OBJECTIVE To explore the characteristic of nosocomial infection and formulate the effective measures of nosocomial infection management. METHODS According to the underlying disease condition and method ICD10,the infection data were to classifed and colleced which including of 160 795 cases during 2003-2006.Then the prospective and retrospective investigation were done for studying the nosocomial infection condition. RESULTS The nosocomial infection rate was 4.69%. The highest infection rate was caused by hematological disease (15.43%). By site of infection the upper respiratory infection rate was 35.34%,the lower respiratory infection rate was 28.22%,the gastrointestinal infection rate was 6.82%,and the intra-abdominal infection was 3.75%. In these infection cases,G-bacteria infection occupied 58.35% (which ranked No.1 in all pathogens),and the fungal infection occupied 17.09%. CONCLUSIONS In order to reduce the infection rate,we must enhance the work of preventing the key diseases,standard the measures of disinfection and isolation,increaseing the quarantine inspection rate and applying antibiotic according to the results of antifugal susceptibility testing.

Objective To investigate the application value of Yishen Huayu Xugu prescriptionin the man-agement of osteoporotic lumbar compression fracture among elderly patients.Methods From March 2022 to August 2023,all elderly patients with osteoporotic lumbar compression fractures were enrolled in our hospital and randomly assigned into two groups.The patients were diagnosed with kidney deficiency and blood stasis syndrome through physical identification.After admission,both groups(85 cases each)underwent percutaneous kyphoplasty.The control group received conventional Western medicine treatment post-surgery,while the observation group was administered Yishen Huayu Xugu prescription.This herbal formula was prepared by decocting 300 mL of juice in water,divided into two doses,and taken warmly after breakfast and dinner for a duration of 12 weeks.Therapeutic effects were compared after completion of the 12-week treatment period.Results After treatment,the serum levels of D-dimer(D-dimer,D-D)were(5.02±0.63),interleukin-17(IL-17)was(53.68±5.47),β-collagen special sequence(β-CTX)was(0.37±0.06,interleukin-6(IL-6)was(69.38±8.27)compared to the control group;bone morphogenetic protein-2(BMP-2)was(2.69±0.31),25-hydroxyvitamin D was(58.93±7.17),and vascular endo-thelial growth factor(VEGF)was(309.81±51.49)which were higher than those in the control group with more sig-nificant improvement observed in the intervention group(P<0.05).Bone mineral density(BMD)increased at both week 6 and week12 after treatment with a more pronounced improvement seen in the intervention group(P<0.05).After treatment,the observation group exhibited a more significant reduction in the total Traditional Chinese Medicine(TCM)symptom score,Cobb Angle,and ODI,compared to the control group(P<0.05).Furthermore,the observation group demonstrated a higher total effective rate of 95.29%(81/85)compared to 85.88%(73/85)in the con-trol group after treatment,with a statistically significant difference between the two groups(P<0.05).Conclusion The Yishen Huayu Xugu prescription holds significant positive implications for this particular medication,as it ex-hibits enhanced efficacy in reducing inflammation,regulating bone metabolism,improving lumbar function,promot-ing disease amelioration,and enhancing clinical outcomes.

Objective: To investigate the feasibility of cine three-dimensional (3D) balanced steady-state free precession (b-SSFP) imaging combined with a non-local means (NLM) algorithm for image denoising in evaluating cardiac function in children with repaired tetralogy of Fallot (rTOF). Materials and Methods: Thirty-five patients with rTOF (mean age, 12 years; range, 7–18 years) were enrolled to undergo cardiac cine image acquisition, including two-dimensional (2D) b-SSFP, 3D b-SSFP, and 3D b-SSFP combined with NLM. End-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), and ejection fraction (EF) of the two ventricles were measured and indexed by body surface index. Acquisition time and image quality were recorded and compared among the three imaging sequences. Results: 3D b-SSFP with denoising vs. 2D b-SSFP had high correlation coefficients for EDV, ESV, SV, and EF of the left (0.959– 0.991; p < 0.001) as well as right (0.755–0.965; p < 0.001) ventricular metrics. The image acquisition time ± standard deviation (SD) was 25.1 ± 2.4 seconds for 3D b-SSFP compared with 277.6 ± 0.7 seconds for 2D b-SSFP, indicating a significantly shorter time with the 3D than the 2D sequence (p < 0.001). Image quality score was better with 3D b-SSFP combined with denoising than with 3D b-SSFP (mean ± SD, 3.8 ± 0.6 vs. 3.5 ± 0.6; p = 0.005). Signal-to-noise ratios for blood and myocardium as well as contrast between blood and myocardium were higher for 3D b-SSFP combined with denoising than for 3D b-SSFP (p < 0.05 for all but septal myocardium). Conclusion The 3D b-SSFP sequence can significantly reduce acquisition time compared to the 2D b-SSFP sequence for cine imaging in the evaluation of ventricular function in children with rTOF, and its quality can be further improved by combining it with an NLM denoising method.

Objective: To investigate the feasibility of cine three-dimensional (3D) balanced steady-state free precession (b-SSFP) imaging combined with a non-local means (NLM) algorithm for image denoising in evaluating cardiac function in children with repaired tetralogy of Fallot (rTOF). Materials and Methods: Thirty-five patients with rTOF (mean age, 12 years; range, 7–18 years) were enrolled to undergo cardiac cine image acquisition, including two-dimensional (2D) b-SSFP, 3D b-SSFP, and 3D b-SSFP combined with NLM. End-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), and ejection fraction (EF) of the two ventricles were measured and indexed by body surface index. Acquisition time and image quality were recorded and compared among the three imaging sequences. Results: 3D b-SSFP with denoising vs. 2D b-SSFP had high correlation coefficients for EDV, ESV, SV, and EF of the left (0.959– 0.991; p < 0.001) as well as right (0.755–0.965; p < 0.001) ventricular metrics. The image acquisition time ± standard deviation (SD) was 25.1 ± 2.4 seconds for 3D b-SSFP compared with 277.6 ± 0.7 seconds for 2D b-SSFP, indicating a significantly shorter time with the 3D than the 2D sequence (p < 0.001). Image quality score was better with 3D b-SSFP combined with denoising than with 3D b-SSFP (mean ± SD, 3.8 ± 0.6 vs. 3.5 ± 0.6; p = 0.005). Signal-to-noise ratios for blood and myocardium as well as contrast between blood and myocardium were higher for 3D b-SSFP combined with denoising than for 3D b-SSFP (p < 0.05 for all but septal myocardium). Conclusion The 3D b-SSFP sequence can significantly reduce acquisition time compared to the 2D b-SSFP sequence for cine imaging in the evaluation of ventricular function in children with rTOF, and its quality can be further improved by combining it with an NLM denoising method.

Objective:To explore the value of cardiac MRI (CMRI) in evaluating left atrial function in patients with postoperative tetralogy of Fallot (rTOF) and postoperative pulmonary stenosis (rPS).Methods:Totally 67 pediatric patients (49 with rTOF, 18 with rPS) with preserved left ventricular ejection fraction (EF) were recruited between January 2019 and October 2021 in Shanghai Children′s Medical Center, School of Medicine, Shanghai Jiao Tong University. Thirty-three healthy volunteers, matched in gender and age, were included as controls from July 2017 to August 2018. Left atrial EF, strain and strain rate of three phases (reservoir, conduit and pump), left atrial volume (maximum volume index, minimum volume index and pre-atrial contraction volume index) were measured with corresponding cardiac function analysis software. Then, the differences in these parameters were analyzed between the three groups by ANOVA or Kruskal-Wallis test with post hoc comparison and Bonferroni correction.Results:Compared with controls, patients with rTOF had lower reservoir function parameters (EF, strain and strain rate), conduit EF, conduit strain, and left atrial maximum volume index ( P<0.05), but higher pump EF ( P<0.05). In patients with rPS, only the reservoir strain rate decreased compared with controls ( P<0.05), and the remaining data showed no significant difference ( P>0.05). The reservoir and conduit EF and strain in patients with rPS were higher than those in patients with rTOF ( P<0.05). Conclusions:In patients with rTOF and rPS, left atrial function has changed despite the preservation of left ventricular EF, which may be an early marker of left ventricular diastolic dysfunction. In children with rTOF, left atrial reservoir and conduit functions decreased while the pump function increased. The reservoir and pump functions in rPS were better than those in rTOF. In addition, CMRI can detect left atrial dysfunction early before it enlarged.

Objective To analyze the drug resistance phenotype and genetic background of New Delhi metallo-β-lactamase (NDM)-producing bacterial strains in Lishui area of Zhejiang province.Methods The imipenem-resistant Enterobacteriaceae strains were isolated from January 2012 to December 2016 in Lishui Municipal Central Hospital of Zhejiang Province.Mrieux Vitek 2 Compact system was used to identified strains and PCR was used to screen for blaNDMgene.Susceptibility was detected by K-B method and MICs were obtained by Vitek 2 with GN13 cards.Plasmids typing was carried out by DNA sequencing of the replication initiator with the transconjugates as templates.The blaNDMgenetic contexts were detected by PCR and complete genome sequencing.Results A total of 102 strains of carbapenem-resistant enterobacteria (CRE), mainly Escherichia coli and Enterobacter cloacae, were isolated, of which 15 were positive for blaNDMwith a positive detection rate of 14.7%.The resistance rate to β-lactam antibiotics was 100%, and the resistance rates to aztreonam, compound sulfamethoxazole , tobramycin and gentamicin were all ＞80%;and the resistance rate to quinolones was ＞50%.Among the 15 NDM-producing strains , 12 strains were positive for Hodge test, and 2 strains of Enterobacter cloacae and 1 strain of Escherichia coli were negative. There were 11 strains of blaNDM-1and 4 strains of blaNDM-1.A variety of plasmid types such as IncX 3, IncFIIγ and IncA/C were detected, and 4 blaNDM-5genes were located in the IncX3 plasmid.Four blaNDMsurrounding gene structures were found, of which 8 blaNDM-1genes were located in ISAb125-hyp-blaNDM-1-bleMBL-TrpF-DsbC-IS26, while blaNDM-5was located in IS3000-IS5-blaNDM-5-bleMBL-TrpF-DsbC-IS26 structure, and the former was reported for the first time in China.Conclusion NDM-producing bacterial strains in Lishui area are prevalent at a low level and have high sensitivity to fosfomycin and polymyxin .The blaNDMgene may have multiple sources, but IncX3 plasmid is still the main source for gene transfer.Some new types of blaNDM-1 gene structure have been also found in this study.

Objective:To evaluate the feasibility of cardiac MRI three dimensional (3D) balanced steady state free precession (b-SSFP) cine imaging in evaluating cardiac function in children with repaired tetralogy of Fallot (TOF).Methods:Thirty children with repaired TOF underwent cardiac MRI examination at Shanghai Children′s Medical Cent er Affiliated to Shanghai Jiao Tong University School of Medicine, were retrospectively collected from April 2018 to October 2019. From June 2017 to August 2018, 10 healthy children were enrolled. Cardiac images of subjects were obtained using both two dimensional (2D) b-SSFP and 3D b-SSFP cardiac cine MRI and the total acquisition time was recorded. The image quality was scored using a 5-point scale, with a score≥3 as diagnostic image quality. The left and right ventricular end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), cardiac output (CO), and cardiac index (CI) were measured. The left and right ventricle parameters were compared using paired ttest or Wilcoxon test. The Pearson correlation or Spearman correlation analysis were used to evluate the correlation between the parameters measured with the 2 methods. Results:The acquisition time of 2D b-SSFP images was (426.5±13.0) s, and the total time of 3D b-SSFP images was (24.7±2.5) s. The 2D b-SSFP image quality score was better than 3D b-SSFP, and the differences were statistically significant (TOF patients: Z=-3.879, P<0.001; volunteers: Z=-2.646, P=0.003). All 2D and 3D b-SSFP image quality scores were ≥ 3 points, which can be used for clinical diagnosis. There were no statistically significant differences in cardiac function parameters between two series measurements in both TOF patients and volunteers ( P>0.05). For TOF patients, the left ventricular EDV, ESV, SV, EF, CO and right ventricular EDV, ESV, and SV showed highly positive correlation ( r>0.8, P<0.05). For volunteers, the left ventricular EDV, ESV, SV and right ventricular EDV and SV showed highly positive correlation ( r>0.8, P<0.05). Conclusion:Compared with the 2D b-SSFP sequence, 3D b-SSFP sequence with fairy good image quality can meet the diagnostic requirement and can accurately measure the cardiac function with shorter acquisition time. The 3D b-SSFP has a good application prospect in pediatric cardiac MRI.