全国细菌耐药监测网2014—2021年血标本分离毗邻颗粒链菌的耐药性变迁

目的了解全国临床血标本分离毗邻颗粒链菌的耐药性变迁,为临床治疗提供依据。方法按照全国细菌耐药监测网(CARSS)技术方案的要求开展细菌耐药监测工作,参考美国临床实验室标准化协会(CLSI)标准,分析2014—2021年CARSS成员单位血标本分离毗邻颗粒链菌对抗菌药物的敏感性数据。结果2014—2021年CARSS成员单位每年血标本临床分离毗邻颗粒链菌为83~152株,2017年后呈逐渐增多趋势。血标本分离毗邻颗粒链菌对万古霉素敏感率为100%,对美罗培南的敏感率为93.7%,对头孢曲松、头孢噻肟、头孢吡肟的敏感率为90%左右,对左氧氟沙星的敏感率为82.8%,对青霉素的敏感率为65.0%,对红霉素和克林霉素的敏感率较低,分别为32.7%、46.8%。2014—2021年毗邻颗粒链菌对部分抗菌药物的敏感率有不同程度上升,对头孢吡肟、美罗培南的敏感率有所下降。结论临床血标本毗邻颗粒链菌检出数量呈上升趋势,且对青霉素、头孢菌素、碳青霉烯类、氟喹诺酮类、大环内酯类均呈现不同程度耐药,但尚未发现对万古霉素耐药的菌株。

2000年来中国人口地理演变的Agent模拟分析

以基于自主体模拟为建模工具,建立了包含气候、农业、社会影响因素的中国2000年来人口地理演变模型。基于该模型对南北人口格局的转变、东西人口格局(即胡焕庸线)的形成以及2000年来全局人口分布演化的动力机制做了分析。研究结果表明:在不考虑气候变化、农业生产潜力波动以及社会因素影响的情景下,中国各省人口模拟值与实际值的相关系数达到0.9733,省区间初始农业生产潜力差异决定了人口的基本分布状态,是人口分布特征的内在因素,对人口地理演化具有深远的影响;中国人口分布南重北轻的人口分布格局发生在910年代左右,以安史之乱导致的战祸和动荡的社会条件为主要演化动力;胡焕庸线中国人口东西部分布格局形成于1235-1255年代左右,以1230-1260A.D.的气候突变为该人口分布特征线形成的主要动力;气候变化对2000来历史人口分布的全局演化过程中起了主导驱动作用,在单影响要素的情景中,气候变化对全局人口分布形成的贡献率最大,为0.9869,进一步,气候变化对人口地理演化的影响以1230-1260A.D.的气候突变为转折点表现为阶段性差异。

Current treatment of chronic hepatitis C in China: Dilemma and potential problems

Major advances have been made in the treatment of chronic hepatitis C virus(HCV) infection with the advent of direct-acting antiviral agents(DAAs). China has the most cases of HCV infection worldwide, but none of the DAAs has been approved in China's Mainland so far, and interferon(IFN)-α-based treatment remains the standard of care. HCV patients without response or with contraindications to IFN-based therapy have no alternative options. However, many patients buy DAAs, especially the generic forms of sofosbuvir, from other countries or areas. Under these circumstances, the use of these drugs may cause many predictable and unpredictable problems in ethics, law and medical practice. Given the obstacles of legal accessibility to DAAs and the potential problems of obtaining and using DAAs in China, the early launching of the DAAs in China or the legalization of buying drugs from areas outside China and using these drugs in China is an urgent issue and needs to be dealt with as soon as possible, in the interest of the patients.

Global efforts in conquering lung cancer in China

Lung cancer,the most prevalent and deadly malignancy in the world,poses a particularly critical healthcare challenge to China due to the rapidly increasing new cases and the unique cancer genetics in Chinese patient population.Substantial progress has been made in molecular diagnosis and personalized treatment of the disease.The field is now moving towards multiple new directions to include(1) new generation of targeted agents such as epidermal growth factor receptor and anaplastic lymphoma kinase inhibitors to overcome resistance to their early generation counterparts;and(2) deeper understanding of tumor genetics of each individual patient and consequently the application of biomarkers to guide personalized treatment as well as novel drug development including combination therapy.The increasing capacity in innovative cancer drug research and development is supported by extensive collaboration within China and globally,and across academia and industry,to build up expertise and infrastructure in early-phase clinical testing of novel drugs.With these combined efforts,new and better medicines will be available for lung cancer patients in China in the near future.

Control Effects of Combination of Plant Induced Resistant Agents against Tobacco Mosaic Virus (TMV)

[ Objective] The paper was explore the control effects of combination of plant induced resistant agents against tobacco mosaic vires （TMV）. [ Method ] The control effects of 6 different combinations of plant induced resistant agents against TMV of flue-cured tobacco cultivar HangDa were studied under the environ- ment of simulated disease nursery. [ Result] The combination of 2 induced agents polypeptide-agent and 3-acetonyl-3-hydroxyoxindole （AHO） had good control effect against TMV, which could obviously delay the incidence time of TMV in infected tobacco plants. With water and Duxiao as control, their average control effects against TMV of tobacco plants during field period reached 69.64% and 43.25% after transplanting for 70 d. They also showed significant superiority accord- ing to Duncan＇s test （p = 0.05 ） in the aspects of plant height and leaf number, and the growth and development condition of leaves was good. Tobacco seedlings carrying TMV virus had no direct correlation with whether the symptoms performed, the seedlings carrying virus would perform symptom only when the incidence condition was suitable. The peak period for the incidence of TMV in seedlings carrying virus was during 19 d after transplanting. Spraying effective agents during nursery stage and field period, as well as promoting quick growth at the initial stage of tobacco seedlings after transplanting were the key measures to control its inci- dence. [ Conclusion] The study provided theoretical basis for preparing the control measures against TMV.

Study on Treatment of Heavy Metals in Fly Ash by a Chelating Agent

The fly ash from two municipal solid waste incineration plants in Shanghai was treated by the self-developed organic composite chelating agent. The results indicated that the stabilization effect of Pb in the fly ash by the composite chelating agent was the best,and the proportions of its easily leaching form in the two kinds of fly ash decreased from 29. 60% and 27. 49% to 3. 05% and 0. 29% respectively. The leaching toxicity of stabilized fly ash was lower than the limits of Standard for Pollution Control on the Landfill Site of Municipal Solid Waste（ GB 16889- 2008）,so it can be landfilled separately in the landfill site of municipal solid waste.

Effects of Different Microbial Agents on Aerobic Composting of Cow Manure

For the control of environment pollution caused by livestock and poultry manure, four microbial strains conducive to aerobic composting were selected and mixed into four compound microbial agents, and effects of different compound microbial agents on aerobic composting of cow manure were studied from aspects of changes in temperature, pH, water content and C/N during the composting process. The results show that microbial agent M2 has the best effect for aerobic composting of cow manure, so microbial agent M2 has broad popularization and application prospect in livestock and poultry farms in low-temperature areas of Northeast China.

Residue Dynamics of 20% Propargite Agent in Apple and Soil

To clear the degradation regularity of propargite in apple, the liquid chromatography was applied to study the residue and degradation dynamics of 20% propargite agent in apple and soil. The results showed that the half life of propargite in apple was 14.6-36.2 d, which was 7.1-8.6 d in soil. When the dosage of 20% propargite agent was 1 500-3 000 ml/hm^2, and the agent was sprayed for 2-3 times, the residues in apple and soil were less than 1.28 mg/kg. With comprehensive consideration on environmental safety, when 20% propargite agent was used to control apple mites, the recommended dosage was 1 500 ml/hm^2, the agent could be sprayed for 2-3 times, and the safety interval was 14 d.

The Application and Modification of Delegation-Agent Model in Agricultural Insurance

The delegation-agent models in agricultural insurance are established both under the circumstances of information symmetry and information asymmetry.Insurers choose effort level-a* according to the first order optimal condition of ∫{v(π-s(π))+λ11[u(s(π))]fa(π,a*)}dπ=λ11c'(a*)u(s(π)) at the present stage when the information is symmetric.While the information is asymmetric,the first order optimal condition changed into v'(π-s(π))u'(s(π))=λ21+μ21(1-fa(π,a)f(π,a)).In other words,the higher the output,the more and more income of insured.The paper also modifies the models,when the information is symmetric,the insurers determine the effort level of insured-a* based on the first order optimal condition of ∫{v(π-s(π))+λ12[u(s(π))]fa(π,a*)}dπ=λ12h'(a*)u(s(π));to the contrary,the first order optimal condition would change into v'(π*-s(π*))u'(s(π*))=λ22+μ22(1-fa(π,a)f(π,a))-λh(a)f(π,a)-μh'(a)f(π,a).The results show that the insured and the insurers would both benefit from the insurance when the effort cost function related to the expectation of the insured(agricultural producers).If the insured manage the objects of insurance more seriously,the rate of disasters would be lowered.Therefore,the insurance claimed against the insured would be lessened,and the benefits of the insurers would be increased at last.

The Research about the Trans-provincial Centralized Bidding Trading Market of East China Power Grid --II:Model Analysis

In this paper a novel cost function based on the relationship between operation cost of unit and generation load rate is employed in an agent-based model of Trans-provincial Centralized Bidding Trading Market of East China Grid. Simulation results are compared to real data to prove that the model is correct. Further analysis on simulation results point out the way to achieve an all-win game for power market members: generation companies improve their average load rates of the units by selling their electricity in the market, which makes units' cost drop and settlement price stay lower than benchmark price. Consequently electricity-demand provinces saved expenses, and units increase their profits. In conclusion, the trans-provincial electricity market of East China Power Grid is a successive case which improves the efficiency of the electricity industry by market-oriented measures.

不同保水剂及覆盖材料对西南旱作农田土壤特性和油菜生长的影响

为应对西南旱作农田耕地质量下降、水土流失严重等问题,通过田间小区试验,以不施加保水剂+无覆盖处理(A_(1)B_(1))为对照,探索不同保水剂:不施加保水剂(A_(1))、常规农用保水剂(A_(2))、微生物保水剂(A_(3)),不同覆盖材料:无覆盖(B_(1))、地膜覆盖(B_(2))、秸秆覆盖(B_(3))处理下对土壤特性的影响.结果表明,油菜花期以前不同覆盖处理配施保水剂能有效提高0~20 cm土层含水量,生长后期秸秆覆盖处理的保水效果减弱;不同覆盖处理配施保水剂可以显著提高土壤养分含量,其中A_(3)B_(2)处理的土壤碱解氮、有机质质量分数较对照处理显著提高了12.93%和45.79%,A_(3)B_(3)处理的土壤速效磷质量分数较对照处理显著提高了12.97%;A_(3)B_(2)及A_(2)B_(3)处理显著提高土壤蔗糖酶活性,各处理对过氧化氢酶活性无显著影响;通过Biolog-ECO培养发现A_(2)B_(1)及A_(3)B_(2)处理能够显著提高土壤微生物碳源代谢活性(AWCD),A_(3)B_(2)处理下土壤微生物对胺类碳源、氨基酸类碳源的利用率较对照处理显著提高了48.53%和33.94%,丰富度指数(R)、香农指数(H)和优势度指数(D)均在A_(3)B_(2)处理下达到峰值;A_(3)B_(2)处理下的油菜株高,地上部、地下部干物质质量及油菜产量显著高于对照处理.综合而言,不同覆盖材料及保水剂对土壤特性有积极影响,地膜覆盖配施微生物保水剂处理(A_(3)B_(2))能够显著改善土壤含水量和土壤养分状况,提高土壤酶及微生物活性,有利于油菜的生长和产量的增加,适宜在西南旱作区推广应用.

全国细菌耐药监测网2021年肿瘤科患者分离细菌耐药监测报告

目的 了解肿瘤科患者感染常见病原菌的分布及耐药性,为临床合理选择抗菌药物提供科学依据。方法 选取2020年10月—2021年9月全国细菌耐药监测网的监测数据,应用WHONET 5.6软件对纳入统计的102 570株细菌数据进行分析。结果 肿瘤科患者主要标本来源为痰(38.3%)、尿(18.5%)和血(12.2%)。临床分离菌株中,革兰阳性菌居前3位的分别是金黄色葡萄球菌(35.9%)、粪肠球菌(13.6%)和屎肠球菌(10.6%)。耐甲氧西林金黄色葡萄球菌(MRSA)检出率为25.0%。粪肠球菌和屎肠球菌对万古霉素耐药率分别为0.1%、0.8%。革兰阴性菌居前3位的分别是大肠埃希菌(30.6%)、肺炎克雷伯菌(21.7%)和铜绿假单胞菌(12.0%)。大肠埃希菌对头孢噻肟、头孢曲松耐药率超过50%,对碳青霉烯类耐药率约为1%。肺炎克雷伯菌对碳青霉烯类耐药率约为3%。耐碳青霉烯类铜绿假单胞菌检出率约为6%。结论 肿瘤患者临床分离细菌主要以革兰阴性菌为主,但耐药率不高。临床应继续加强抗菌药物合理使用,做好细菌耐药监测工作。

全国细菌耐药监测网2021年风湿免疫科患者分离细菌耐药监测报告

目的 了解2021年全国风湿免疫科患者临床分离菌株分布及对抗菌药物敏感情况。方法 按照全国细菌耐药监测网(CARSS)方案,将2021年所有CARSS成员单位上报的风湿免疫科患者临床分离细菌的数据纳入统计分析,药敏试验结果依据2022年美国临床实验室标准化协会(CLSI)标准判读。结果 2021年风湿免疫科患者分离非重复细菌28 863株,其中革兰阴性菌占72.0%(20 784株),革兰阳性菌占28.0%(8 079株)。居前5位的菌种分别为大肠埃希菌(9 825株,34.0%)、肺炎克雷伯菌(3 222株,11.2%)、金黄色葡萄球菌(3 002株,10.4%)、铜绿假单胞菌(1 793株,6.2%)、粪肠球菌(866株,3.0%)。标本来源主要为尿(13 496株,46.8%)、痰(7 597株,26.3%)、血(2 402株,8.3%)、脓液(1 243株,4.3%)。耐甲氧西林金黄色葡萄球菌(MRSA)与耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率分别为22.8%、67.2%,MRCNS对利奈唑胺耐药率为0.1%,未发现对万古霉素及替考拉宁耐药的葡萄球菌。粪肠球菌和屎肠球菌对万古霉素及利奈唑胺的耐药率为0.2%~4.0%。非脑脊液标本分离的肺炎链球菌对青霉素的耐药率为2.8%。铜绿假单胞菌和鲍曼不动杆菌对亚胺培南的耐药率分别为9.6%、20.2%。大肠埃希菌对头孢噻肟的耐药率为41.0%,对亚胺培南的耐药率为0.9%;肺炎克雷伯菌对头孢噻肟的耐药率为18.2%,对亚胺培南的耐药率为4.5%。流感嗜血杆菌对氨苄西林的耐药率为69.4%。结论 风湿免疫科患者临床分离菌主要来自尿标本,分离的细菌对常见抗菌药物的耐药率仍处于较高水平。

西南地区60家医院2000年～2002年降血糖药动态分析

目的 :掌握西南地区医院降血糖药的应用现状及趋势 ,以供生产、营销、使用等部门参考。方法 :调查2000年～2002年西南地区60家医院降血糖药的用药金额、主要品种数量、用药频度、每日药费等情况。结果 :口服降血糖药和胰岛素注射剂的用药金额年均增长率分别为14 12 %和42 09 % ,所占市场份额分别为67 20 %和32 78 %。结论 :二甲双胍、格列吡嗪是主要的口服降血糖药 ;胰岛素用药金额增长迅速 。

我国发展体育经纪人的对策研究

体育经纪人作为体育市场发展的行为主体之一,为活跃体育市场,开发体育商业价值起着重要的作用。在我国实行两个根本性转变的社会重大转型时期,建立和完善体育经纪人的管理体制和制度、法规,对促进我国体育经纪人的发展,有着积极的现实意义。本文通过文献研究和社会调查,就体育经纪人的基本理论,国外体育经纪人的管理体制与运行机制,我国体育经纪人目前的发展状况和前景等开展研究,并对建立我国体育经纪人的管理体系、法规体系、培训体系等提出可行性建议。提出体育行业经纪人应由国家体育总局和工商行政管理部门共同管理,国家体育总局的管理应分为总局、项目管理中心、具体操作部门3 个层次,抓住资格审定和注册、行纪过程的管理和监督以及教育和培训等主要环节,并提出了相应的管理制度和措施。

设立中国体育经纪人协会的可行性分析

通过对成立中国体育经纪人协会的必要性、可行性(合理性和合法性)的探讨,分析了在当前我国成立中国体育经纪人协会的可行性,提出了相关建设方案,并讨论了协会在建设过程中应处理好的几种关系,以期通过该协会对规范我国体育经纪人的从业行为和政府机构改革起到推动作用。

2006～2007年度中国西北地区十家临床教学医院嗜血杆菌耐药监测

目的分析中国西北地区十家教学医院2006～2007年度临床分离嗜血杆菌的耐药状况。方法常规方法培养分离医院内感染病原菌,并应用半自动或全自动细菌鉴定分析仪鉴定到种,药敏试验方法按CLSI规定的标准进行。采用WHONET5.4软件进行数据统计分析。结果2006～2007年度西北地区10家教学医院共分离出嗜血杆菌356株,其中流感嗜血杆菌112株,副流感嗜血杆菌134株,溶血性嗜血杆菌89株,副溶血性嗜血杆菌21株。药敏监测结果显示,流感嗜血杆菌、副流感嗜血杆菌均对复方新诺明、氨苄西林、环丙沙星高度耐药,耐药率分别为72.4,42.6,34.6和51.1,32.1,35,对亚胺培南、美罗培南完全敏感;溶血性嗜血杆菌、副溶血性嗜血杆菌均对氨曲南、氨苄西林、头孢曲松高度耐药,对左氧氟沙星、头孢呋新、氨苄西林/舒巴坦较敏感。结论嗜血杆菌对多种抗生素的耐药呈现明显上升趋势,开展不间断的完整的耐药监测,合理使用抗菌药物,对于控制耐药菌株快速上升具有重要意义。

全国细菌耐药监测网2018—2021年中医医院多重耐药菌监测报告

目的 了解全国中医医院临床标本常见多重耐药菌分布及变化趋势,为临床抗菌药物合理应用提供科学依据。方法 收集2018—2021年全国中医医院临床分离的常见细菌体外药敏数据。其中,体外药敏试验方法包括纸片扩散法、自动化仪器法和E-test法等,按照美国临床实验室标准化协会(CLSI)标准判读药敏结果。按照全国细菌耐药监测网(CARSS)技术方案,应用WHONET 5.6软件对菌种分布和多重耐药菌检出情况及变化趋势进行分析。结果 2018—2021年临床分离菌株中,革兰阳性菌占比26.4%~27.4%,革兰阴性菌占比72.6%~73.6%,趋势稳定。革兰阳性菌中,耐甲氧西林金黄色葡萄球菌(MRSA)检出率呈上升趋势,从28.5%上升至30.2%,但耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)、耐万古霉素屎肠球菌、耐青霉素肺炎链球菌检出率均呈下降趋势,分别从2018年的76.1%、2.7%、3.1%,下降至72.4%、1.5%、1.8%。革兰阴性菌中,耐碳青霉烯类大肠埃希菌和耐碳青霉烯类肺炎克雷伯菌的检出率逐渐上升,分别从1.6%、10.4%上升至1.9%、13.3%,但耐碳青霉烯类铜绿假单胞菌和耐碳青霉烯类鲍曼不动杆菌的检出率均呈下降趋势,分别从22.4%、49.5%下降至21.9%、48.2%。此外,多重耐药菌的检出存在明显地区差异,MRSA在安徽省、江苏省和广东省检出率最高,在云南省、黑龙江省和吉林省检出率最低。同时,耐碳青霉烯类肺炎克雷伯菌在安徽省、上海市和河南省检出率最高,在宁夏、青海省和吉林省检出率最低。结论 MRSA、耐碳青霉烯类肺炎克雷伯菌、耐碳青霉烯类大肠埃希菌检出率呈上升趋势,其他临床常见多重耐药菌的检出率呈下降趋势或持平,多重耐药菌的检出率存在时间及地域性差异。应继续加强抗菌药物合理应用的管理及医院感染防控,做好细菌耐药监测工作。

美国、中国体育经纪人之比较研究

通过对美国、中国体育经纪人的内涵、经纪特点、管理的机构和内容以及运作方式的比较分析 ,找出了我国体育经纪人与美国体育经纪人之间存在的差异 ,指出了我国体育经纪人目前存在的问题 ,并提出了对策措施。

论我国旅游消费者的权益保护

旅游已逐渐成为我国人们生活中必不可少的消费娱乐活动,但随之产生的旅游消费者的权益保护问题也暴露出来。我国还尚未制定出一套完善的旅游法律体系、旅游信息的不对称、旅游消费者自身的法律意识薄弱,我国旅游消费者的合法权益在实践中无法得到有效的保护,这在一定程度上制约了我国旅游经济的发展,为了进一步促进旅游业的发展,我国必须采取各种措施保护旅游消费者的合法权益。