Objective To understand the pathogens distribution situation in children with acute respiratory tract infection (ARTI) in Bozhou area.Methods A total of 2 846 children with ARTI in our hospital from April 2015 to March 2016 were enrolled to investigate the pathogens distribution.The indirect immunofluorescence assay was performed to detect adenovirus,influenza virus A,influenza virus B,respiratory syncytial virus,parainfluenza virus,mycoplasma pneumoniae,chlamydophila pneumoniae and legionella pneumophila in peripheral blood samples.Results Of all 2 846 cases,1 161 (40.8％) cases were the pathogen detection positive.Among them,the top 3 viruses of highest detection rates were mycoplasma pneumoniae(470,16.5 ％),influenza virus A (252,8.9％) and respiratory syncytial virus (117,4.1％),and 79(2.8％) cases were mixed infection.With age increase,the pathogen detection rate showed the declining trend(x2 =20.724,P=0.000 1).The infections in infants and young children were dominated by respiratory syncytial virus(11.2 ％),which in preschool and school children was dominated by mycoplasma pneumoniae(15.2 ％-25.4 ％).The pathogen detection rate was highest in winter (57.7 ％),and lowest in summer (22.5 ％).Conclusion The prevalence distribution of ARTI pathogens varies with age and seasons.The infection rate in infants and young children is higher than that in other age groups.Mycoplasma pneumoniae,influenza virus A and respiratory syncytial virus are the main pathogens causing ARTI in children of Bozhou area,winter and summer have ARTI high onset,it is notable to strengthen the prevention of infection.

Objective To evaluate the effect of the urinary reservoir constructed with ileocecum-appendix in the elderly with bladder cancer. Methods From March 2002 to June 2008, 12 cases were treated using ileocecum-appendix as the reservoir after radical cystectomy. They all received the imaging urodynamics examination and were followed up for 1 year. Results The 11 of 12 patients had urinary continence completely. Only 1 case had incontinence and 3 cases had incontinentia urinae at night. Times of uresis were 8-10/day and 3-5/night within 3 months after surgery, and 4-6/day and 0-2/night 6 months after surgery. The urinary output was 150-350 ml/time. Urodynamics showed that mean urinary flow rate was 10.5 ml/s, mean initial bladder pressure was 27 cm H2O, the maximum filling pressure was 35 cm H2O. The average reservoir capacity was 152 ml and 420 ml, respectively. The out let pressure of posterior urethra was 52 cm H2O. The volume of residual urine was 0-65 ml. No evidence of ureteral reflux occurred, no hyperchloremic acidosis was observed. Conclusions Orthotopic bladder reconstruction is considered as an ideal form of urinary diversion characterized by low pressure, larger capacity and continence.

Objective To investigate the correlation between large artery atherosclerotic stroke and paraoxonase 1 (PON1) Q192R polymorphism.Methods Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect the PON1 Q192R polymorphism of 120 patients with large artery atherosclerotic stroke (case group) and 117 healthy subjects (control group).Results There was significant difference in the genotype distribution of PON1 Q192R (x2 =18.727,P＜0.001) and the allele frequency distribution (x2 =16.427,P ＜0.001) between the case group and the control group.Multivariate logistic regression analysis showed that RR genotype was an independent risk factor for large artery atherosclerotic stroke (odds ratio 1.377,95％ confidence interval 1.032-2.185; P =0.026).Conclusions The allelic gene mutation rate of PON1 Q192R in patients with large artery atherosclerotic stroke was significantly higher than that in the healthy population.RR genotype is an independent risk factor for large artery atherosclerotic stroke.

ObjectiveTo investigate a suspected outbreak of carbapenem-resistant Acinetobacter baumannii （CRAB） nosocomial infection in an intensive care unit （ICU） and provide scientific evidence for prevention and control of multi-drug resistant nosocomial infection. MethodsClinical and epidemiological data of 4 patients with CRAB infection were retrospectively investigated in the ICU of Renji Hospital in November 2021. Environmental hygiene monitoring and multilocus sequence typing （MLST） were conducted and intervention measures were taken. ResultsA total of 4 cases with CRAB infection were identified， among which 1 case was determined to be community-acquired and3 cases were hospital-acquired. The isolated strains shared the same drug resistance， and were all classified into ST368 type. In the surface and hand samples （n=40）， 2 CRAB strains were detected in the air filter beside the bed of the first case， with a detection rate of 5%. After adopting comprehensive prevention and control strategies， including environmental cleaning and disinfection， hand hygiene， staff management and training， and supervision， no similar case with CRAB infection was found. ConclusionThis suspected outbreak of CRAB nosocomial infection may be induced by inadequate environmental cleaning and disinfection， and inadequate implementation of hand hygiene. Timely identification， investigation， and targeted measures remain crucial to effective control of possible nosocomial infection.

Objective: To assess the interobserver variations in delineating the planning target volume (PTV) and organs at risk (OAR) using different contouring methods during intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC), aiming to provide references for the quality control of multi-center clinical trials. Methods: The PTV and OAR of CT image of 1 NPC patient manually delineated by 10 physicians from 8 different radiation centers were defined as the " manual contour group" , and the OAR auto-contoured using the ABAS software and modified by the physicians were defined as the " auto+ manual contour group" . The maximum/minimum ratio (MMR) of the PTV and OAR volumes, and the coefficient of variation (CV) for different delineated contours were comparatively evaluated. Results: Large variation was observed in the PTV and OAR volumes in the manual contour group. The MMR and CV of the PTV were 1.72-3.41 and 0.16-0.39, with the most significant variation in the PTV_nd (MMR=3.41 and CV=0.39 for the PTV_nd-L). The MMR and CV of the manually contoured OAR were 1.30-7.89 and 0.07-0.67. The MMR of the temporal lobe, spinal cord, temporomandibular joint, optic nerve and pituitary gland exceeded 2.0. Compared with the manual contour group, the average contouring time in the auto+ manual group was shortened by 68% and the interobserver variation of the OAR volume was reduced with an MMR of 1.04-2.44 and CV of 0.01-0.37. Conclusions Large variation may occur in the PTV and OAR contours during IMRT plans for NPC delineated by different clinicians from multiple medical centers. Auto-contouring+ manually modification can reduce the interobserver variation of OAR delineation, whereas the variation in the delineation of small organs remains above 1.5 times. The consistency of the PTV and OAR delineation and the possible impact upon clinical outcomes should be reviewed and evaluated in multi-center clinical trials.