Objective: To explore the application of interactive nursing model in children with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods: From July 2015 to August 2017, 110 children with OSAHS admitted to our hospital were enrolled in this study. The patients were divided into two groups (55 cases) according to the digital random table method. Control group routine care, observation group interactive nursing model. Anxiety, pain, treatment compliance and nursing satisfaction were compared between the two groups before and after treatment. Results: The scores of anxiety before operation and at 24h after operation in observation group were (45.01±5.22) points, (50.26±5.44) points and (48.37±5.21) points respectively before operation and (48.87±5.79) points, (56.28±6.03) points and (51.46±5.28) points respectively, the difference was statistically significant (t= 3.672, 5.497, 3.089, P <0.05). The VAS scores of the observation group at 6h and 24h after operation were (4.65±0.78), (2.82±0.51) points in the control group and (5.14±0.73) points and (3.43±0.57) points in the control group (t= 3.402, 5.915, P<0.05) The treatment compliance and nursing satisfaction were 94.55%(52/55) and 96.36%(53/55) respectively, while those in the control group were 74.55%(41/55) and 72.73%(40/55), respectively. The difference was statistically significant (χ²=8.419, 11.758, P<0.05). Conclusions The interactive nursing model applied to children with OSAHS surgery can relieve anxiety, relieve postoperative pain, improve treatment compliance and satisfaction with nursing, which is worthy of popularization.

OBJECTIVE To analyze the profile of the pathogens and their drug resistance isolated from children with lower respiratory tract infection in Wenzhou area from Jan 2004 to Dec 2006.METHODS Lower respiratory tract secretions were obtained from children with lower respiratory tract infection for bacterial culture.The K-B method was applied for the antibiotic susceptibility test.RESULTS Total 1605 strains were isolated.The isolating rates of Gram-positive cocci,Gram-negative bacilli and fungi were 24.9%,61.2% and 14.0%,respectively.60.5%,and 54.6% of the isolates of Escherichia coli and Klebsiella pneumoniae produced extended-spectrum beta-lactamases(ESBLs).The rate of Penicillin-resistant Streptococcus pnenmoniae(PRSPN)was 30.6%.20.5% isolates of Staphylococcus aureus were MRSA.All isolates of Enterobacteriaceae and Gram-positive cocci were susceptible to imipenem and vancomycin in vitro.CONCLUSIONS Gram-negative bacilli are still the primary pathogens resulting in lower respiratory tract infection in children.Fungi and muti-drug-resistant bacteria are on the rise trend.

12 m/s group,n=70;cfPWV≤12 m/s group,n=49). Carotid atheromatous plaque was assessed by Doppler echocardiograph;blood pressure and hemoglobin A1c were measured. Results After adjustment for body mass index (BMI),sex,stroke and fasting blood glucose,logistic multivariable analysis showed that cfPWV associated with age,systolic blood pressure(SBP),pulse pressure,coronary artery disease,diabetes,carotid atheromatous plaque and hemoglobin A1c. Conclusion Arterial stiffness in elderly patients with essential hypertension was strongly positively associated with age,SBP,pulse pressure,coronary artery disease,diabetes,carotid atheromatous plaque and hemoglobin A1c.

ObjectiveTo observe the clinical effect of compositive treatment on cerebral palsy children with rapid acupoint acupuncture at passive position.Methods37 children were treated with compositive treatment including acupoint acupuncture and physical training.Other 21 who treated with medicine were included as control.Results3 cases were cured and 33 cases were markedly effective in treatment group,which was better than that of control(P<0.05).ConclusionThe therapy composed of rapid acupoint acupuncture and physical training can significantly improve the function of children with cerebral palsy.

Objective To analyze the prevalence and genetic characteristics of influenza A(H3N2) viruses in the city of Xiangyang in 2022-2023, and to provide a scientific basis for predicting the epidemic and mutation of influenza virus. Methods Throat swab specimens of the influenza like cases were collected from national influenza monitoring sentinel hospitals in Xiangyang every week. RNA was extracted from the specimens for influenza diagnosing using real-time RT-PCR．Viruses were isolated from H3N2 positive specimens, and HA and NA genes were amplified and sequenced．3D modeling analyses were conducted. Results The gene phylogenetic tree showed that the H3N2 isolates in 2022-2023 belonged to 3C.2a1b.2a1 and 3C.2a1b.2a2 branches, respectively. The A(H3N2) influenza virus strains all had amino acid point mutation sites on important antigenic determinants of HA protein. The epitope mutations of the 2022 A(H3N2) strain mainly occurred in regions B, C, and D. The epitope mutations of the A(H3N2) strain in 2023 mainly occurred in regions C and D. Different glycosylation sites of HA gene were found in 2022-2023 strains. No variation was found in key amino acid sites associated with neuraminidase inhibitor resistance. The difference of overall structure was not obvious in the three-dimensional simulation structure diagram. Conclusion The A(H3N2) influenza strains isolated in this study have shown antigenic drift, especially the mutation of HA, which may affect the protective effect of the vaccine on the local population and lead to influenza epidemic. The variations of HA and NA suggest that close attention should be paid to the epidemic and genetic variation of H3N2 subtype influenza virus, to provide a scientific basis for the selection of influenza virus vaccine strains and the prevention and control of influenza.

Objective To understand the exposure level of disinfection by-products (DBPs) in drinking water in Xiangyang City and to evaluate the health risks of the population, so as to provide reference for the safety risk control of drinking water. Methods Sampling and laboratory testing were conducted according to national standard methods. The risk assessment model provided by USEPA was used to evaluate the health risks. Results Trichloromethane (TCM), bromodichloromethane (BDCM), dibromochloromethane (DBCM) and tribromomethane (TBM) were detected in drinking water in Xiangyang City. The contents of halogenated hydrocarbon DBPs in water disinfected with liquid chlorine were higher than those with chlorine dioxide. The contents of three DBPs were higher in wet season than those in dry season except TBM. The content of TCM in pipe network terminal water and secondary water supply disinfected with chlorine dioxide was higher than that in factory water. The carcinogenic risk of DBPs in drinking water disinfected with liquid chlorine was 4.33×10^-5, and the non-carcinogenic risk was 0.114. The carcinogenic risk of DBPs in drinking water disinfected with chlorine dioxide was 1.24×10^-6, and the non-carcinogenic risk was 3.15×10^-3. Conclusion The health risk of DBPs in drinking water in Xiangyang City is acceptable, but TCM produced by liquid chlorine disinfection should be paid more attention. It is recommended that chlorine dioxide disinfection be used to reduce the health risks of halogenated hydrocarbon DBPs.

Objective The aim of this study is to evaluate clinical outcomes of patients with acute type A intranural hematoma of the aorta(IMH) received surgical treatment.Methods We analyzed 40 consecutive patients with acute type A aortic IMH in Fuwai hospital.The patients are from 2012.1.1 to 2015.12.31.The average age of patients is(56 ± 11) years.Clinical outcomes and morphological evolution by CT were analyzed for 2 years.Results Most of the patients were treated medically during their initial hospitalization.There were 2 patients died in in-hospital and no 2-year mortality.16 patients (40％) were received acute surgery,24 patients(60％)were received normal surgery.Conclusion Surgical treatment would be a favorable treatment option in type A acute IMH.

Objective To explore the correlation between lower urinary tract symptoms (LUTS) with prostate volume and peak flow rate in aging staff men with benign prostatic hyperplasia (BPH). Methods A total of 180 elderly patients were randomly enrolled. They were diagnosed with BPH by rectal touch and transected ultrasound from April 2008 to December 2008. The international prostate symptom score (IPSS), prostate volume (PV) as well as peak flow rate (QMAX)were analyzed respectively. Results IPSS were ( 9. 1 ± 0. 7 ) scores, ( 12. 1 ± 0. 7 ) scores and (14.0±1.3) scores in 60-69 years old group, 70-79 years old group and more than 80 years old group. PV were (40. 6±1.9) ml, (42. 4±1.9) ml and (48. 7±2.8) ml in corresponding groups, and PV was elevated along with aging (F= 5. 705, 2. 983, P＜0. 05). QMAX were ( 14.7 ± 0. 6) ml/s,(14.0±0. 5) ml/s and (12.6±0.9) ml/s, and QMAX was decreased along with aging (F=2. 131, P＞0. 05). Along with aggravation of LUTS, PV (ml) increased (39. 2±18. 1 vs. 45.7±16.9 vs. 47. 9± 16. 5) and QMAX (ml/s) decreased ( 15.0 ± 4.8 vs. 13. 5 ± 5.06 vs. 11.5 ± 4. 7, F= 3. 427, 4. 742, P ＜0.05). Conclusions The LUTS of patients with BPH is aggravated with aging, at the same time, the degree of LUTS increases with PV and decreases with QMAX. If get active treatment of drugs if available, they may improve their quality of life.

Objective To investigate mutation and deletion of genes mecR1 and mecI in clinical methicillin-resistant staphylococci isolates and study the mutation and deletion have effect on gene mecA expression and drug resistance phenotype.Metheods PCR was used to detecte gene mecA and the regulatory genes mecR1 and mecI in staphylococci which were separated from clinical specimen in 2006,then the sequence of gene mecI was determined and compared with the sequence obtains from pre-MRSA strain N315(GI:BA000018).Results Gene mecA was detected in 60 strains of Staphylococcus aureus,58 strains of Staphylococcus epidermidis and 37 strains of Staphylococcus heamolyticus,but gene mecA in 6 strains of Staphylococcus epidermidis and 4 strains of Staphylococcus heamolyticus were only amplified by primer mecA2-F/R and not by primer mecA1-F/R.The percentage of gene mecR1 exist in Staphylococcus aureus was higher than Staphylococcus epidermidis and Staphylococcus heamolyticus,but the percentage of gene mecR1 exist in Staphylococcus epidermidis was not higher than Staphylococcus heamolyticus.The mutation and deletion of gene mecI were often seen,the wild type mecI was only detected in 14 strains,the point mutation of nucleotice 202 was detected in 36 strains.Conclusions Gene mecA expression in Staphylococcus aureus could be chiefly induced by mecR1,but which in coagulase-ngeative staphylococci could be other factors.The mutation and deletion of mecI were universal phenomenon in clinical strains,there could be a mechanism for overcoming the repressing of resistance caused by mecI in staphylococci.

Objective:To investigate the prevalence of frailty in elderly patients with stage 3-5 non-dialysis chronic kidney disease(ND-CKD)and to analyze its related factors.Methods:A cross-sectional study was conducted.Patients ≥65 years old with stage 3-5 CKD who had never undergone dialysis in the nephrology department and the internal medicine department of our hospital between October 2017 to September 2018 were enrolled.Patients were divided into the non-frail group and the frail group according to the Fried frailty phenotype.Clinical data and laboratory results were collected and comprehensive geriatric assessment was carried out to evaluate participants' medication, comorbidities, daily living ability, nutritional status, depression, cognitive and physical performance.The relevant factors for frailty were analyzed.Results:A total of 193 elderly patients with stage 3-5 ND-CKD were enrolled, 106 male and 87 female, including 68 outpatients and 125 inpatients, with a median age of 79.00(73.00, 85.00)years.There were 143 frailty patients(74.1%), including 41 outpatients and 102 inpatients, accounting for 60.3% and 81.6% of the eligible outpatients and inpatients respectively.Multivariable Logistic regression analysis showed that CKD stage( OR=9.74, 95% CI: 1.12-84.54)and polypharmacy( OR=3.69, 95% CI: 1.09-12.42)were associated with frailty in outpatients, and CKD stage( OR=11.75, 95% CI: 1.38-99.99)and malnourishment or risk of malnutrition( OR=4.22, 95% CI: 1.40-12.74)were correlated with frailty in inpatients. Conclusions:The prevalence of frailty is high in elderly patients with stage 3-5 ND-CKD.CKD stage, polypharmacy and malnourishment or the risk of malnutrition are closely correlated with frailty.