Objective To discuss correlation of hypertension grading and hemorrhinia and the corresponding nursing measures. Methods Retrospective analysis was carried out in 151 cases of hypertension patients. Results 94 patients (62.3%) among 151 cases of hypertension patients occurred hemorrhinia, 42 patients (27.8%) were in grade 3 hypertension, male 30, female 12. 2 37 patients (24.5%) were in grade 2 hypertension, 22 males, 15 female; 15 cases (9.9%) were in grade 1 hypertension, 9 males and 6females. Hypertension grading was correlated with hemorrhinia, but not with the sexual distinction of hemorrhinia patients. Conclusions Hypertension grading is correlated with hemorrhinia, so we should treat hypertension actively, decrease hypertension grading in order to lower the incidence of hemorrhinia.

Objective To investigate the prenatal diagnosis and postnatal management of fetal hydronephrosis.Methods One hundred and two cases (87 unilateral and 15 bilateral,with a total of 117 kidneys) of fetal hydronephrosis in singleton pregnancy were diagnosed by prenatal ultrasonography in Jinhua People's Hospital between January 2011 and December 2014.During pregnancy and postpartum,all cases were routinely examined by genitourinary ultrasound for the classification of severity of hydronephrosis.The age of gestation at diagnosis of fetal hydronephrosis,the classification of hydronephrosis and postnatal follow-up outcome were recorded and retrospectively analyzed by descriptive statistical analysis.Results Of the 102 pregnancies,the mean gravida age and gestational age at diagnosis of fetal hydronephrosis was (28.1 ± 3.7) years (20-39 years) and (30.44-4.9) gestational weeks (16-40 gestational weeks),respectively.One hundred and two cases (35 right,52 left and 15 bilateral) of fetal hydronephrosis were diagnosed by antenatal ultrasonography.In the second trimester,59 cases (11 bilateral) of fetal hydronephrosis were diagnosed,including 28 mild (five bilateral),24 moderate (three bilateral),four severe (one bilateral) and three terminated ones.In the third trimester,43 cases (four bilateral) were diagnosed,including 22 mild (two bilateral),17 moderate (one bilateral),two severe and two terminated ones.All these patients were re-examined by ultrasonography at 48 hourspostpartum,and hydronephrosis was still present in 41 cases (five bilateral),including 19 grade 1 (two bilateral),11 grade 2 (two bilateral),seven grade 3 and four grade 4 (one bilateral).From the second and third trimester to postnatal period,there were 18 (two bilateral) and 23 (three bilateral) cases of hydronephrosis,respectively.The regression rate of prenatal hydronephrosis was 53.8％ (63/117),including 64.3％ (45/70) in the second trimester and 38.3％ (18/47) in the third trimester.During postnatal follow-up period,two cases (6.7％,2/30,unilateral) of grade 2,four grade 3 (4/7,unilateral) and four grade 4 (one bilateral) underwent surgery.Eleven cases of grade 3-4 hydronephrosis (one bilateral) were followed up and nine kidneys were treated with surgery due to ureteropelvic junction obstruction (6/9),ureter stricture (1/9),vesicoureteral stricture (1/9) and posterior urethral valves (1/9).Conclusions Although the majority of cases of fetal hydronephrosis spontaneously regress,postnatal hydronephrosis should be monitored timely and continuously by ultrasound.In particular,grade 3-4 hydronephrosis should be followed up to evaluate renal functions.If hydronephrosis presents with symptoms,progressive aggravation,pathological obstruction,or differential renal function ＜ 40％,early surgical intervention should be provided to improve renal functions.

OBJECTIVE To explore the disinfection methods for ophthalmology and to strengthen the measures of disinfection.METHODS The disinfection methods of the environment,equipment and operation field in ophthalmology were investigated and analyzed,and the good disinfection methods were summarized.RESULTS Due to strictly control the disinfection measures in ophthalmology,strengthen management,the hospital infection was reduced.In 2006 eye hospital infection rate was 0.CONCLUSIONS Good disinfection methods can effectively prevent eye hospital infection.

OBJECTIVE:To establish the method for the content determination of rapamycin (RAPA) in human monocyte THP-1 derived foam cells,and to study the effects of RAPA targeting preparation(RAPA-NP-Apt)targeting at foam cells. METH-ODS:Foam cells model were established through THP-1 cells were induced by oxidized low density lipoprotein. Foam cells were incubated with 200 ng/mL RAPA or 200,400,800 ng/mL RAPA-NP-Apt for 60 min. The content of RAPA was determined by HPLC. The determination was performed on Diamonsil C18 column with mobile phase consisted of acetonitrile-water(90:10,V/V) at flow rate of 1.0 mL/min. The column temperature was set at 40 ℃,and the detection wavelength was 278 nm. The sample size was 20 μL. RESULTS:The concentration of RAPA ranged 50-6400 ng/mL (r=0.99996) with average recovery of 98.72%(RSD=0.62%,n=3). RSDs of inter-day and intra-day were not more than 6.15%(n=6),RSD of stability was lower than 2%(n=6),and RSD of repeatability was 1.64%(n=6). After foam cells were incubated with RAPA or low-concentration,medi-um-concentration and high-concentration of RAPA-NP-Apt,the contents of RAPA were 12,43,98,140 ng/106 cells. CONCLU-SIONS:The method is simple,stable and reproducible. It can be used for content determination of RAPA in foam cells. RA-PA-NP-Apt can improve the effects of RAPA targeting at foam cells.

Objective:To investigate the clinical and genetic characteristics of peroxisome D-bifunctional protein deficiency (PDBPD) associated with HSD17B4 mutation. Methods:The clinical and genetic characteristics of 2 cases of PDBPD in August 2020, at Children′s Hospital Affiliated to Nanjing Medical University caused by HSD17B4 gene mutation were retrospectively analyzed. Results:Male proband and his sister suffered from neonatal epilepsy, psychomotor development disorders, ataxia, myasthenia, hearing impairment, and foot deformity.The very long chain fatty acids in serum were normal, and brain magnetic resonance imaging (MRI) showed bilateral cerebellar hemisphere atrophy.Electromyography suggested changes in the myoelectricity of multiple peripheral neurogenic lesions.Auditory evoked potential displayed severe bilateral sensorineural hearing loss.Exome sequencing identified compound heterozygous mutations (c.1171G > C, c.686-2A>T) in HSD17B4.The clinical diagnosis was PDBPD, aged 8 and 14 years, respectively. Conclusions:Two cases of HSD17B4 mutation-induced PDBPD were first reported in Chinese mainland, which was in line with its typical clinical manifestations.The newly discovered c. 1171G> C and c. 686-2A>T mutations enriched the HSD17B4 mutation spectrum.

The elements of the teaching system driven by the "Internet +" era are undergoing fundamental changes . Intelligent teaching platform is gradually becoming an important guarantee of the reform of teaching system elements for educators while they are teaching. With the support of intelligent teaching platform, the elements of teaching system break through the limitation of classroom teaching, the traditional structure of teacher-centered is disintegrating, the individual roles of teachers and students are being reconstructed , the teaching content is greatly enriched , and the function of teaching media is becoming more and more intelligent. This thesis, which will take the learning support function of the WeChat Public Platform of "Medical History" as an example by drawing lessons from the reversed classroom teaching mode, carries out the mixed teaching model of Chinese Medical History course by three stages: pre-class autonomous learning, in-class knowledge perfection and after-class knowledge transfer. It will elaborate its overall influence on the elements of the teaching system of Chinese Medical History and its important technical support for the reform of classroom teaching structure.

Objective:To investigate the clinical and genetic features of children with Arts syndrome.Methods:The clinical features of a child with Arts syndrome diagnosed in Department of Neurology, Children′s Hospital of Nanjing Medical University were retrospectively analyzed.Relevant literatures about Arts syndromes were reviewed as well.Results:It was a 17-month-old boy with initial symptoms of hearing loss after birth, delayed motor development and early-onset hypotonia.At the age of 15 months old, the boy had respiratory failure due to pneumonia.Electromyographic suggested multiple peripheral neurogenic lesions.Visual evoked potentials were normal.Gene sequencing of PRPS1 of the boy revealed a novel hemizygous missense c. 421C>T (p.P141S) hemizygote missense mutation, and therefore, the boy was diagnosed as Arts syndrome.Motor development improved after rehabilitation treatment.Through literature review, 14 children with Arts syndrome, including 4 genotypes of missense mutations were reviewed in 4 English-published literatures.These cases had similar manifestations with the case reported in this study.Conclusions:Arts syndrome is a rare X-linked recessive inheritant disorder caused by PRPS1 mutations with complex clinical phenotypes.The novel missense mutation c. 421C>T found in this study expands the PRPS1 gene mutation profile.

Objective To investigate the bacterial resistance in nationwide and understand the distribution of bacterial and resistance trend.MethodsThe 6507 clinical isolates were collected from 19 hospitals in 17 cities.The susceptibility tests were performed using agar dilution method recommended by Clinical and Laboratory Standards Institute (CLSI) in central laboratory.The values of MIC50,MIC90 and MICrange were calculated by SPSS 17.0 and the susceptibilities of isolates to antimicrobial agents were determined by using CLSI (2010) guideline.Of all 6507 isolates,4691 strains were collected from target wards and 1816 were isolated from others wards.ResultsAmong 4691 strains,1156 were Gram-positive (24.6％ ) and 3535 were Gram-negative (75.4％).Based on the minimum inhibitory concentration results,the prevalence of methicillin resistant Stapylococcus aureus and methicillin resistant Stapylococcus epidermidis are 51.6％ ( 325/630 ) and 87.0％ ( 228/262 ) respectively.Staphylococci showing intermediate or full resistance to vancomycin were not observed. Coagulase negative Staphylococci showed 2.5％ (16/642)intermediate rate and 1.6％ ( 10/642 ) full resistance rate to teicoplanin,and showed 0.5％ ( 3/642 )resistance rate to linezolid.Antibiotic resistance rate of Enterococcus faecalis to ampicillin was 17.1％(19/111),while the resistance rate of Enterococcus faecium to ampicillin reached up to 85.0％(164/193).Three Enterococcus faecium were resistant to glycopeptides.The prevalence of penicillin resistance Streptococcus pneumoniae and penicillin intermediate Streptococcus pneumoniae were 41.2％ ( 145/352) and 37.2％ (131/352) respectively based on oral penicillin criterion,while the prevalence were 0.0％ (0/352) and 6.0％(21/352) based on vein to non-meningitis criterion.A vast majority of Enterobacteriaceae maintained high susceptibility to carbapenems,with resistance rate less than 2.0％.In addition,tigecycline,moxalactam,fosfomycin and amikacin displayed desirable antibacterial activity against Enterbacteriaceae,and resistance rates to these drugs were all less than 10.0％.For non-fermenting Gramnegative isolates,resistance rate of Pseudomonas aeruginosa and Acinetobacter baumannii to imipenem were 23.1％ ( 139/601 ) and 53.5％ (419/784) respectively.Resistance rate of Acinetobacter baumannii was much higher than that during the period 2007 - 2008.Colistin,tigecycline,minocycline and fosfomycin demonstrated good antibacterial activity against Acinetobacter baumannii in vitro.Conclusions Compared with MOHNARIN 2007 -2008year surveillance results, significant increase in resistance rate of Acinetobacter baumannii was demonstrated.Resistant strains to linezolid and tigecycline were found.Bacterial resistance has been a widespread problem in our country,which requires much more attention.