Objective To summmrize the clinical characteristics complications,antimicrobial resistance and prognosis in 15 children with streptococcus pneumoniae meningitis so as to improve the diagnosis and treatment of this disease.Methods A systematic retrospective analysis was carried out in the Qilu Children's Hospital of Shandong University from Jan.2010 to Jan.2013,and clinical data from 15 children with streptococcus pneumococcal meningitis were retrospectively analyzed and followed up for 6 months in order to observe the prognosis.Results Eleven cases of streptococcus pneumoniae meningitis occuned in the winter and spring.And it often occuned in children less than 2 years of age who lived in rural areas (13 cases).The clinical manifestations showed diverse characteristics,severe symptoms,obvious changes in symptoms and cerebrospinal fluid were observed.Severe or death cases had low temperature,low leukopenia or low blood platelet.Common complications of streptococcus pneumoniae meningitis included anemia (10 cases),hypoalbuminemia (9 cases),sepsis (8 cases).Multi-drug resistance and complications in streptococcus pneumoniae meningitis led to the therapeutic difficulties.In this study,3 cases were cured,9 cases had varying degrees of sequences,such as left languages,sports,hydrocephalus and cognitive dysfunction,and 3 cases died,and the main cause of death was multiple organ dysfunction syndrome.Conclusions Streptococcus pneumoniae meningitis mainly occurred in the winter and spring.And the children under 2 years of age who lives in rural areas were often attacked.Clinical characteristics and cerebrospinal fluid changes obviously; severe cases are common with low temperature,low leukopenia or blood platelet.And there aye often diverse complications and multi-sequelae; the problem of multi-drug resistant and complications can lead to great difficulties in the clinical treatment.

OBJECTIVE To establish a fingerprinting method by randomly amplified polymorphic DNA.Epidemiological study was carried out on Pseudomonas aeruginosa in Ruijin Hospital. METHODS To obtain optimum scheme on reaction system for randomly amplified polymorphic DNA(RAPD) of P.aeruginosa. RESULTS P.aeruginosa strains isolated from the same ward shared the same RAPD fingerprint type,except for pulmonary ward.Different ward was with different fingerprint type. CONCLUSIONS Prevalent strain was not found in the whole hospital,but within ward exists hospital-acquired infection phenomenon.

Objective To study retrospectively the changes of bone mineral density,the prevalence of osteopenia/osteoporosis and risk factors in urban residents in Chongqing.Methods The data of radial bone mineral density of 9,158 healthy Han people (4 577 males and 4 581 females) who received health examination in the Health Management Center of Southwest China University were collected,from September 2012 to December 2016.Osteoporosis was judged according to T-value and the detection rate,BMI and OSTA indexes were calculated respectively.Results The total detection rate of osteoporosis in this group was 15.6％ (9.5％ in males and 21.6％in females,respectively).Among all the vocational groups,the detection rate of osteoporosis of teachers was the highest,while that of workers was the lowest.The detection rate of osteoporosis in the fcmales was higher than those in male,which in the emaciation group was much higher than those in the overweight/obesity group,among all the BMI status.The male over 70 years and female over 50 years belonged to the intermediate-risk group,which were also the focus for osteoporosis prevention and treatment.Conclusions The detection rate of osteoporosis in the urban residents in Chongqing is higher than those in other regions of China.Hence,Chongqing has a high-prevalence area of osteoporosis.Meanwhile,risk assessment using indexes such as vocation,BMI and OSTA and systematic intervention of osteopenia/osteoporosis for the urban residents are critical for the prevention and control of osteoporosis incidences.

Objective To compare the effectiveness of surgical procedures (devascularization,shunt and combined shunt and devascularization) in treating recurrent variceal bleeding and other complications in patients with portal hypertension.Methods A systematic literature search was carried out on patients with portal hypertension,and a Meta-analysis was conducted using Revman 5.3 software to evaluate the effectiveness of different surgical procedures on recurrent esophageal variceal bleeding,hepatic encephalopathy,operative mortality and survival rates.Results A total of 24 trials were finally selected using predetermined inclusion criteria.Meta-analysis showed there was no significant difference among the three operations on operative mortality (P ＞ 0.05).The rebleeding rate of the combined group was significantly lower than the devascularization group (P ＜ 0.05).The encephalopathy rate of the combined group was significantly lower than the shunt group (P ＜ 0.05),and the 1-year and 3-year survival rates of the combined group were better than the devascularization group (both P ＜ 0.05),but there were no significant difference in the 5-year survival rates between these two groups (P ＞ 0.18).The 1-year and 3-year survival rates were not significantly different between the combined and the shunt groups (both P ＞ 0.05).Conclusions Combined shunt and devascularization had better therapeutic effectiveness than either devascularization alone or shunt alone in patients with portal hypertension with a high rebleeding risk.There were no significant difference among the three surgical procedures in operative mortality.The survival rates of combined surgery were significantly better than devascrlarization alone.

Objective To assess the level and trend of community acquired respiratory distress syndrome (CARDS) toxin after the infection of Mycoplasma pneumonia(MP),and evaluate the clinical characteristics,the level of immunoglobulin E (IgE) and interleukin-4 (IL-4) so as to find the association among these factors.Methods According to whether the child had wheezing symptoms,all the 63 children were divided into wheezing group (26 ca-ses) and non-wheezing group (3 cases).The levels of CARDS toxin were respectively detected in the acute stage of MP infection,3 and 6 months later after MP infection in different groups,moreover,IgE and IL-4 levels were monitored at the same time.Results (1) The mean level of IgE were (384.96 ± 316.62) × 103 IU/L and (87.32 ± 66.32) × 103 IU/L in wheezing group and non-wheezing group,respectively,and there was statistically significant difference (P ＜ 0.05).(2) The load of CARDS toxin in wheezing group and non-wheezing group were (1.87 ± 0.62) Delta Rn and (1.15 ± 0.48) Delta Rn in the stage of acute infection,respectively,and there was statistically significant difference (P ＜ 0.05).Nevertheless,differences between 2 groups after 3 months and 6 months were not significant.(3) In the acute stage,the level of CARDS toxin in the severe cases were higher than the mild cases [(2.37 ± 0.37) Delta Rn vs (1.21 ± 0.45) Delta Rn],and there was statistically significant difference (P ＜ 0.05).(4) IL-4 showed significant difference in the acute stage and 3 months later after acute infection between 2 groups,however,there were no difference between 2 groups after 6 months later.(5)The load of CARDS toxin showed no significant difference between 2 groups at 3 months [(0.96 ± 0.35) vs.(0.99 ± 0.40) Delta Rn,P =0.757] and 6 months [(0.67 ± 0.20) vs.(0.69 ±0.32) Delta Rn,P =0.641] later after MP infection.(6)The children in wheezing group coughed for (24.89 ±7.04) days after acute infection and the last time for non-wheezing group was (16.46 ± 4.79) days,and there was statistically significant difference(P =0.000).Conclusions The load of CARDS toxin decreased after acute MP infection and it was still detectable six months after onset in the blood.The level of CARDS toxin was associated with the cough and wheezing symptom and the severity of disease.

Objective To investigate the correlations of serum calcium,25-hydroxyvitamin D and uric acid levels with benign paroxysmal positional vertigo(BPPV).Methods A total of 96 pa-tients with BPPV were enrolled in vertigo group and further divided into mild vertigo(30 cases),moderate vertigo(42 cases),and severe vertigo(24 cases)groups based on the severity of vertigo symptoms.Additionally,63 healthy people undergoing physical examination without BPPV were re-cruited as control group.Serum calcium,25-hydroxyvitamin D,and uric acid levels were compared among groups,and their correlations with the severity of vertigo in BPPV patients were analyzed.Fol-low-up was conducted for 3 months to record the recurrence rate of BPPV.Results The serum calci-um and 25-hydroxyvitamin D levels in the moderate and severe vertigo groups were significantly lower,while uric acid levels,total score of Dizziness Handicap Inventory(DHI)as well as functional,emo-tional,and physical scores were significantly higher than those in the mild vertigo group and control group(P＜0.05).Moreover,the severe vertigo group exhibited lower serum calcium and 25-hydroxyvitamin D levels and higher uric acid level,DHI total score and functional,emotional,as well as physical scores(P＜0.05).No significant differences were observed in serum calcium,25-hydroxyvitamin D,uric acid levels,or DHI scores between the mild vertigo group and the control group(P＞0.05).The severity of vertigo in BPPV patients was negatively correlated with serum calcium(r=-0.557,P＜0.05)and 25-hydroxyvitamin D levels(r=-0.467,P＜0.05),and positively correlated with uric acid levels(r=0.504,P＜0.05).The 3-month recurrence rate of BPPV was 8.33％(8/96).Compared to patients with serum calcium ≥2.11 mmol/L,25-hydroxyvitamin D ≥30 ng/mL,and uric acid ≤428 μmol/L,those with serum calcium＜2.11 mmol/L,25-hydroxyvitamin D＜30 ng/mL,and uric acid＞428 μmol/L had significantly higher BPPV recurrence rates(P＜0.05).Conclu-sion BPPV patients exhibit abnormally lower serum calcium and 25-hydroxyvitamin D levels and abnormally higher uric acid levels.The severity of vertigo in BPPV patients is negatively correlated with serum calcium and 25-hydroxyvitamin D levels and positively correlated with uric acid levels.

Objective To investigate the correlations of serum calcium,25-hydroxyvitamin D and uric acid levels with benign paroxysmal positional vertigo(BPPV).Methods A total of 96 pa-tients with BPPV were enrolled in vertigo group and further divided into mild vertigo(30 cases),moderate vertigo(42 cases),and severe vertigo(24 cases)groups based on the severity of vertigo symptoms.Additionally,63 healthy people undergoing physical examination without BPPV were re-cruited as control group.Serum calcium,25-hydroxyvitamin D,and uric acid levels were compared among groups,and their correlations with the severity of vertigo in BPPV patients were analyzed.Fol-low-up was conducted for 3 months to record the recurrence rate of BPPV.Results The serum calci-um and 25-hydroxyvitamin D levels in the moderate and severe vertigo groups were significantly lower,while uric acid levels,total score of Dizziness Handicap Inventory(DHI)as well as functional,emo-tional,and physical scores were significantly higher than those in the mild vertigo group and control group(P＜0.05).Moreover,the severe vertigo group exhibited lower serum calcium and 25-hydroxyvitamin D levels and higher uric acid level,DHI total score and functional,emotional,as well as physical scores(P＜0.05).No significant differences were observed in serum calcium,25-hydroxyvitamin D,uric acid levels,or DHI scores between the mild vertigo group and the control group(P＞0.05).The severity of vertigo in BPPV patients was negatively correlated with serum calcium(r=-0.557,P＜0.05)and 25-hydroxyvitamin D levels(r=-0.467,P＜0.05),and positively correlated with uric acid levels(r=0.504,P＜0.05).The 3-month recurrence rate of BPPV was 8.33％(8/96).Compared to patients with serum calcium ≥2.11 mmol/L,25-hydroxyvitamin D ≥30 ng/mL,and uric acid ≤428 μmol/L,those with serum calcium＜2.11 mmol/L,25-hydroxyvitamin D＜30 ng/mL,and uric acid＞428 μmol/L had significantly higher BPPV recurrence rates(P＜0.05).Conclu-sion BPPV patients exhibit abnormally lower serum calcium and 25-hydroxyvitamin D levels and abnormally higher uric acid levels.The severity of vertigo in BPPV patients is negatively correlated with serum calcium and 25-hydroxyvitamin D levels and positively correlated with uric acid levels.

Objective To investigate the bacterial resistance profile of clinical isolates collected in the hospitals across Chuzhou in 2016. Methods Antimicrobial susceptibility testing was carried out by Kirby-Bauer method. The data were analyzed using WHONET 5.6 software according to CLSI 2015 breakpoints. Results A total of 5 465 clinical isolates were collected during 2016, of which gram positive organisms and gram negative organisms accounted for 25.9％ (1 416/5 465) and 74.1％ (4 049/5 465), respectively. Prevalence of MRSA was 37.6％ among S. aureus and the prevalence of MRCNS was 78.1％ in CNS. All Staphylococcus, E. faecalis and E. faecium isolates were sensitive to vancomycin and linezolid. The prevalence of extended spectrum-lactamases (ESBLs) positive strains was 51.2％ in E. coli, 23.4％ in Klebsiella spp. (K. pneumoniae and K. oxytoca), and 23.6％ in P. mirabilis isolates, respectively. The Enterobacteriaceae strains were highly sensitive to carbapenems. The percentage of the P. aeruginosa isolates resistant to the antimicrobials tested was lower than 30％. The percentage of the Acinetobacter strains resistant to meropenem and imipenem was 65.6％ and 67.4％, respectively. Conclusions The situation of antibiotic resistance is still very serious, especially multi-drug or pan-drug resistant strains, which is of great concern.

Objective:To explore the clinical efficacy, recurrence rate, and quality of life of elderly patients with Qi deficiency constipation treated with umbilical moxibustion combined with stone needle acupoint massage.Methods:Convenience sampling method was used to select 160 elderly patients with qi deficiency constipation who were hospitalised in the Department of Respiratory Medicine of Dongfang Hospital, Beijing University of Chinese Medicine, Xiyuan Hospital of China Academy of Chinese Medical Sciences, and Guang'anmen Hospital, China Academy of Chinese Medical Sciences from June 2021 to January 2023 as the study subjects. A total of 160 elderly patients with Qi deficiency constipation were randomly divided into four groups by using the method of randomisation of district groups, the control group ( n=40) received routine health education and nursing, the massage group ( n=40) was treated with needle stone acupoint massage, the umbilical moxibustion group ( n=40) received umbilical moxibustion with moxa and ginger, and the massage and umbilical moxibustion group ( n=40) was treated with needle stone acupoint massage combined with umbilical moxibustion. All patients were treated continuously for two weeks. This study compared the clinical efficacy, constipation symptom score, traditional Chinese medicine syndrome score, score of Patient Assessment of Constipation-Quality of Life (PAC-QOL) and the recurrence rate after three months of treatment among four groups of patients. Results:After treatment, compared with the other three groups, the massage and umbilical moxibustion group had the highest total clinical effective rate, with the lowest scores for constipation symptoms, traditional Chinese medicine syndromes, and PAC-QOL, with statistical differences ( P<0.05). There was a statistically significant difference in the recurrence rate among the four groups ( P<0.05) . Conclusions:Needle stone acupoint massage and umbilical moxibustion can both improve the clinical symptoms of elderly patients with Qi deficiency constipation, and combination of the two has a better effect, reducing recurrence rate, and improving quality of life.

OBJECTIVE: To investigate the relationship between sleep quality and bone mineral density (BMD) in urban residents. METHODS: Data of 28 756 Han adults (14 355 males and 14 401 females), who completed both Pittsburgh sleep quality index (PSQI) assessment and radial BMD tests by dual energy X-ray absorptiometry in the Health Management Center of Southwest China University from June 2012 to June 2019 were retrospectively analyzed. The degree of sleep disorder was determined based on PSQI scores, while osteopenia and osteoporosis was diagnosed according to BMD T-value. The test and multiple regression model were used to investigate the relationship between sleep quality and BMD. RESULTS: The numbers of normal BMD, osteoponia and osteoporosis were 17 039 (59.3%), 7916(27.5%) and 3801(13.2%), respectively. The mean PSQI score was 5.6±1.4 points. According to PSQI scores, there were 15 936 subjects without sleep disorder (55.4%), 5965 with mild (20.7%), 4897 with moderate (17.0%) and 1958 with severe sleep disorder (6.8%), respectively. There was no significant difference in osteoponia/osteoporosis rate between subjects with mild sleep disorder and normal ones (=0.948, >0.05), while the rate of osteoporosis in moderate sleep disorder group was higher than that in mild group (=525.583, <0.01), and the rate of osteoponia/osteoporosis in severe sleep disorder group was much higher than that in moderate group (=1124.877, <0.01). Multiple regression results showed that female, elders, mental labor, smoking and higher PSQI scores were independently associated with lower T-value (all <0.05), while moderate to intense daily physical activity was associated with higher T-value (<0.05). CONCLUSIONS Sleep disturbances may be a major risk factor for BMD loss in urban residents, indicating that it would be a potential target of osteoporosis prevention.