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ObjectiveEvaluate the effect of the combination of clindamycin with low-dose trimethoprim-sulfamethoxazole (TMP/SMX) regimen on sever Pneumocystis pneumonia (PCP) after renal transplantation.Method20 severe PCP patients after renal transplantation were included in this historical-control, retrospective study. A 10 patients were treated with the standard dose of TMP/SMX (T group), the other 10 patients were treated with the combination of clindamycin and low dose TMP/SMX (CT group).ResultsAlthough there was no significant difference in the hospital survival between the two groups, the CT protocol improved the PaO2/FiO2 ratio more significantly and rapidly after the 6th ICU day (1.51 vs. 0.38, P = 0.014). CT protocol also ameliorated the pulmonary infiltration and the lactate dehydrogenase level more effectively. Moreover, the CT protocol reduced the incidence of pneumomediastinum (0 vs. 50%, P = 0.008), the length of hospital staying (26.5 vs. 39.0 days, P = 0.011) and ICU staying (12.5 vs. 22.5 days, P = 0.008). Furthermore, more thrombocytopenia (9/10 vs. 3/10, P = 0.020) was emerged in the T group than in the CT group. The total adverse reaction rate was much lower in the CT group than in the T group (8/80 vs. 27/80, P < 0.001). Consequently, the dosage of TMP/SMX was reduced in 8 patients, while only 2 patients in the CT group received TMP/SMX decrement (P = 0.023).ConclusionThe current study proposed that clindamycin combined with low-dose TMP/SMX was more effective and safer the than single use of TMP/SMX for severe PCP patients after renal transplantation (NCT 04328688).

Introduction:We previously showed that a “10-hour daytime on-site” and “nighttime (NT) on-call” staffing strategy was associated with higher mortality for intensive care unit (ICU) patients admitted during NT than it was for patients admitted during office hours (OH). In here, we evaluated the clinical effects of a 24-hour intensivist staffing model.Methods:We formed an intervention group of 3034 consecutive ICU patients hospitalized from January 2013 to December 2015, and a control group of 2891 patients from our previous study (2009-2011). We applied propensity score matching (PSM) for whole and subgroup analyses adjusting for confounding factors. We compared clinical outcomes of patients under the 2 staffing models using multivariate logistic regression and survival analyses.Results:After PSM, we balanced the clinical data between the complete cohorts and the subgroups. Comparison of ICU survivals between the intervention and control cohorts yielded no significant differences. However, the intervention was significantly associated with a higher ICU survival in the NT (5:30 pm-07:30 am) admission patients ( P = .049) than in those admitted during OH (07:30 am to 5:30 pm; P = .456). Additionally, the intervention shortened the LOSHOS( P = .001) and/or LOSICU( P < .001), reduced the hospital ( P = .672) and/or ICU ( P = .004) expenses, and resulted in earlier mechanical ventilation extubation ( P = .442) as compared to the same variables in the control group, especially for NT admissions.Conclusions:The 24-hour intensivists staffing could significantly improve ICU outcomes, especially for NT-admission patients in high-acuity, high-volume ICUs with frequent NT admissions.

The cerium oxide films with high refractive index and good UV irradiation shielding performance were synthesized on the glass substrates by a hydrothermal method using Ce(NO 3 ) 3 ·6H 2 O and CO(NH 2 ) 2 as raw materials. The films and the powders prepared at the same time were characterized by SEM, XRD, FT-IR, ellipsometer and UV-vis. The influences of original Ce(III) concentration and urea dosage on cerium oxide films were researched. The results show that the films are smooth and the particles are small at low Ce(III) concentration and urea dose. The sediments are cerium oxide and Ce(CO 3 ) 2 O·H 2 O crystal, and silicon of substrate is involved in hydrothermal reaction. Meanwhile, the film refractive indexes are affected by film compact and chemical composition. Both of absorbance and absorption wavelength edge become big with increasing of Ce(III) concentration and urea dose, and the main influence factors are the film thickness and composite semiconductors. The optimal Ce(III) concentration is 0.008 mol/L, and the optimal urea dosage is 0.06 g.

An approach to a method of Bi-level programming and value of travel time is used to study the strategies of passenger transport pricing. The Bi-level programming approaches and the value of travel time have been used to study several of transportation problems, but few studies have included both of them. In this research with dividing passengers into some groups of different income levels, a variable of comfort levels is introduced to calculate the generalized value of travel time. A pricing model which is based on the value of travel time and Bi-level programming is put forward to maximize the benefit of the railway agencies and the passengers' utility, which considers the passenger's mode choice behavior with different income levels. The study results show that the model is appropriate for problems of passenger transport pricing. The relative optimal result based on the value of travel time and Bi-level programming has been proved correctly through studying an example of the Beijing-Shanghai high speed railway passenger ticket pricing. The pricing model would support the passenger ticket pricing of high speed railway.

According to the relevant data of farmers’ net income from the Hebei Statistical Yearbook 2009, seven indicators are selected covering regional gross production , the total output of the primary industry , the number of the people employed and the number of the large livestock at the end of year and so on, to analyze the factors that affect the per capita net income of farmers. The results show that the regional gross production is in positive proportion to the total output value of the primary industry and the influneces are great; the total output value of the non-agricultural industry and the local financial expenditure are the important factors that affect the income of farmers; though the total value of rural residents’ fixed investment is in positive proportion to the income of farmers, the degree is not so great; the regression coefficient of the number of people employed and the number of the large livestock at the end of year is negative and the number of people employed is a positive correlation to the net income of farmers. Based on the above analysis, the countermeasures on improving the income of rural residents are put forward: firstly, optimizing the rural indutrial structure, promoting the developement of the primary industry and improving the regional total output of production; secondly, Expanding the development channel of non-agricutlural economic and attracking the rural surplus laborers; thirdly, enlarging the local financial expenses and Expanding the developmental space of the three agricultural issues concerning peasants, countryside and agriculture.