BackgroundChina launched a 3-year rectification scheme for the clinical use of antibiotics in 2011, and a specific scheme for carbapenem use in 2017. The aim of this study was to investigate the effects of government policies on carbapenem use, and their correlation with carbapenem-resistant Pseudomonas aeruginosa (CRPA).MethodsThe study was divided into four stages: preintervention (2010), antimicrobial programme (2011–2013), post-antimicrobial programme (2014–2016) and carbapenem programme (2017). A point-score system was proposed for evaluating the rationality of carbapenem use, and evaluated based on the indications, microbial culture, single dose, interval, and duration. Any prescription without a global score of 10 points was judged as irrational. The trend was analyzed by regression analysis, and Spearman correlation analysis was used for testing the correlation.FindingsThe rate of rational use of carbapenems was 29.7% in 2010, and increased by 55.5, 45.2, and 51.5% during the subsequent three stages. The rationality declined slightly during the post-antimicrobial programme (2014–2016) while the consumption of carbapenems was markedly increased. These two parameters improved slightly in 2017. Moreover, the prevalence of CRPA was significantly negatively correlated with the rate of rational carbapenem use (Coefficient = − 0.553, P < 0.05), and not with the consumption of carbapenems (P > 0.05).ConclusionsThe rational application of carbapenems was related to government policies in this study, with irrational carbapenem use possibly related to the development of CRPA. The current point-score system could be a useful tool for performing assessments.

Background: The management of Key Monitoring Drugs has become one of important aspects to control the growth of pharmaceutical expenditures in China. The first batch of the China National Key Monitoring Drugs (NKMDs) policy was released in July 2019. However, little is known about the impact of the national stewardship on the trends of NKMDs prescribing practice in hospitals, especially in the Northwestern China.Methods: We collected 8-years of monthly NKMDs usage data from a tertiary hospital between 2014 and 2021. A segmented regression model of interrupted time series (ITS) analysis was used to evaluate the Defined Daily Doses (DDDs) and spending trends of ten NMKDs in the hospital throughout the study period. The pre-implementation period was from January 2014 to November 2019 and the post-implementation period was from December 2019 to June 2021.Results: Prior to the implementation of the NKMDs policy, there was an increasing trend both in DDDs and spending for 8 of 10 NKMDs. The interventions managed by clinical pharmacists after the implementation of the national stewardship policy led to a significant decreasing trend of DDDs in the 19 months following implementation, of 430 fewer DDDs per month in total, compared to the pre-implementation period (p &lt; 0.001). A similar decrease in spending was seen in the post-implementation period, with a trend of $4,682 less total spending on medications in those months compared to the pre-implementation trend (p = 0.003). There was a significant decrease in both monthly DDDs and spending for 6 of the 10 medications in the post-implementation period, while there was a significant increased trend both in monthly DDDs and spending on 1 medication in that period.Conclusion: Using ITS analysis, the total DDDs and spending on 10 NKMDs in this hospital indicated sustained reductions over 19 months after multidimensional interventions under the implementation of the national policy guidance. The national stewardship policy could therefore be considered an effective strategy. Additional comprehensive policies should be introduced to further improve the rational use of NKMDs.

Abstract. TCable system is an important part of the aircraft.As the plane "nervous system",cable system is the important role of carrying out electricity, assigned signal and transmission tasks,but also to provide contact information between each system control. The volume and weight of the cable is restricted because of the characteristic of the aircraft structure，it usually uses smaller diameter and thinner insulating layer wires,the cable is densely distributed and hidden deep in the various parts of the aircraft.It requests high integrity and security in the flight environment. In the process of flight,wire is often subjected to the influence of chemical pollution, radiation, heat and cold, electricity, vibration, friction, external force.The insulating layer will be wear, corrosion and aging,eventually led to the arc fault, timely detection of cable fault and implementation according to situation to ensure flight safety.This article expounds several kinds of commonly used wire fault localization method and compares their advantages and disadvantages, and application conditions, preparing for further research in the future .