Objective: To analyze the distribution and drug resistance characteristics of clinical separation germ in a hospital from 2013 to 2015 to provide reference and basis for the prevention and control of nosocomial infection and rational use of antibiotics.Methods: The microbial susceptibility of isolated strains was detected using the conventional methods, and the drug sensitivity was analyzed by BioMerieux ATB 1.22.The drug sensitivity was determined according to CLSI 2014 criteria.Results: A total of 18 421 specimens were isolated during 2013 and 2015, and a total of 3 744 strains were isolated with the total positive rate of 20.32%.The separation and identification of pathogenic bacteria at the top 5 were Escherichia coli (967 strains, 44.34%), Bauman Acinetobacter (323 strains, 14.81%), Klebsiella pneumoniae (312 strains, 14.31%), Staphylococcus aureus (297 strains 13.62%) and Pseudomonas aeruginosa (282 strains, 12.92%).Besides the natural resistance of Klebsiella pneumoniae to amoxicillin, the resistance rate of Escherichia coli to piperacillin was over 75%, while the sensitivity rate of Klebsiella pneumoniae to piperacillin and tazobactam was more than 90%.The sensitivity of Acinetobacter baumannii and Pseudomonas aeruginosa to clinical antibiotics was basically below 40%, and the overall resistance level was higher than that of Bauman.MRSA was sensitive to nitrofurantoin, minocycline, quinupristin-Dafoe and leptin glycopeptide antibiotics (such as teicoplanin and vancomycin).Conclusion: The hospital should strengthen the monitoring of bacterial resistance and track the results in a timely manner so as to provide reference for the rational drug use in clinical practice.

OBJECTIVE:To study the plasma total homocysteine(tHcy)level in the uremia patients and to study the therapeutic effects of folic acid combined with methylcobalamin in the intervention treatment of uremia patients with homo-cysteinemia.METHODS:Levels of plasma tHcy of60uremia patients(treatment group)and40normal subjects(control group)were determined both before treatment and8weeks after intervention treatment with folic acid combined with methylcobal-amin.RESULTS:The plasma level of tHcy in uremia patients were significantly higher than that in the normal subjects(P

Objective To explore the efficacy of a new elastic suspension strap orthosis, designed by the authors, in improving the motor function and walking ability of stroke patients. Methods Thirty-nine stroke pa-tients less than 1 month after stroke were recruited and divided randomly into a treatment group and a control group. The patients in the treatment group accepted walking training with the assistance of an elastic suspension strap orthosis, 5 times a week for 8 weeks, while the control group accepted the same training without the assistance of the elastic suspension strap orthosis. Results The treatment group improved significantly more than the control group with regard to its average Fugl-Meyer score, the functional ambulation categories of its members, and their walking speeds. Conclusions The elastic suspension strap orthosis could help correct abnormal gait patterns, improve walking speed, and enhance the recovery of walking ability in stroke patients.

Objective To indentify the gene mutation of fibroblast growth factor receptor 3 (FGFR3) gene in a Chinese family with congenital achondroplasia (ACH). Methods The genomic DNA from 2 clinically diagnosed ACH patients and the other 4 members from the same family was prepared for PCR. The products of PCR were purified and then sequenced directly. Results Two patients with ACH in this family showed G-A transition mutation at nucleotide 1138 as heterozygotes. Conclusion The G-A transition mutation at nucleotide 1138 in transmembrane domain of FGFR3 gene seems to be the pathologic cause of this Chinese family with ACH.

Objective    To investigate the feasibility and effectiveness of using ultrasound to evaluate the internal mammary artery (IMA) and explore the related factors affecting the quality of IMA. Methods    From July 2020 to January 2021, for patients who underwent coronary artery bypass grafting at the Department of Cardiovascular Surgery, Fuwai Hospital, ultrasound was applied to measure bilateral IMA at the parasternal second intercostal space. There were 62 males and 18 females with an average age of 59.9±8.3 years. The clinical data of the patients were recorded and analyzed. Results    A total of 160 IMA were measured. The IMA was detected in 99.4% (159/160), and the one that was not measured was proved to be occluded by enhanced CT. A total of 157 (98.1%) IMA intima were smooth, 2 (1.3%) were found to have uneven intimal thickening and less smooth, and only 1 (0.6%) was occluded. The intravascular diameter, peak systolic flow rate, peak diastolic flow rate, and blood flow rate of the left second intercostal IMA were 1.9±0.3 mm, 66.8±17.7 cm/s, 6.4 (0.0, 9.7) cm/s, 19.7±9.4 mL/min; and those of the right one were 2.1±0.3 mm, 69.7±18.5 cm/s, 6.0 (0.0, 9.2) cm/s and 22.8±11.5 mL/min, respectively. IMA vessel diameter and blood flow were greater on the right than those on the left side in the same individual (P<0.01). In univariate analysis, sex and body surface area were the factors that influenced the size of the IMA vessel among different individuals, and by linear regression analysis, the size of the IMA vessel was only related to body surface area among different individuals. On univariate analysis, diabetes mellitus was the only factor affecting IMA blood flow, with a mean reduction in blood flow of 18.4% (left) and 21.7% (right) in the diabetic group (P<0.05). Conclusion    Preoperative evaluation of the IMA using ultrasound over the parasternal second intercostal space is easy, noninvasive, and has a high success rate. The internal diameter of the IMA is positively correlated with body surface area, and blood flow is significantly reduced in patients with diabetes.

Objective    To assess mid-term outcomes of reduction ascending aortoplasty (RAA) in adult patients undergoing aortic valve replacement (AVR). Methods    We retrospecctively analyzed clinical data of 30 adult patients with aortic valve diseases and ascending aortic dilatation in Fuwai Hospital from 2010 to 2019. There were 20 males and 10 females with an age of 38-72 (55.73±9.95) years. All patients received AVR+RAA using the wedge resection technique. Ascending aorta diameter (AAD) was measured by echocardiography or CT scan preoperatively and postoperatively. Results    There was no perioperative death. The mean preoperative and postoperative AAD in all patients were 48.23±3.69 mm and 37.60±5.02 mm, respectively. And the mean AAD of follow-up was 40.53±4.65 mm. There was a statistical difference in AAD between preoperation and postoperation, postoperation and final follow-up, preoperation and final follow-up. The median follow-up time was 28.50 (12-114) months. The median rate of increase in AAD postoperatively was 0.76 mm per year. And the rate of increase was ≥3 mm per year in 5 patients, while ≥5 mm per year in 4 patients with indications for reoperation. Conclusion    Mid-term outcomes of RAA in adult patients undergoing aortic valve replacement using the wedge resection technique are satisfying and encouraging. However, some patients still need surgical re-intervention.

Objective    To assess mid- and long-term outcomes and share our clinical method of reduction ascending aortoplasty (RAA) in adult patients undergoing aortic valve replacement (AVR). Methods    We retrospectively analyzed clinical data of 41 adult patients with aortic valve disease and ascending aortic dilatation before and after operation of RAA+AVR in Fuwai Hospital from January 2010 to July 2017. There were 28 male and 13 female patients aged 28-76 (53.34±12.06) years. Twenty-three patients received AVR+RAA using the sandwich technique (a sandwich technique group), while other 18 patients received AVR+ascending aorta wrap (a wrapping technique group). Ascending aorta diameter (AAD) was measured by echocardiography or CT scan preoperatively and postoperatively. Results    There was no perioperative death. The mean preoperative AAD in the sandwich technique group and the wrapping technique group (47.04±3.44 mm vs. 46.67±2.83 mm, P=0.709) was not statistically different. The mean postoperative AAD (35.87±3.81 mm vs. 35.50±5.67 mm, P=0.804), and the mean AAD at the end of follow-up (41.26±6.54 mm vs. 38.28±4.79 mm, P=0.113) were also not statistically different between the two groups. There were statistical differences in AAD before, after operation and at follow-up in each group. All 41 patients were followed up for 23-108 (57.07±28.60) months, with a median follow-up of 51.00 months. Compared with that before discharge, the AAD growth rate at the last follow-up was –1.50-6.78 mm/year, with a median growth rate of 0.70 mm/year, and only 3 patients had an annual growth rate of above 3 mm/year. Conclusion    Mid- and long-term outcomes of RAA in adult patients undergoing AVR with both methods are satisfying and encouraging.

Objective:To explore the effect of fully automatic image segmentation of adenoid and nasopharyngeal airway by deep learning model based on U-Net network. Methods:From March 2021 to March 2022, 240 children underwent cone beam computed tomography（CBCT） in the Department of Otolaryngology, Head and Neck Surgery, General Hospital of Shenzhen University. 52 of them were selected for manual labeling of nasopharynx airway and adenoid, and then were trained and verified by the deep learning model. After applying the model to the remaining data, compare the differences between conventional two-dimensional indicators and deep learning three-dimensional indicators in 240 datasets. Results:For the 52 cases of modeling and training data sets, there was no significant difference between the prediction results of deep learning and the manual labeling results of doctors（P>0.05）. The model evaluation index of nasopharyngeal airway volume: Mean Intersection over Union（MIOU） s （86.32±0.54）%; Dice Similarity Coefficient（DSC）: （92.91±0.23）%; Accuracy: （95.92±0.25）%; Precision: （91.93±0.14）%; and the model evaluation index of Adenoid volume: MIOU: （86.28±0.61）%; DSC: （92.88±0.17）%; Accuracy: （95.90±0.29）%; Precision: （92.30±0.23）%. There was a positive correlation between the two-dimensional index A/N and the three-dimensional index AV/（AV+NAV） in 240 children of different age groups（P<0.05）, and the correlation coefficient of 9-13 years old was 0.74. Conclusion:The deep learning model based on U-Net network has a good effect on the automatic image segmentation of adenoid and nasopharynx airway, and has high application value. The model has a certain generalization ability.
Child ; Humans ; Adolescent ; Adenoids/diagnostic imaging* ; Image Processing, Computer-Assisted/methods* ; Pharynx ; Cone-Beam Computed Tomography ; Nose