>During 2005 and September 2008, 435 strains of influenza viruses were isolated from flu-like patients in Wuxi Area, among which 164 isolates are of A/H1N1 subtype, 80 isolates are of A/H3N2 subtype, and 191 isolates are of B type. These types/subtypes have significant seasonal distributions. Sequences of HA genes for H3 subtype show that the 9 strains isolated in Wuxi area are similar to those of strains isolated in Shanghai within the same period. Many of the sequences belong to the same branch of the phylogenetic tree, and are similar to sequences of vaccine strains in WHO 2008-2009 repositories.</p><p><b>CONCLUSION</b>A/H1N1, A/H3N2 and B still attribute to most of the sporadic and local outbreaks of influenza infection in Wuxi area in recent years. HA genes of A/H3N2 strains isolated in Wuxi area are similar to those of strains isolated in Shanghai in the same period, and also similar to those of vaccine strains recommended by WHO for 2008-2009.</p>
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Animals , Humans , Cell Line , China , Epidemiology , Genetic Variation , Hemagglutinin Glycoproteins, Influenza Virus , Genetics , Influenza A Virus, H3N2 Subtype , Classification , Genetics , Influenza, Human , Epidemiology , Virology , Molecular Sequence Data , Phylogeny , Population SurveillanceABSTRACT
Objective To investigate the differences between the sequences of papA and papG of UPECA030 strain and the related genes, to better understand the genetic variation of UPEC4030 papA and its combination forms with papG so as to identify if it was a new genotype. Methods Cloning and sequencing methods were used to analyze the sequences of papG and papA of UPEC4030 strain and to compare their related sequences. Results Through sequence analysis of papA, it was revealed that there was a 722 bp gene,encoding 192 amino acid polypeptide. The overall homology of the papa genes between UPEC4030 and the standard strains of ten F types were 36.11%-77.95 % and 22.20%-78.34% at nueleotide and deduced amino acid levels. Homology between the sequences of reverse primers and the corresponding sequence of UPEC4030 papA was 10.00%-66.67%. The results confirmed that UPECA030 strain contained a novel papA variant. Through sequence analysis of UPEC4030 papG, we revealed a 1100 bp gene, encoding 337 amino acid polypeptide. The homology of the papG genes between UPEC4030 and UPEC IA2, the standard strain, was 99.00 % at nucleotide level and 99.11% at deduced amino acid and UPEC4030 strain carried class I] genotype of papG. Conclusion UPEC4030 strain contained an unknown papA variant or the new genotype and carried class II genotype of papG. The pathogenic mechanism and epidemiology call for further study.
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<p><b>OBJECTIVE</b>To evaluate the effect of surgical manipulation on the dissemination of cancer cells into blood circulation in patients with gastric cancer and to analyze its risk factors.</p><p><b>METHODS</b>This study included 45 consecutive patients with gastric cancer undergoing curative resection and 13 control cases (10 healthy persons and 3 patients with peptic ulcer receiving gastrectomy). Peripheral blood was obtained preoperatively and just after surgical manipulation. The mRNA levels of carcinoembryonic antigen (CEA) from the blood samples were assayed by reverse transcription-polymerase chain reaction(RT-PCR) and compared between the 2 groups.</p><p><b>RESULTS</b>CEA mRNA was negative in all control cases. Of the 45 gastric cancer patients, the preoperative positive rate of CEA mRNA was 8.9%, while the postoperative positive rate was 48.9%, which was significantly higher than that of preoperation (P=0.000). Multivariable Logistic regression analysis showed that operative duration (P=0.014) and tumor depth (P=0.010) were independent risk factors for cancer cell dissemination. Furthermore, the operative duration in patients with positive postoperative CEA mRNA was markedly longer than that in patients with negative postoperative CEA mRNA (P=0.000), and positive rate of postoperative CEA mRNA in advanced gastric cancer was higher compared with that in early gastric cancer (P=0.034).</p><p><b>CONCLUSIONS</b>Surgical manipulation of curative gastrectomy can provoke dissemination of cancer cells into blood circulation, and the operative duration and tumor invasion depth may be 2 of the risk factors for cancer cell dissemination.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Carcinoembryonic Antigen , Blood , Case-Control Studies , Gastrectomy , Neoplasm Staging , Neoplastic Cells, Circulating , Pathology , RNA, Messenger , Genetics , Reverse Transcriptase Polymerase Chain Reaction , Risk Factors , Stomach Neoplasms , Blood , Pathology , General SurgeryABSTRACT
This study was aimed to establish the reference values of blood lymphocyte immunophenotype in healthy adult between Ugyur and Han nationalities in Xinjiang and to compare the difference between these two nationalities in respect to nationality and gender, anticoagulated peripheral blood samples of 75 Ugyur people and 104 Han people were stained with monoclonal antibodies; the lymphocytes were analyzed by flow cytometry for the expression of lymphocyte-population bearing surface markers, the data were analyzed by SPSS 11.0. The results showed that the reference ranges of blood lymphocyte subsets in Uygur and Han adults were as follows: total T cells amounted to 67.85 +/- 8.97% and 69.98 +/- 10.14% respectively; helper T cell to 36.86 +/- 5.74% and 40.07 +/- 6.10% respectively; inhibitor T cell to 26.67 +/- 6.15% and 27.16 +/- 6.29% respectively; CD4/CD8 ratio to 1.46 +/- 0.47 and 1.56 +/- 0.47 respectively; NK cell to 16.91 +/- 9.89% and 12.81 +/- 7.34% respectively; B cell to 10.09 +/- 3.33% and 11.78 +/- 3.81% respectively; CD3(+)/HLA-DR(+) to 10.05 +/- 2.95% and 11.27 +/- 4.98% respectively; CD25(+) cell to 1.76 +/- 5.26% and 4.10 +/- 4.30% respectively. The differences of those two nationalities were mainly in total T cells, NK cell, B cell and CD25(+) cell. Furthermore there were also some differences between male and female. There might exist differences in helper T cells, CD4/CD8 ratio between Ugyur male and female, while this difference in Han lied in inhibitor cell and NK cell. Compared to those of two nationalities, the helper T cell percentage and CD4/CD8 ratio of Uygur male were lower than those in Han male. And in female, Uygur people had higher percent of NK cell (P < 0.01), but lower CD25(+) cell than those in Han's (P < 0.01). In conclusion, the nationalities and gender could influence the reference value of lymphocyte immunophenotype, the reference values of blood lymphocyte immunophenotype in the normal healthy adults of Ugyur and Han nationalities in Xinjiang were defined, and the differences between these two nationalities in respect to nationality and gender were elucidated.