Tobacco retailer outside middle schools in Wuhan City and its impact on smoking behavior among students / 中国学校卫生

Objective@#To understand the distribution of tobacco retailer within 100 meters outside middle schools in Wuhan City and its impact on smoking behavior of middle school students, so as to provide basis and feasible suggestions for the development of tobacco control policy for adolescents.@*Methods@#From February to May 2023, a multi stage stratified cluster random sampling method was used to select 20 middle schools from 4 districts in Wuhan City. To investigate the distribution of tobacco retailer within 100 metres outside the school and the sale of tobacco to minors. A total of 4 882 students were surveyed using the core questions of the 2021 Chinese Adolescent Tobacco Prevalence Questionnaire. Fisher exact probability test, Chi square test and Chi square trend test were used for statistical analysis.@*Results@#Nearly 70.00% of middle schools had tobacco retailer within 100 metres, with an average of (1.10±0.97) per middle school. The awareness rate (100.00%) and labeling rate (87.50%) of licensed tobacco retailer were higher than those of non licensed tobacco retailer (33.33%, 16.67%) ( P <0.05). The rates of tried smoking, current smoking and buying cigarettes within 30 days were 7.13%, 1.99% and 2.54%, respectively. The rates of students who tried smoking ( 8.58 %), current smoking (2.29%) and buying cigarettes within 30 days (2.85%) in schools with tobacco retailer within 100 metres were higher than those in schools without tobacco retailer (3.79%, 1.28%, 1.83%)( χ 2=35.80, 5.37, 4.37 , P <0.05). And as the grade increased, the rates of tried smoking, current smoking and buying cigarettes among middle school students all showed an upward trend ( χ 2 trend =66.20, 36.10, 16.17, P <0.05).@*Conclusions@#Middle school students in Wuhan City have high tobacco availability. The findings suggest that school ban should be extended from 50 meters to 100 meters, and the regulatory authorities must strictly prohibit selling tobacco products to minors at tobacco retailer.

Perioperative application of thoracic paravertebral nerve block combined with general anesthesia in elderly patients with non-small cell lung cancer / 中国医师杂志

Objective@#To investigate the effect of thoracic paravertebral nerve block combined with general anesthesia in the perioperative period of elderly patients with non-small cell lung cancer (NSCLC).@*Methods@#50 elderly patients with NSCLC in our hospital from June 2015 to June 2018 were randomly divided into control group (n=25) and observation group (n=25). The control group was given general anesthesia, while the observation group was given thoracic paravertebral nerve block combined with general anesthesia. Postoperative recovery (recovery time, extubation time, ambulation time, feeding time) and hospitalization time, visual analogue scale (VAS) score at 2, 12, 24 and 48 hours after operation, serum tumor markers [cyfra21-1], carbohydrate antigen 125 (CA125), CA199, carcinoembryonic antigen (CEA) were counted and compared. The heart rate (HR), mean arterial pressure (MAP) [preoperative (T1), 15 minutes (T2), 5 minutes (T3) after anesthesia], and the incidence of adverse reactions were recorded.@*Results@#⑴ Postoperative recovery and hospitalization time: hospitalization time, recovery room stay time, extubation time, out-of-bed activity time and eating time of the observation group were shorter than those of the control group (P<0.05); ⑵ Pain degree: VAS score of the observation group was lower than that of the control group at 2, 12 and 24 hours after operation (P<0.05), and 48 hours after operation VAS score of the observation group was lower than that of the control group (P<0.05). There was no significant difference between the two groups (P>0.05); ⑶ Serum tumor markers: there was no significant difference in serum cyfra21-1, CA125, CA199 and CEA levels between the two groups before operation (P>0.05). After operation, serum cyfra21-1, CA125, CA199 and CEA levels of the two groups were decreased, and the indexes in observation group were lower than that of the control group (P<0.05); ⑷ Hemodynamics: there was no significant difference in HR and MAP between the two groups at T1 (P>0.05). HR and MAP in the two groups at T2 were lower than those at T1, but the levels of each index in the observation group were higher than those in the control group (P<0.05). HR and MAP in the observation group at T3 stage returned to the level at T1, and there was significant difference between the two groups (P<0.05); ⑸ Adverse reactions: the incidence of adverse reactions in the observation group (8.0%) was lower than that in the control group (32.0%, P<0.05).@*Conclusions@#The application of thoracic paravertebral nerve block combined with general anesthesia in total thoracoscopic lobectomy is safe and can inhibit the large fluctuation of hemodynamics in elderly patients with non-small cell lung cancer, shorten hospitalization time and post-operative rehabilitation time, alleviate post-operative pain, reduce the content of serum tumor markers, and reduce the risk of adverse reactions.

Perioperative application of thoracic paravertebral nerve block combined with general anesthesia in elderly patients with non-small cell lung cancer / 中国医师杂志

Objective To investigate the effect of thoracic paravertebral nerve block combined with general anesthesia in the perioperative period of elderly patients with non-small cell lung cancer (NSCLC).Methods 50 elderly patients with NSCLC in our hospital from June 2015 to June 2018 were randomly divided into control group (n =25) and observation group (n =25).The control group was given general anesthesia,while the observation group was given thoracic paravertebral nerve block combined with general anesthesia.Postoperative recovery (recovery time,extubation time,ambulation time,feeding time) and hospitalization time,visual analogue scale (VAS) score at 2,12,24 and 48 hours after operation,serum tumor markers [cyfra21-1],carbohydrate antigen 125 (CA125),CA199,carcinoembryonic antigen (CEA) were counted and compared.The heart rate (HR),mean arterial pressure (MAP) [preoperative (T1),15 minutes (T2),5 minutes (T3) after anesthesia],and the incidence of adverse reactions were recorded.Results (1) Postoperative recovery and hospitalization time:hospitalization time,recovery room stay time,extubation time,out-of-bed activity time and eating time of the observation group were shorter than those of the control group (P ＜ 0.05);(2) Pain degree:VAS score of the observation group was lower than that of the control group at 2,12 and 24 hours after operation (P ＜0.05),and 48 hours after operation VAS score of the observation group was lower than that of the control group (P ＜ 0.05).There was no significant difference between the two groups (P ＞ 0.05);(3) Serum tumor markers:there was no significant difference in serum cyfra21-1,CA125,CA199 and CEA levels between the two groups before operation (P ＞ 0.05).After operation,serum cyfra21-1,CA125,CA199 and CEA levels of the two groups were decreased,and the indexes in observation group were lower than that of the control group (P ＜ 0.05);(4) Hemodynamics:there was no significant difference in HR and MAP between the two groups at T1 (P ＞ 0.05).HR and MAP in the two groups at T2 were lower than those at T1,but the levels of each index in the observation group were higher than those in the control group (P ＜ 0.05).HR and MAP in the observation group at T3 stage returned to the level at T1,and there was significant difference between the two groups (P ＜0.05);(5) Adverse reactions:the incidence of adverse reactions in the observation group (8.0％) was lower than that in the control group (32.0％,P ＜ 0.05).Conclusions The application of thoracic paravertebral nerve block combined with general anesthesia in total thoracoscopic lobectomy is safe and can inhibit the large fluctuation of hemodynamics in elderly patients with non-small cell lung cancer,shorten hospitalization time and post-operative rehabilitation time,alleviate post-operative pain,reduce the content of serum tumor markers,and reduce the risk of adverse reactions.

Meta-analysis of flucytosine or fluconazole plus amphotericin B for the treatment of acquired immunodeficiency syndrome-associated cryptococcal meningitis / 中华传染病杂志

Objective To evaluate the survival benefit of amphotericin B (AmB) plus flucytosine or fluconazole for treatment of patients with acquired immunodeficiency syndrome (AIDS)-associated cryptococcal meningitis.Methods The following database were searched from the beginning to October 2013,including Cochrane library,PubMed,OVID,Embase,Wanfang Date,CNKI and Chinese Biomedical Database,and the references of eligible studies were manually screened.Reference lists of relevant articles were screened according to selection and extraction criteria.Meta-analysis was performed using RevMan 5.2.Results Four prospective controlled studies with a total of 399 patients with cryptococcal meningitis were identified,including 386 patients with AIDS-associated cryptococcal meningitis and 13 human immunodeficiency virus (HIV)-negative patients.Two hundred and twentyseven patients were treated with AmB and flucytosine combination therapy,including 217 patients with AIDS-associated cryptococcal meningitis and 10 HIV-negative patients.One hundred and seventy-two patients were treated with AmB and fluconazole combination therapy,including 169 patients with AIDS-associated cryptococcal meningitis and 3 HIV-negative patients.The Meta-analysis revealed that the mortality rate in AmB plus flucytosine combination therapy group was 6.6％ (95％ CI:18.5％-31.6 ％) at two weeks point,which was significantly lower than that in AmB plus fluconazole combination group (19.7％,95％CI:-23.6％-62.9％; OR=0.51,95％CI:0.27-0.93,P＜0.05).But at 10 weeks point,the mortality rate in flucytosine combination group was 12.9％ (95％oo CI:-22.2％-48.0％),which was lower than that in fluconazole combination group (31.4％,95％ CI:-23.1％-85.9 ％).However,there was no statistically significant difference between these two groups at 10 weeks point (OR=0.70,95％CI:0.44-1.13,P=0.15).Conclusion Administration of AmB plus flucytosine at early stage can reduce the mortality rate in patients with AIDS-associated cryptococcal meningitis.

Study on the possibility of pulp regeneration of different irreversible pulpitis / 中国基层医药

Objective To investigate the possibility of pulp regeneration of different irreversible pulpitis with absorbable gelatin sponge as the scaffold,and dental seed cells,induced molecules and MTA closed.Methods 150 patients with irreducible pulpitis,who were removed the crown infection pulp and retained the root living pulp,according to the visiting sequence,were randomly divided into two groups.The experimental group was given absorbable gelatin sponge as the scaffold and MTA closed.The control group was given calcium hydroxide coverage.The symptoms situation and pulp situation were observed.Results 6 months after surgery,the success rate of acute pulpitis and chronic closed pulpitis in the experimental group was 76.5％ and 47.0％,which were significantly higher than those of the control group (14.3 ％,8.8％) (P ＜ 0.01).In the experimental group,the success rate of chronic hyperplastic pulpitis and chronic ulcerative pulpitis was 33.0％ and 35.0％,which were higher than those of the control group(9.1％,6.0％),but the differences between the two groups were not statistically significant (P ＞ 0.05).Conclusion Pulp regeneration in vivo is possible with absorbable gelatin sponge as the scaffold and MTA,pulp regeneration of acute pulpitis and chronic closed pulpitis are more likely to induce.

Study on the therapeutic efficacy of root canal preparation using pathfile in combination of protaper / 中国医师杂志

Objective To evaluate the clinical effect of the use of pathfile and protaper nickel-titanium instruments for machine in root canal preparation.Methods A total of 200 patients suffering from pulpitis and periapical that needs root canal treatment was randomly divided into two groups according to treatment order (100 patients/each group).The experimental group was used pathfile and protaper in root canal preparation,and filled with warm gutta vertical condensation.The control group was used protaper root canal preparatory standards method,and filled with warm gutta vertical condensation.The required time of two sets of root canal preparation and the number of equipment broken were recorded,and X-ray film at the preoperation intraoperation and postoperation were used to evaluate effect of preparation and root filling.Results In the root canals prepared of the two groups,no issued offset,no side wear,no step-forming,and no position changed of the apical foramen were occurred,which was consistent with preperative X-ray film.One case was occurred fracture of instrument in the experimental group and the control group,it was Slfile.Tooth position was right mandibular,second molar nearly the root apical 1/3,and upper left second molar mesial buccal root apical position.The root canal preparation time of experimental group was significantly shorter than the control group[the front teeth:(4.73 ± 1.12) min vs (6.32 ± 1.84) min,t =2.243,P ＜0.05; the premolars:(7.83±1.23)min vs (10.25±2.68)min,t =2.475,P ＜0.05; the molars (10.14 ± 1.18) min vs (15.43 ± 5.94) min,t =2.991,P ＜ 0.01].Postoperative X-ray showed that 2 cases were occurred small amount of paste overfilled,the root canal closed tight,no less filling; and 3 cases of the control group occurred paste overfilled,no less filling too.Conclusions The use of nickel-titanium instruments pathfile and protaper for machine in root canal preparation is feasible,and improves the efficiency of root canal preparation.

Three hundred and ninety-five eases of nosocomial bloodstream infection / 中华传染病杂志

Objective To characterize clinical feature, frequency of isolation and antimicrobial susceptibility of pathogens isolated from patients with nosocomial bloodstream infections in Huashan Hospital, Fudan University from 1995 to 2004. Methods The clinical data of all patients who were diagnosed with nosocomial bloodstream infections based on national diagnostic criteria of nosocomial bloodstream infections were retrospectively analyzed. The pathogens were routinely isolated and identified. Susceptibilities against antimicrobial agents were determined by Kirby-Bauer methods and analyzed by WHONET 5.0 software. Results During the 10-year study period, a total of 395 patients were diagnosed with nosocomid bloodstream infection with 435 strains isolated from blood specimen.Gram positive bacteria, Gram negative bacilli and fungi, accounted for 47.4%, 45.1 % and 7.6%,respectively. Coagulase-negative Staphylococci (21.4%), S. aures (17.9%), E.coli (13.6%), K. pneumoniae (10.8%), Candidaspp (7.4%), Enterococci (6.0%), Pseudomonasspp (6.0%) and Acinetobacter spp (3.7%) were frequently identified isolates. S. aures and coagulase-negative Staphylococci resistant to methicillin were 62.8% and 87.1%, respectively. The susceptibilities of cefotaxime and ceftazidime against E. coli and K. preumonine were 46%-78% and 27.7%-40.4%, respectively. Conclusions The Gram positive cocci are slightly more prevalent than Gram negative bacilli in nosocomial bloodstream infections and resistance to the first line antibiotics is common among all pathogens isolated. Candida spp is the fifth leading cause of nosocomial bloodstream infections.