Objective To analyze the distribution of common pathogenic bacteria and their drug resistance ,in children with bron‐chial pneumonia ,and provide reference for making antimicrobial treatment strategies .Methods 857 hospitalized pediatric patients with bronchopneumonia from January to December 2014 were enrolled in the study ,bacterial culture and drug susceptibility test were performed ,and the results were analyzed .Results In the 857 pdiatric patients ,the positive rate was 36 .87% (316/857) .A‐mong them ,175 cases were gram positive bacteria(20 .42% ) ,141 cases were gram negative bacteria(16 .45% ) ,140 cases were Streptococcus pneumoniae(16 .34% ) ,70 cases were Haemophilus influenzae(8 .17% ) .The susceptibility of Streptococcus pneu‐moniae to penicillin with enzyme inhibitors ,levofloxacin and vancomycin was the highest(higher than 90 .00% ) ,followed by the third generation cephalosporin(non meningitis) ,to which the sensitivity rate were above 80 .00% .The susceptibility of Haemophi‐lus influenzae to the third generation cephalosporins ,ampicillin/Sulbactam ,levofloxacin and imipenem were the highest(more than 90 .00% ) ,while the resistance to ampicillin and cotrimoxazole was 80 .00% .Conclusion Gram positive bacteria are the most im‐portant pathogenic bacteria ,and Streptococcus pneumoniae is the most common bacteria in bronchopneumonia .In clinical treatment , the results of drug sensitivity test should be paid attention to ,so as to adjust the treatment plan and achieve the ideal effect .

Objective To analyze retrospectively the risk factors and predictors of post-encephalitic epilepsy (PEE) and refractory epilepsy in patients with encephalitis.Methods In a hospital based study,the patients with encephalitis were reviewed retrospectively between the January of 1995 and December of 2010.Related factors were evaluated including age,sex,seizure types,neuroimaging,electroencephalogram(EEG) in intermittent period,clinical symptoms,consciousness level,initial seizure and steroid hormone therapy,etc.Results 237 patients with encephalitis were enrolled,whose median age was 26.3 (range 15-57) years old.PEE occurred in 103 (43.46％) patients; and 67 of whom had partial seizure.Significant risk factors for PEE included age (OR =3.72,95％ CI 2.70-5.25,P =0.018),disturbance of consciousness level(OR =5.37,95％ CI 2.43-13.03,P =0.012),cortical lesion in imaging (OR =11.42,95％ CI 5.94-31.27,P =0.000),spike discharges in EEG (OR =18.04,95％ CI 7.30-48.38,P =0.000) and initial seizures in acute phase (OR =32.68,95％ CI 9.62-97.59,P =0.000).The refractory epilepsy occurred in 6t patients.The significant risk factors of refractory PEE included focal seizures(OR =4.09,95％ CI 2.14-9.10,P =0.021),status epilepticus (OR =4.48,95％ CI 1.89-8.07,P =0.017) and poor controlled seizure (OR =6.17,95％ CI 3.52-11.34,P =0.001) during acute phase,multifocal spikes discharge in EEG(OR =5.53,95％ CI 2.91-10.07,P =0.006),cortical lesion in neuroimaging(OR =2.33,95％ CI 1.37-7.72,P =O.028),however,early steroid hormone therapy (OR =2.19,95％ CI 1.11-4.87,P =0.037) and longer time to initial seizure (OR =4.40,95％ CI 3.19-11.62,P =0.014) could significantly reduced the incidence of refractory epilepsy in PEE patients.Conclusion Our data indicated that PEE occur in 43.46％ patients especially in younger patients with disturbance of consciousness level,cortical lesion in imaging,spike discharges in EEG and initial seizures in acute phase.And the risk factors for refractory PEE are also discussed.

Objective To investigate the clinical and electroencephalogram (EEG) features of patients with idiopathic generalized epilepsy in adults with phantom absences.Methods Six patients were referred to the clinic of epilepsy from April,2007 to December,2011.They all had clinical assessment,EEG,or video EEG confirming absences seizure.Results Six patients showed the following similar clinical-EEG features:(1) mild ictal impairment of consciousness associated with generalized 3.0-3.5 Hz spike and slow wave discharges; (2) late-onset generalized tonic-clonic seizures; (3) absence status epilepticus with or without secondary generalized tonic-clonic seizures; (4) generalized discharges were mostly seen in three types in the awaking stage:fragmented discharge (＜4 s),brief discharge (4-10s) and long-time discharge (＞ 10 s).None of the patients had myoclonic jerks or photosensitivity.One patient' s mother had a history of generalized tonic clonic seizures.One patient had a history of children absence epilepsy and one patient had a history of febrile convulsion in the age of 1-3.Conclusion Idiopathic generalized epilepsy with phantom absences has distinct clinical and EEG features and may become a new idiopathic generalized epilepsy syndrome in adults.

Objective To investigate in vitro porcine myocardial shear modulus using real-time shear wave elastography.Methods Shear wave elastography was used on four in vitro porcine hearts.The probe was placed parallel to the long or short-axis of the heart on the anterior wall of the left ventricle,and myocardial shear modulus were measured in subepicardial,middle,subendocardial layers,respectively.Results Shear modulus of subepicardial,middle,subendocardial myocardium were (46.04 ± 17.07)kPa,(87.70 ± 29.67) kPa,( 115.73 ± 30.04) kPa,respectively,when the probe was placed parallel to the long-axis of the heart; whereas those were (78.71 ± 26.48) kPa,(77.08 ± 34.00)kPa,(70.69 ± 41.38) kPa,respectively,when the probe was placed parallel to the short-axis of the heart.Conclusions By using realtime shear wave elastography,the shear modulus values measured in subepicardial,middle,subendocardial myocardium of the left ventricle are different,even myocardium in the same location appears different shear modulus values when the probe orientation are different.

Objective To investigate left ventricular (LV) strain in patients with hypertension (HT)and myocardial hypertrophy using three-dimensional speckle tracking echocardiography.Methods Myocardial movement was analyzed in 37 primary HT patients with myocardial hypertrophy and 27 healthy volunteers.LV longitudinal,circumferential,radial and area strains were measured.The correlation between each global strain parameter and LV ejection fraction (LVEF) was analyzed.Results LV global longitudinal strain(GSL),global radial strain (GSR) and global area strain (GSA) of HT patients with myocardial hypertrophy were significantly lower than the contrast group,whereas global circumferential strain(GSC) showed no significant difference between the two groups.Longitudinal,radial and area strains were decreased in LV basal and middle levels,while decreased circumferential strain was detected only in basal level.There were significant correlations between LVEF and GSL,GSC,GSR,GSA.Conclusions Impairment of LV regional myocardial contractility can be detected by three-dimensional speckle tracking echocardiography.

Objective To understand college students on-site first aid training demand situation in Chongqing ,in order to provide the basis for college students to carry out on-site first aid training .Methods Using stratified random sampling method ,a question-naire survey was conducted on 1 232 students of 6 university in Chongqing .Results 90 .9% of the students hoped that they could master the on-site first-aid knowledge and skills ,students of different genders had significant differences on learning attitude of field first aid knowledge(P<0 .05) .The on-site first-aid knowledge among college students in Chongqing city most wanted to know was thetrauma emergency stop(74 .8% ) ,the most loving way of learning was to the hospital or emergency center study tour(47 .7% ) ,The love of on-site first aid training and learning style were theory teaching+watch video teaching or teacher demon-stration+classroom practice (63 .6% ) ,The operation way of learning the most love was teacher ,all the students into groups of two ,mutual operation practice(65 .9% ) ,and in both gender and specialty had significant differences(P<0 .05) .The survey of col-lege students in Chongqing city training status display results ,43 .5% of the students never received on-site first aid training .In ad-dition ,college students receive on-site first aid training frequencies were low ,48 .6% students in more than 2 years received 1 ses-sions of training .while the rescue confidence survey of college students after the on-site first aid training ,only 13 .1% of the students“completely had the confidence to do” .Conclusion College students in Chongqing have strong desire to learn on-site first aid training ,and there are differences in gender and major on demand ,past state of first aid training is poor ,in urgent need of the relevant departments give attention ,and formulate the on-site first aid training programs to improve college students′competence .

Objective:To explore the role of 17β-estradiol(17β-E2) derived from the hippocampus and gonad in the cognitive memory during the reconsolidation period of fear memory in rats with post-traumatic stress disorder(PTSD).Methods:The 8-week-old clean grade female SD rats were used for this study. Single prolonged stress combined with context fear conditioning was used to prepare the rat PTSD model.(1) Gonad estradiol experiment: 50 female rats were randomly divided into blank control group, model group, sham ovariectomy group, ovariectomy group, and ovariectomy+ estradiol group by random number table method, with 10 rats in each group. The rats in model group, sham ovariectomy group, ovariectomy group, and ovariectomy+ estradiol group were established PTSD model. Rats in ovariectomy group and ovariectomy+ estradiol group underwent ovariectomy, while rats in sham ovariectomy group only were removed adipose tissue of the same mass around the ovaries. And the rats in ovariectomy+ estradiol group were injected with 17β-E2(1 mg/kg, once a day for 14 days) 7 days after ovariectomy.(2) Hippocampal estradiol experiment: 40 female rats were randomly divided into blank control group, model group, hippocampal solvent control group and hippocampal estradiol inhibitor group by random number table method, with 10 rats in each group.The rats in model group, hippocampal solvent control group and hippocampal estradiol inhibitor group were established PTSD model.Rats in hippocampal estradiol inhibitor group were given letrozole once(bilateral, 0.5 μL per side) during the fear memory consolidation period) and rats in the hippocampus solvent control group were injected once with dimethyl sulfoxide in the hippocampus(bilateral, 0.5 μL per side) . The open field test and elevated cross maze test were used to evaluate the anxiety level and autonomous exploration ability, the freeze test was used to evaluate the fear memory, the new object recognition test was used to evaluate the non-spatial memory, and ELISA was used to detect serum 17β-E2 level. SPSS 25.0 software was used for data analysis, and one-way ANOVA was used for inter group comparisons, LSD test was used for further pairwise comparisons.Results:(1)In the gonad estradiol experiment, there were statistical differences in various indicators among the five groups of rats in the open field test, elevated cross maze test, freeze test, and new object recognition test( F=20.200, 12.702, 7.514, 10.094, 7.899, 13.211, all P<0.05). The number of upright times, central area activity time, distance and frequency of entering the open arm, and cognitive index of the model group rats were all lower than those of the blank control group(all P<0.05), and the freezing time was higher than that of the blank control group( P<0.05). The number of upright positions((11.20±1.55) times), central area activity time((11.33±1.80) s), distance((1.49±0.26) m) and times((10.00±1.50) times) entering the open arm, the freezing time((92.20±6.07) s) and cognitive index((60.40±3.71)%) in ovariectomy+ estradiol group were all higher than those of ovariectomy group((4.90±0.65) times, (4.31±1.07) s, (0.49±0.06) m, (3.10±0.62) times, (60.30±5.28) s, (32.60±8.08)%)(all P<0.05). (2) In the hippocampal estradiol experiment, there were statistical differences in various indicators among the four groups in the open field test, elevated cross maze test, freeze test, and new object recognition test( F=40.831, 5.553, 9.087, 5.848, 7.657, 9.191, all P<0.05). The numbers of upright positions, distance and frequency of entering open arms of the model group rats were lower than those of the blank control group(all P<0.05). The number of upright positions((3.00 ± 0.39) times), distance of entering open arm((1.17±0.37) m), freezing time((46.70±3.57)s), and cognition index((29.60±2.70)%) in the hippocampal estradiol inhibitor group were all lower than those in the hippocampal solvent control group((10.10±1.40) times, (4.02±0.79) m, (93.70±9.73) s, (54.20±5.08)%)(all P<0.05). Conclusion:17β-E2 derived from the hippocampus and gonad both had ameliorative effect on cognitive memory and anxiety-like behavior in the reconsolidation period of fear memory in PTSD model rats.

Objective To observe the electroencephalogram (EEG) activity of sleep disorders and mild cognitive impairment (MCI) patients with Parkinson's disease (PD).Methods Forty-nine PD patients,admitted to our hospital from December 2012 to June 2013,were examined by Parkinson's Disease Rating Scale,Hospital Anxiety and Depression Scale,Pittsburgh Sleep Quality Scale (PSQS) and Scale Montreal Cognitive Assessment (MoCA); electroencephalogram and their clinic features were analyzed.Results As compared with the normal sleep and non-MCI patients with PD (61.8％),sleep disorder and MCI patients with PD showed higher incidence of slow wave (65.6％).Logistic regression analysis showed that sleep quality was positively correlated to the incidence of slow wave (OR=4.117,P=0.042).PD patients with slow wave had higher PSQS scores and lower MoCA scores as compared with PD patients without slow wave.Conclusion PD patients with sleep disorder and MCI show high incidence of slow wave.

Objective:To study the correlation between liver imaging reporting and data system (LI-RADS) category with tumor differentiation, Ki67 index, microvascular infiltration, and predictive prognosis in hepatocellular carcinoma (HCC).Methods:We retrospectively analyzed the clinical and radiological data of 178 patients with HCC who were confirmed by histopathological studies after liver resection between January 2015 and September 2020 at Lishui Central Hospital and Lishui People’s Hospital. There were 156 males and 22 females, with age of (57±10) years old. These patients were assessed for LI-RADS categories according to the 2018 version of LI-RADS, and they were divided into 4 groups according to the assessment results: 12 patients with LI-RADS-3 (the LI-RADS-3 group); 26 patients with LI-RADS-4 (the LI-RADS-4 group); 102 patients with LI-RADS-5 (the LI-RADS-5 group); and 38 patients with LI-RADS-M (the LI-RADS-M group). The patients' general information, tumor markers, pathology and other clinical data were recorded. Correlation analysis between the LI-RADS category with pathology was performed by the Kendall's tau-b test. Survival analysis between groups was performed by the Kaplan-Meier analysis. The Cox regression risk model was used to analyze the relationship between these variables with the risk of death.Results:The Kendall's tau-b test showed that LI-RADS category was positively correlated with the degree of tumor differentiation ( t=0.204, P=0.002), but not with microvascular infiltration and Ki 67 index ( P>0.05). All patients were followed up for 4.2 to 84.2 months (median follow-up 36.3 months). By the end of follow-up, 31 patients had died and 147 patients were alive. The cumulative 1-year and 3-year survival rates of the LI-RADS-5 group were 97% and 90% respectively, which were significantly higher than those in the LI-RADS-M group (81% and 63%), and the LI-RADS-4 group (96% and 81%), ( P<0.05). The cumulative 1-year and 3-year survival rates of patients in the LI-RADS-3 group were 100% and 67% respectively, and there was no statistically significant difference with the LI-RADS-5 group ( P>0.05). The Cox multivariate regression analysis showed that tumor glycoantigen 199 (>50 μl/ml) to be an independent influencing factor in survival of HCC patients ( HR=0.43, 95% CI: 0.24-0.76, P=0.004). Conclusion:The LI-RADS category of HCC was positively correlated with the degree of tumor differentiation, and patients with HCC meeting the LI-RADS-5 criteria had relatively better prognosis.

【Objective】 To describe the current situation of sleep duration and living environment of school-aged children so as to analyze the effects of the living environment on sleep duration comprehensively and provide advice for improving children’s sleep duration. 【Methods】 By cluster sampling, 82 families were selected from 1 rural and 2 urban areas in Xi’an. Data were collected by questionnaire survey and environmental sampling. Proportion was used for statistical description, and factor analysis and pathway analysis were used for statistical analysis. 【Results】 50.0% of the school-aged children in Xi’an slept less than 8 hours. Pollution was mainly caused by lower humidity, CO2, temperature, PM10 and aerobic bacterial count, their standard-exceeding rates being 26.8%, 21.3%, 5.5%, 4.3% and 1.8%, respectively. The results of path analysis showed that the influencing factors were as follows in a descending order: strong night light (1.031), presence of the computer (0.549), pressure (0.444), pets (0.408), distance from the driveway (-0.390), humidifier (-0.219), potted plants (0.138), indoor environment factors (0.098), and the floor level (0.039). 【Conclusion】 The sleep duration of school-aged children in Xi’an is relatively inadequate. More attention should be paid to indoor humidity, CO2, temperature, PM10 and aerobic bacterial count. The children’s sleep duration is positively correlated with a good indoor environment, humidifier, being away from the driveway, and low floor level, but is negatively correlated with pressure, strong night light, keeping pets, using computer and potted plants. We need to pay more attention to these factors to improve the sleep quality of school-aged children.