Sulphate reduction, mixed sulphide- and thiosulphate-driven Autotrophic denitrification, NItrification, and Anammox (SANIA) integrated process for sustainable wastewater treatment.

This study proposes the Sulphate reduction, mixed sulphide- and thiosulphate-driven Autotrophic denitrification, Nitrification, and Anammox integrated (SANIA) process for sustainable treatment of mainstream wastewater after organics capture. Three moving-bed biofilm reactors (MBBRs) were applied for developing sulphate reduction (SR), mixed sulphide- and thiosulphate-driven partial denitrification and Anammox (MSPDA), and NItrification (N), respectively. Typical mainstream wastewater after organics capture (e.g., chemically enhanced primary treatment, CEPT) was synthesized with chemical oxygen demand (COD) of 110 mg/L, sulphate of 50 mg S/L, ammonium of 30 mgN/L. The feasibility of SANIA was investigated with mimic nitrifying effluent supplied in MSPDA-MBBR (Period I), followed by the examination of the applicability of SANIA process with N-MBBR integrated (Period II), under moderate temperatures (25-27 â„ƒ). In Period I, SANIA process was established with both SR- and MSPDA-MBBR continuously operated for over 300 days (no Anammox biomass inoculation). Specifically, in MSPDA-MBBR, high rates of denitratation (2.7 gN/(m2·d)) and Anammox (2.8 gN/(m2·d)) were achieved with Anammox contributing to 81 % of the total inorganic nitrogen removal. In Period II, the integrated SANIA system was continuously operated for over 130 days, achieving up to 90 % of COD, 93 % of ammonium, and 61 % of total inorganic nitrogen (TIN) removal, with effluent concentrations lower than 10 mg COD/L, 3 mg NH4+-N/L, and 13 mg TIN-N/L. The implementation of SANIA can ultimately reduce 75 % and 40 % of organics and aeration energy for biological nitrogen removal. Considering the combination of SANIA with CEPT for carbon capture and sludge digestion/incineration for energy recovery, the new integrated wastewater technology can be a promising strategy for sustainable wastewater treatment.

Application value of Qisexingtai hand diagnostic method in diagnosis of coronary artery disease.

OBJECTIVE: To evaluate the diagnostic efficacy of Qisexingtai hand diagnostic method in the diagnosis of coronary artery disease (CAD). METHODS: This was an investigator-initiated, prospective, multi-center, cross-sectional study. All the participants from three hospitals in China had been diagnosed by both Qisexingtai hand diagnostic method and coronary angiography. We compared the two diagnostic methods to calculate the sensitivity, the specificity, the omission diagnostic rate, the mistaken diagnostic rate and accuracy in order to evaluate the diagnostic efficacy of Qisexingtai hand diagnostic method for CAD. RESULTS: A total of 326 subjects were enrolled, diagnosed by both Qisexingtai hand diagnostic method and coronary angiography. As a result, there were 166 positive cases according to Qisexingtai hand diagnostic method, and 131 positive cases according to coronary angiography. Compared with the results of coronary angiography, the sensitivity of Qisexingtai hand dia-gnostic method was 80.2%, the specificity was 68.7%, the omission diagnostic rate was 19.8%, the mistaken diagnostic rate was 31.3%, and the accuracy was 73.3%. Area under the receiver operating characteristic curve was estimated as 0.735 for all, and 0.718, 0.735, 0.783 for the three sub-centers. CONCLUSION: Qisexingtai hand diagnostic method with high accuracy and sensitivity has certain application value in the diagnosis of CAD.

Copper(II) Frameworks with Varied Active Site Distribution for Modulating Selectivity of Carbon Dioxide Electroreduction.

Metal-organic frameworks (MOFs) can be utilized as electrocatalysts for CO2 reduction reaction (CO2RR) due to their well dispersed metal centers. However, the influence of metal node distribution on electrochemical CO2RR was rarely explored. Here, three Cu-MOFs with different copper(II) site distribution were employed for CO2 electroreduction. The Cu-MOFs [Cu(L)SO4]·H2O (Cu1), [Cu(L)2(H2O)2](CH3COO)2·H2O (Cu2), and [Cu(L)2(H2O)2](ClO4)2 (Cu3) were achieved by using the same ligand 1,3,5-tris(1-imidazolyl)benzene (L) but different Cu(II) salts. The results show that the Faraday efficiency of CO (FECO) for Cu1 is 4 times that of the FEH2, while the FECO of Cu2 is twice that of the FEH2. As for Cu3, there is not much difference between FECO and FEH2. Such difference may arise from the distinct electrochemical active surface area and charge transfer kinetics caused by different copper site distribution. Furthermore, the different framework structures also affect the activity of the copper sites, which was supported by the theoretically calculated Gibbs free energy and electron density, contributing to the selectivity of CO2RR. This study provides a strategy for modulating the selectivity of CO2RR by tuning the distribution of the active centers in MOFs.

Fluorescent Zn(II) frameworks with multicarboxylate and pyridyl N-donor ligands for sensing specific anions and organic molecules.

Three novel fluorescent Zn(II) frameworks, namely [Zn(DPA)(NDA)]2·2DMF (1), [Zn2(DPA)(OBA)2]·2DMF·4H2O (2) and [Zn(DPA)(HNTB)]·H2O (3) (DPA = 2,5-di(pyridin-4-yl)aniline, H2NDA = 1,4-naphthalenedicarboxylic acid, H2OBA = 4,4'-oxydibenzoic acid, H3NTB = 4,4',4''-nitrilotribenzoic acid, DMF = N,N-dimethylformamide), were successfully fabricated and structurally characterized. Due to the variety of organic linkers, 1-3 exhibit varied topologies: 1 is a 4-c three-dimensional (3D) framework with {65·8} topology, 2 is a 6-c 3D net with point symbol of {44·610·8}, and 3 is a 4-c two-dimensional network that further stacks into a 3D structure by hydrogen bonding interactions with {44·62} topology. Experiments related to fluorescence show that 1-3 can be utilized to quickly identify specific anions of CrO42-/Cr2O72-, and organic molecules such as 2,4,6-trinitrophenol and benzaldehyde.

Severe diabetic foot repaired by tibial bone transverse transport combined with flap transfer: Report of 7 cases / 中华显微外科杂志

Objective:To investigate the clinical effect of Ilizarov technique of tibial bone transverse transport combined with flap transfer in the treatment of severe diabetic foot.Methods:From April 2016 to March 2020, 7 patients with severe diabetic foot were treated by Ilizarov technique of tibial bone transverse transport combined with flap transfer in the Department of Hand and Foot Surgery of Foshan Nanhai Public Health Hospital. Diabetes Wagner classification: 2 cases were in Grade 3, in which, 1 case was ulcer in right heel and deep plantar with abscess and infection, and 1 case was ulcer in left great toe and phalanx infection; Other 5 cases were in Grade 4, of them, 2 cases were gangrene in proximal and distal of left great toe, 1 case were gangrene and infection in proximal, middle and distal segment of right 2nd toe, 1 case were gangrene and infection in proximal, middle and distal segment of left 4th toe, and 1 case were gangrene in distal segment of left 4th toe. Wound area was 2.0 cm×2.0 cm-6.0 cm×12.0 cm. Sural neurouascular flaps were used in 1 case, dorsal plantar artery flaps in 4 cases and medial plantar artery flaps in 2 cases. Size of flap was 2.0 cm×2.0 cm-6.0 cm×12.0 cm. Follow-up was conducted regularly by outpatient clinic, telephone and WeChat interviews. Content of the follow-up included foot wound healing, skin temperature of dorsal foot, lower limb paralysis, puncture exudation of external fixation stent, and blood supply of calf skin. Foot function was assessed according to the American Orthopedic Foot and Ankle Association (AOFAS) score.Results:All 7 patients entered the follow-up for 6-28 months, with an average of 8.2 months. All the foot ulcers healed. The pain of affected limbs eased off in 5 patients, and 2 patients had significant pain relief in affected limbs. Foot paralysis significantly alleviated in 7 patients, with calf skin temperature increased (1.81±0.56) ℃, and no recurrence of foot ulcers. According to AOFAS score, 3 cases were excellent, 3 cases were good and 1 case was fair.Conclusion:Ilizarov technique of tibial bone transverse transposition combined with flap transfer in the treatment of severe diabetic foot has a good clinical effect and it could be an option in the treatment of diabetic foot.

Oleanolic acid regulates the Treg/Th17 imbalance in gastric cancer by targeting IL-6 with miR-98-5p.

BACKGROUND: Gastric cancer (GC) was a type of malignant tumor with a very high fatality rate. Oleanolic acid (OA) was a class of pentacyclic triterpenes which was proved to have anti-cancer activity. While the specific molecular mechanism of OA's role in inhibiting GC was not fully understood. This study aimed to explore how OA played an anti-cancer role in GC. METHODS: Expression of miR-98-5p was examined using qPCR, and expression levels of Treg/Th17-related factors were evaluated using qPCR and western blot. Flow cytometry was conducted to assess the proportion of Treg cells and Th17 cells. Besides, dual luciferase reporter assay was performed to verify that IL-6 was a target of miR-98-5p. RESULTS: Downregulation of miR-98-5p and upregulation of Treg/Th17-related factors were observed in GC tissues. What's more, the Treg/Th17 imbalance was found in PBMCs of GC patients. Overexpression of miR-98-5p promoted balance of Treg/Th17 cells via directly targeting IL-6 to downregulate expression of IL-6. Finally, OA could promote balance of Treg/Th17 cells by upregulating expression of miR-98-5p. DISCUSSION: All our results proved that OA could promote balance of Treg/Th17 cells in GC by targeting IL-6 with miR-98-5p, indicating a potential drug for treatment of GC.

A single-crystal to single-crystal transition from a 7-fold interpenetrated coordination polymer to a non-interpenetrated one by photochemical [2 + 2] polymerization and their sensing properties.

Two complexes, namely [Zn(bpeb)(sda)] (1) and [Zn(poly-bpeb)(sda)] (2), were synthesized by an organic ligand with an extensively conjugated system, bpeb = 1,4-bis[2-(3-pyridyl) vinyl]-benzene, H2sda = sulfonyldibenzoic acid and d10 metal centers Zn2+. Structural analysis revealed that compound 1 was nonporous and possessed 7-fold interpenetrated three-dimensional (3D) frameworks constructed from one-dimensional (1D) Zn-bpeb and Zn-sda chains. Interestingly, due to the short distance between the vinyl groups from two neighboring bpeb ligands, compound 1 could undergo a photochemical [2 + 2] polymerization reaction to generate 2 in a single-crystal to single-crystal (SCSC) manner under the irritation of UV. Moreover, the organic polymer in 2 could be depolymerized by heating to realize the reversible transformation from 2 to 1. Furthermore, both compounds 1 and 2 could be used as fluorescent sensors for 2,4,6-trinitrophenol (TNP) with high selectivity and sensitivity.

Luminescent silver(i) complexes with pyrazole-tetraphenylethene ligands: turn-on fluorescence due to the coordination-driven rigidification and solvent-oriented structural transformation.

A new tetrapyrazole-modified tetraphenylethene (TPE) ligand L was designed and found to display "turn-on" fluorescence when it combines with Ag+ ions in dilute solution by restricting intramolecular rotation of TPE. A series of Ag complexes 1-7 were obtained, and they exhibit excellent fluorescence properties in the solid state. Compared with PF6-, the silver complex with the CF3SO3- anion can further enhance its fluorescence due to the transformation of its structure from Ag2L (2) to Ag4L2 (3). As zero-dimensional complexes, 1 and 3 have excellent piezochromic properties with a color change from blue to green. Furthermore, structural changes of 1 and 3 to the corresponding three-dimensional frameworks 4 and 5 occur upon immersing in ethanol. In addition, 1 can act as a potential fluorescent probe for sensing nitrile compounds.

Recovery of a patient with severe COVID-19 by acupuncture and Chinese herbal medicine adjuvant to standard care / 中西医结合学报

There is currently no drug or therapy that can cure the coronavirus disease 2019 (COVID-19), which is highly contagious and can be life-threatening in severe cases. Therefore, seeking potential effective therapies is an urgent task. An older female at the Leishenshan Hospital in Wuhan, China, with a severe case of COVID-19 with significant shortness of breath and decrease in peripheral oxygen saturation (SpO

Relationship between programmed cell death and myocardial ischemia-reperfusion injury and new perspectives of traditional Chinese medicine intervention / 中国中药杂志

Myocardial ischemia-reperfusion injury(MIRI) is an urgent problem in clinical treatment. As cardiomyocytes are terminal cells, MIRI-induced cardiomyocyte death will irreversibly damage the structure and function of the heart. In previous studies, apoptosis was considered to be the only way to regulate cell death, while necrosis could not be regulated. However, current studies have shown that cell necrosis could also be regulated, which was collectively called programmed cell death(PCD). Regulated cell death is actively mediated through molecular pathways, so there is the possibility of inhibiting this signaling to reduce MIRI. At present, PCD mainly includes apoptosis, autophagy, necrosis, pyroptosis and ferroptosis. As a unique treature in China, traditional Chinese medicine has the advantages of multiple pathways, multiple targets, low toxicity, less side effects and low economic costs. With the in-depth study of the efficacy of traditional Chinese medicine against MIRI, it has been confirmed that traditional Chinese medicine could regulate PCD to reduce MIRI. Therefore, this paper focuses on the relationship between PCD and MIRI, and new studies on intervention with relevant traditional Chinese medicine, with the aim to provide new MIRI prevention and treatment methods from the perspective of "intervention of PCD".

Clinical characteristics of coronavirus disease 2019 infected with Delta variant in Guangzhou:A real-world study / 中华急诊医学杂志

Objective:To summarize the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) infected with Delta variant, so as to provide further references for clinical diagnosis and treatment.Methods:A real-world study was conducted to analyze the characteristics of 166 COVID-19 patients infected with Delta variant at Guangzhou Eighth People’s Hospital, Guangzhou Medical University.Results:The study enrolled 5 asymptomatic cases, 123 non-severe cases (mild and moderate type), and 38 severe cases (severe and critical type). Among these patients, 69 (41.6%) were male and 97 (58.4%) were female, with a mean age of 47.0±23.5 years. Thirty-nine cases (23.5%) had received 1 or 2 doses of inactivated vaccine. The incidence of severe COVID-19 cases was 7.7% in 2-doses vaccinated patients, which was lower than that of 11.5% in 1-dose and 26.8% in unvaccinated patients. The proportion of severe cases in 2 dose-vaccinated patients was 7.7%, which was lower than that of 11.5% in 1-dose vaccinated patients and 26.8% in unvaccinated patients, but the difference was not significant ( P>0.05). The most common clinical symptom was fever (134 cases, 83.2%), and 39.1% of cases presented with high-grade fever (≥39 °C); other symptoms were cough, sputum, fatigue, and xerostomia. The proportion of fever in severe cases was significantly higher than that of non-severe cases (97.4% vs. 76.4%, P<0.01). Similarly, the proportion of severe cases with high peak temperature (≥39 ℃) () was also higher than that of non-severe cases (65.8% vs. 30.9%, P<0.01). The median minimal Cycle threshold (Ct) values of viral nucleic acid N gene and ORFlab gene were 20.3 and 21.5, respectively, and the minimum Ct values were 11.9 and 13.5, respectively. Within 48 h of admission, 9.0% of cases presented with decreased white blood cell counts, and 52.4% with decreased lymphocyte counts. The proportions of increased C-reactive protein, serum amyloid A, interleukin 6, and interleukin 10 were 32.5%, 57.4%, 65.3%, and 35.7%, respectively. The proportions of elevated C-reactive protein, serum amyloid A and interleukin-6 in severe cases were significantly higher than those in non-severe cases ( P<0.01). Logistic regression analysis showed that older age and higher peak temperature were associated with a higher likelihood of severe cases ( OR>3, 95% CI: 2-7, P<0.01). In terms of treatment, traditional Chinese medicine (TCM) was used in 97.6% of non-severe cases and 100% in severe cases. Other treatments included respiratory and nutritional support, immunotherapy (such as neutralizing antibodies and plasma of recovered patients). The median times from admission to progression to severe cases, of fever clearance, and of nucleic acid conversion were 5 days, 6 days and 19 days, respectively. No deaths were reported within 28 days. Conclusions:The symptoms of Delta variant infection in Guangzhou are characterized by a high proportion of fever, high peak temperature, long duration of fever, high viral load, a long time to nucleic acid conversion, and a high incidence of severe cases. The severe cases exhibit a higher percentage of elderly patients, a longer duration of fever and have a higher fever rate and a higher hyperthermia rate than non-severe cases. Age and hyperthermia are independent risk factors for progression to severe disease. The combination of TCM and Western medicine can control the progression of the disease effectively.

Effect of Tongguan Capsules () on Restenosis after Coronary Stent Implantation: Study Protocol for A Randomized Controlled Trial / 中国结合医学杂志

BACKGROUND@#Although percutaneous coronary intervention (PCI) had become widely employed therapeutic procedure for coronary artery disease, stent restenosis limited the benefits of this revascularization and the question how to prevent such events remained unresolved. While numerous empirical observations suggested Tongguan Capsules (), a patented Chinese Medicine, could decrease frequency and duration of angina pectoris attacks, evidence supporting its efficacy on restenosis remained inadequate.@*OBJECTIVE@#This trial was designed to determine whether Tongguan Capsules would reduce restenosis rate in patients after successful stent implantation.@*METHODS@#Approximately 400 patients undergoing percutaneous coronary stent deployment were enrolled and randomized to control group or Tongguan Capsules (4.5 g/d) for 3 months. All patients received standard anti-platelet, anti-coagulation and lipid-decreasing treatments, concurrently. The primary clinical endpoint was the 12-month incidence of the major adverse cardiovascular events (defined as cardiac death, myocardial infarction, and recurrence of symptoms requiring additional revascularization). The angiographic end point was restenosis rate at 6 months.@*CONCLUSION@#This study would provide important evidence for the use of Tongguan Capsules in patients after stent implantation in combination with routine therapies, which may significantly reduce incidence of the restenosis so as to potentially improve the clinical outcomes. (registration number: ChiCTR-TRC- ChiCTR-IIR-17011407).

Effect of PI3K/Akt Signal Pathway Crosstalk in Myocardial Ischemia Reperfusion Injury and Prevention and Treatment with Traditional Chinese Medicine Therapy / 中国实验方剂学杂志

Myocardial ischemia-reperfusion injury （MIRI） was originated from the ischemic injury to myocardial cells due to some factors， and the injury will be aggravated after the blood supply recovery. MIRI will cause reperfusion arrhythmia， myocardial stagnation， microcirculation disorders or blood loss reflow， and become a key issue to be solved in the clinical treatment. Therefore， it is of important clinical significance to explore how to improve MIRI. The phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway has been regarded to be an important cascade signaling pathway to prevent MIRI， which is cross-talked in such mechanisms as oxidative stress， calcium overload， autophagy， inflammation， endoplasmic reticulum stress and mitochondrial dysfunction. This pathway is at the core site and closely related to the severity of MIRI. Meanwhile， traditional Chinese medicine（TCM） has its unique advantages in the prevention and treatment of MIRI， including multiple targets， multiple pathways， fewer toxic and side effect， as well as TCM characteristics of syndrome differentiation treatment and overall concept. A great number of studies have confirmed that this pathway is a common mechanism of action for most TCM compounds， TCM monomers and extracts. In this paper， we clarify the effect of PI3K/Akt signaling pathway crosstalk on the myocardial ischemia-reperfusion injury， with the focus on the relationship between the key targets of PI3K/Akt signaling pathway and MIRI. It will give great insights to the intricate relationship between them and promote the future development of new drugs targeting the PI3K/Akt signaling pathway. Finally， we also summarized the existing findings of TCM on PI3K/Akt pathway， which provides a reference for the treatment and drug development of MIRI.

Application of Free Venous Flap with Tendons and Nerves for Repairing Compound Palmar Tissue Defects / 现代医院

Objective To explore a one-time repairing method for defects in palmar skin soft tissue, proper palmar nerves and arteries, and flexor tendon.Methods From March 2011 to June 2016, the defects in palamar skin, nerves, blood vessels or flexor tendons of 21 fingers in 20 cases were repaired by using the resected superficial veins and tendons and nerves of skin soft tissue on axes of indicis proprius tendon (extensor digiti quinti) or forearm-palmaris longus tendon or foot back short tendons of the first or second toes were cut according to the defects in palmar skin soft tissue, nerves, blood vessels and flexor tendon, Results All the vein flaps of the 20 cases were survived.The patients were followed up for 6 to 24 months.Both the shape and function of the fingers recovered well.The flaps were of good quality, with no obvious pigmentation, and good at sensations (The sensation between two points were 9 mm on average).Conclusion It was a simpler and more convenient way to repair defects in palmar skin soft tissue, nerves, blood vessels and flexor tendons using free venous flap with tendons and nerves for transplantation.It also ensures the blood-supply without sacrificing the main vessels, and thus it is an ideal method for repairing simultaneous defects in skin soft tissue, nerves and flexor tendon.

Analysis of on medication rules for Qi-deficiency and blood-stasis syndrome of chronic heart failure based on data mining technology / 中国中药杂志

To analyze the medication features and the regularity of prescriptions of traditional Chinese medicine in treating patients with Qi-deficiency and blood-stasis syndrome of chronic heart failure based on modern literature. In this article, CNKI Chinese academic journal database, Wanfang Chinese academic journal database and VIP Chinese periodical database were all searched from January 2000 to December 2015 for the relevant literature on traditional Chinese medicine treatment for Qi-deficiency and blood-stasis syndrome of chronic heart failure. Then a normalized database was established for further data mining and analysis. Subsequently, the medication features and the regularity of prescriptions were mined by using traditional Chinese medicine inheritance support system(V2.5), association rules, improved mutual information algorithm, complex system entropy clustering and other mining methods. Finally, a total of 171 articles were included, involving 171 prescriptions, 140 kinds of herbs, with a total frequency of 1 772 for the herbs. As a result, 19 core prescriptions and 7 new prescriptions were mined. The most frequently used herbs included Huangqi(Astragali Radix), Danshen(Salviae Miltiorrhizae Radix et Rhizoma), Fuling(Poria), Renshen(Ginseng Radix et Rhizoma), Tinglizi(Semen Lepidii), Baizhu(Atractylodis Macrocephalae Rhizoma), and Guizhi(Cinnamomum Ramulus). The core prescriptions were composed of Huangqi(Astragali Radix), Danshen(Salviae Miltiorrhizae Radix et Rhizoma) and Fuling(Poria), etc. The high frequent herbs and core prescriptions not only highlight the medication features of Qi-invigorating and blood-circulating therapy, but also reflect the regularity of prescriptions of blood-circulating, Yang-warming, and urination-promoting therapy based on syndrome differentiation. Moreover, the mining of the new prescriptions provide new reference and inspiration for clinical treatment of various accompanying symptoms of chronic heart failure. In conclusion, this article provides new reference for traditional Chinese medicine in the treatment of chronic heart failure.

Is there an improvement of antibiotic use in China? Evidence from the usage analysis of combination antibiotic therapy for type I incisions in 244 hospitals / 华中科技大学学报（医学）（英德文版）

The improvement of antibiotic rational use in China was studied by usage analysis of combination antibiotic therapy for type I incisions in 244 hospitals. Five kinds of hospitals, including general hospital, maternity hospital, children's hospital, stomatological hospital and cancer hospital, from 30 provinces were surveyed. A systematic random sampling strategy was employed to select outpatient prescriptions and inpatient cases in 2011 and 2012. A total of 29 280 outpatient prescriptions and 73 200 inpatient cases from 244 hospitals in each year were analyzed. Data were collected with regards to the implementation of the national antibiotic stewardship program (NASP), the overall usage and the prophylactic use of antibiotic for type I incisions. Univariate analysis was used for microbiological diagnosis rate before antimicrobial therapy, prophylactic use of antibiotics for type I incision operation, and so on. For multivariate analysis, the use of antibiotics was dichotomized according to the guidelines, and entered as binary values into logistic regression analysis. The results were compared with the corresponding criteria given by the guidelines of this campaign. The antibiotic stewardship in China was effective in that more than 80% of each kind of hospitals achieved the criteria of recommended antibiotics varieties. Hospital type appeared to be a factor statistically associated with stewardship outcome. The prophylactic use of antibiotics on type I incision operations decreased by 16.22% (P<0.05). The usage of combination antibiotic therapy for type I incisions was also decreased. Region and bed size were the main determinants on surgical prophylaxis for type I incision. This national analysis of hospitals on antibiotic use and stewardship allows relevant comparisons for bench marking. More efforts addressing the root cause of antibiotics abuse would continue to improve the rational use of antibiotics in China.

Is nationwide special campaign on antibiotic stewardship program effective on ameliorating irrational antibiotic use in China? Study on the antibiotic use of specialized hospitals in China in 2011-2012 / 华中科技大学学报（医学）（英德文版）

With dwindling number of new antibiotics and inappropriate use of antibiotics, the emergence and spread of antibiotics resistance occurs commonly in healthcare institutions worldwide. In China, antibiotics are commonly over prescribed and misused. This study is to assess the effect of the nationwide special campaign on antibiotic stewardship program (ASP) at specialized hospitals in China by investigating prescription information from 2011 to 2012. Data on the hospital consumption and prescription of systemic antibiotics were obtained from four specialized hospitals, including maternity, children's, stomatological and cancer hospitals. Systematic random sampling was used to select outpatient prescriptions and inpatient cases. A total of 105 specialized hospitals in 2011 and 121 specialized hospitals in 2012 were analysed. The defined daily doses (DDDs) per 100 inpatient days, the percentage of antibiotic use in outpatient prescriptions, and the percentage of antibiotic use in inpatient cases were used as measurements of antibiotic use. The overall antibiotic use density in the selected hospitals decreased between 2011 and 2012 from 39.37 to 26.54 DDD/100 inpatient days (P<0.001). The percentage of antibiotic use in outpatient prescriptions (range: 24.12%-18.71%, P=0.109) and inpatient cases (64.85%-60.10%, P=0.006) also decreased within the two years. Significant changes were observed among regions and different hospitals within the two years. And antibiotic consumption was correlated with the type and size of specialized hospital in 2012, but not with the regions. This analysis of antibiotic consumption of specialized hospitals allows relevant comparisons for benchmarking and shows that national ASP has improved antibiotic rational use in China. The data will assist policymakers in formulating effective strategies to decrease antibiotic overuse and identify areas that require further work.

Is nationwide special campaign on antibiotic stewardship program effective on ameliorating irrational antibiotic use in China? Study on the antibiotic use of specialized hospitals in China in 2011-2012 / 华中科技大学学报（医学）（英德文版）

With dwindling number of new antibiotics and inappropriate use of antibiotics, the emergence and spread of antibiotics resistance occurs commonly in healthcare institutions worldwide. In China, antibiotics are commonly overprescribed and misused. This study is to assess the effect of the nationwide special campaign on antibiotic stewardship program (ASP) at specialized hospitals in China by investigating prescription information from 2011 to 2012. Data on the hospital consumption and prescription of systemic antibiotics were obtained from four specialized hospitals, including maternity, children's, stomatological and cancer hospitals. Systematic random sampling was used to select outpatient prescriptions and inpatient cases. A total of 105 specialized hospitals in 2011 and 121 specialized hospitals in 2012 were analysed. The defined daily doses (DDDs) per 100 inpatient days, the percentage of antibiotic use in outpatient prescriptions, and the percentage of antibiotic use in inpatient cases were used as measurements of antibiotic use. The overall antibiotic use density in the selected hospitals decreased between 2011 and 2012 from 39.37 to 26.54 DDD/100 inpatient days (P<0.001). The percentage of antibiotic use in outpatient prescriptions (range: 24.12%-18.71%, P=0.109) and inpatient cases (64.85%-60.10%, P=0.006) also decreased within the two years. Significant changes were observed among regions and different hospitals within the two years. And antibiotic consumption was correlated with the type and size of specialized hospital in 2012, but not with the regions. This analysis of antibiotic consumption of specialized hospitals allows relevant comparisons for benchmarking and shows that national ASP has improved antibiotic rational use in China. The data will assist policymakers in formulating effective strategies to decrease antibiotic overuse and identify areas that require further work.

Effect of clinical pathways based on integrative medicine for patients with chronic heart failure: a multi-center research / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To assess a multi-center study effectiveness of clinical pathways based on integrative medicine (IM) for chronic heart failure (CHF) patients.</p><p><b>METHODS</b>A combined method of historical control study and clinical study on concurrent control was used. After the standard management for clinical pathways was carried out in four hospitals at home, the effects on hospitalization days, medical expenses, clinical efficacy, patient satisfaction, and quality of life were assessed.</p><p><b>RESULTS</b>Results of non-concurrent historical control study showed that: the hospital stay was significantly shorter in the pathways group than in the retrospective group (12.59 days vs 18.44 days), and the total cost of hospitalization was significantly reduced in the pathways group (yen 9 051.90 vs yen 11 978.40), showing statistical difference (P < 0.01). Moreover, the effect on the heart function was better in the pathways group than in the retrospective group (the markedly effective rate: 45.60% vs 21.90%; the total effective rate: 96.80% vs 86.10%), showing statistical difference (P < 0.01). Results of clinical study on concurrent control showed that the hospital stay was significantly shorter in the pathways group than in the control group (11.19 days vs 13.21 days), showing statistical difference (P < 0.05). The average total cost of hospitalization was significantly lower in the pathways group than in the control group (yen 8 656.80 vs yen 11 609.70), showing statistical difference (P < 0.01). As for clinical efficacy of Chinese medical syndrome, the total effective rate was higher in the pathways group than in the control group (97.10% vs 93.62%), showing statistical difference (P < 0.05). The markedly effective rate of heart function was better in the pathways group than in the control group, showing statistical difference (49.30% vs 38.30%, P < 0.05). The overall satisfaction was higher in the pathways group than in the conventional group (P < 0.01). There was no statistical difference in the mortality within 3 months after discharge from hospital, and the readmission rate due to heart failure between the two groups (P > 0.05). But there was statistical difference in the quality of life (P < 0.05).</p><p><b>CONCLUSION</b>The pathway could shorten the hospitalization time, decrease the cost of hospitalization, improve the clinical efficacy, improve patients' quality of life and satisfaction, therefore, it could be spread nationwide.</p>

Double blinded randomized and controlled study on treatment of chronic heart failure by nuanxin capsule / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To evaluate the effect and safety of Nuanxin Capsule (NXC) in treating patients with chronic heart failure (CHF).</p><p><b>METHODS</b>Adopting the randomized, positive controlled, double-blinded design, 150 CHF patients were assigned to the treatment group and the control group equally, they were treated with optimal western medical therapeutic scheme in combining respectively with NXC and placebo for 24 weeks. The indices for effectiveness and safety evaluation, such as Chinese medicine syndrome, grade of heart function, myocardial contraction, as well as the re-hospitalization rate and mortality, were observed.</p><p><b>RESULTS</b>The total effective rate on heart function in the treatment group and the control group was 78.87% and 64.38% respectively, that on Chinese medicine syndrome was 85.9% and 63.0% respectively, comparisons of the two indices between the two groups all showed significant difference (P < 0.05, P < 0.01). And a better efficacy for improving patients' cardiac contraction function and quality of life was shown in the treatment group (P < 0.05, P < 0.01). The re-hospitalization rates in them were 23.9% and 53.4% respectively (P < 0.05), and 22.54% and 42.5% of the re-hospitalized patients had attack of acute heart failure, a significant difference was found between the two groups (P < 0.05). The mortality in them was 2.90% and 8.95% respectively, showing no significant difference between groups (P > 0.05). No obvious adverse effect was found in both groups.</p><p><b>CONCLUSIONS</b>NXC could improve the heart function of patients, it has obvious curative effect and good safety in treating chronic heart failure.</p>